JOHN W BARCH, MHAS R . D I R E C T O R O F C L I N I C A L

O P E R A T I O N S

JANET M RIVERAM A N A G E R , PA T I E N T M A N A G E M E N T

A N D B U S I N E S S O F F I C E

BRIANNE E PORCHE, BBAS U P E R V I S O R O F PA T I E N T A C C O U N T S

JULIE M GARZA, BSA C C O U N T S PA Y A B L E A N D R E C E I VA B L E

C L E R K

San Antonio’s success in obtaining EHR Incentive Funding through CMS and

Texas Medicaid

Goals Participate in the American Recovery and Reinvestment

Act of 2009 Procure axiUm’s certified version of the EHR

CE 5.10, axiUm Patient Access Module, eRx

Why Efficiency – Gives providers the ability to share information Effectiveness – Computes information (drug

interactions/allergies) and provides “decisions support” for clinicians.

Financial Incentives – Federal Government is encouraging providers to transition to a certified EHR with dollars

Authorization/Eligibility The Health Information Technology for Economic and Clinical

Health (HITECH) Act 2009 EHR Incentive Program Period

Runs from 2011-2021 Providers must be enrolled by 2016 to be eligible for any incentives

EHR Incentive Program is run by State Medicaid Agency Texas-Texas Health and Human Services Commission (HHSC)

Texas Medicaid provides dental services to pediatric patients and limited adult services

Pediatric Dentist must be board certified in Pediatric Dentistry or have completed a residency in Pediatric Dentistry Must be licensed to practice in the State of Texas Must be a contracted provider with Texas Medicaid

Electronic Health Record (EHR) Incentive Program

San Antonio’s success in obtaining EHR Incentive Funding through CMS and Texas Medicaid

Select and adopt a certified EHR

Provider Eligibility and Centers for Medicare and Medicaid Services (CMS) Registration

Obtain EHR Certification code

Register at the Texas Medicaid website

Receive incentive payment

Year two “meaningful use” for 90 days and attest

`

Step 1

Select and

Adopt a certified

EHR

axiUm 5.10 Certified Edition Package includes the following:

axiUm CE 5.10, axiUm Patient Access v2.00, axiUm eRx v3.25.R2P1.B2

Purchase order obtained September 2012

Implementation scheduled for July 2013

Step 2Provider Eligibility and CMS

Registration

Identifying Eligible Providers and Calculating Patient Volume To be an eligible provider, at least 30% of your

services furnished to Medicaid patients in an outpatient setting (20% requirement for pediatricians) This percentage should be an average of 3

consecutive months. This percentage must be volume by facility by

provider. Volume based on prior calendar year services at

treating facility, as required by CMS. UTHSCSA used 2011 service dates Pediatric Dentist must be board certified in

Pediatric Dentistry or have completed a residency in Pediatric Dentistry • Must be licensed to practice in the State of Texas • Must be a contracted provider with Texas

Medicaid

Step 2Register at the CMS

Registration Portal

axiUm Info Manager Valid charge transaction in

location where the Treatment Date fell in the month and the Instructor was  a faculty provider.

The visits were distinguished by transaction Insurance Company or Insurance Company equal to  patient Financial Class  identifier.

Step 2Register at the CMS

Registration Portal

Registering with CMS Identify the Authorized Official

E-mailed Eligible Providers a notification explaining the enactment of the Medicaid EHR incentive program. Identify the person submitting application on behalf of providers.

Authorized Official required Name, SS#, Affiliation

Registering each Eligible Provider with CMS: https://ehrincentives.cms.gov

Required Items for registering Individual Provider NPI Treating Facility Address and NPI (if

applicable) Obtain a CMS EHR certification number

Step 2Register at the CMS

Registration Portal

After registration of the Authorized Official on CMS website, an approval was required by each Eligible Provider.

Eligible Provider logged into the NPPES https://pecos.cms.hhs.gov/pecos/login.do to complete this process Authorized Official found this to be the

most challenging aspect of this process! Authorized Official received email

acknowledgement and was able to proceed to the state level for application submission.

Step 3

Obtain EHR

Certification code

Obtain EHR certification code http://oncchpl.force.com/ehrcert/CH

PLHome CMS EHR Certification ID for axiUm

5.10 Certified Edition: A000001CDSBWEAZ

Step 4Register

with Texas Medicaid

Registration with the Texas Medicaid The provider’s NPI, treating facility and

entity receiving payment was attested, along with the provider’s volume.

In the Texas Medicaid and Healthcare Partnership (TMHP) website, the state of TX had a check mechanism that would prompt the Authorized Official, if volumes did not meet their requirement.

Attach Adoption, Implementation, or Upgrade (AIU) supporting documentation. Purchase Order was used as our AIU

documentation. A letter accompanied this Purchase Order stating our satellite clinics were under the umbrella of UTHSCSA and axiUm agreement.

Step 4Register

with Texas Medicaid

Once all information was entered and deemed accurate, the Authorized Official signed electronically and submitted the application. An email confirmation of submission followed.

Application status was monitored via CMS and TMHP websites.

Once the process was started and the first application was submitted, each subsequent application went smoothly and efficiently.

Step 5

Receive incentive payment

Receiving Payment The time from application

submission to receiving payment was approximately 30 days. Some of our payments were received

in bulk, along with our regular Medicaid claim payments.

Payment status was monitored via CMS and TMHP websites.

Not necessarily to achieve meaningful use to qualify for the first year of EHR incentives.

Step 5

Receive incentive payment

Step 6Year two

“meaningful use” for

90 days and attest

Stage two UTHSCSA is scheduled for the

new release of axiUm 5.10 CE in July 2013

UTHSCSA will be eligible for stage two “meaningful use” in 2015

Incentive Payments Audits Authorized by the Medicaid/CHIP

division of the Texas Health and Human Services Commission, as required by HITECH Act of 2009

Center for Oral Health Care & Research Opening in 2015