idd connects · health & wellness 101. individual’s record tab 102 individual 360 status...
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IDD Connects
Disclaimer: Please note that screens used in this
presentation are for demonstration purposes only
and actual content may vary.
Provider
Key Objectives
• How to search for and access individuals’ records Task bar and Dashboard view
• How to upload and label documents within the IDD Connects System• View Individual Service Plans (ISP) • How to look at assessments in the IDD Connects System
• Nursing, Behavioral, Social Work, SIS, HRST
• View Requests for Clinical Review and Support Notes• Request for Clinical Review formerly SCTAR
• View Coaching and Referrals• View Individual 360• View Claims
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IDD Connects System
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https://IDDgeorgiacollaborative.com/IDDPortal/dbhdd
IDD Connects System
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Reset Password/Forgot password/Forgot username?Click on the Forgot Password hyperlink
IDD Connects System: Staff Access
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Reset Password?
Click the submit button
How to Reset Password
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IDD Connects System: Landing Page
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Each tile is connected to a designated part of the IDD Connects System for quick access
IDD Connects System: Open Tasks
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IDD Connects: View My Task
View My Task Categories:Assigned DateTask DescriptionCID#First Name, Last NameDue DateAssigned by
View My Tasks
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To search a particular task, click on the Filter icon.The page expands to enter the information in the fields available in filter section.
Click on the CID# to begin assigned task.
IDD Connects System: Open Notification
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Notifications
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Types of Tasks and Notifications for Providers
Type of Task
Complete HRST.
Type of Notifications
Document removal request accepted/rejected.
Document Categorization for an document a provider uploaded was updated by another user.
PA has been updated.
A new provider has been identified and entered into the PA#.
A new Coaching or Referral is added• Including Focus area, Target completion date, Status, Comments entered by SC.
Granted/revoked access to view information for an Individual.
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IDD Connects System: Messages
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Messages
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How do I Send a New Messages?
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IDD Connects System: Landing Page
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Search an Individual
Access to individuals served
How can I Search for an Individual?
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Consumer ID (CID#)Last Name, First Name
Birth Month, Social Security#, Medicaid ID, Status, Region, County
Eligibility Status, Funding Source, Planning List, SC Agency, SC Supervisor, Support Coordinator
How can I Access an Individual?
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Individual Demographic Information
Displays
Individual Record Displays
Click CID#
Sections of the Individual’s Record
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Tabs Providers have view access to:• Demographics• Evaluation • ISP• Documents • Outcome & Support Notes• Services • Individual 360
Sections of the Evaluation Tab
Diagnosis Summarytab displays an Individual’s IDD diagnosis.
HRST/SIS tab displays and provides a link to
access the Health Risk Screening Tool
(HRST) and the Support Intensity
Scale tool (SIS)
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Health Risk Screening Tool (HRST)
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HRST Log In Page
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IDD Connects populates information in HRST About Me Page
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HRST About Me Page
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Provider Hierarchy of HRST Assignment
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• Community Residential Alternative Services (CRA)
• Community Living Support Services (CLS)
• Nursing Services - RN
• Community Access Group Services (CAG)
• Prevocational Services (Prevoc)
• Community Access Individual Services (CAI)
• Supported Employment Individual Services (SEI)
• Supported Employment Group Services (SEG)
• DBHDD Staff
Individual’s RecordIndividual Service Plan (ISP) Tab
Provider
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Accessing the ISP
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Step 2
Step 1
Search for ISP
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Click on the ISP type (NOW) to access the ISP.
Select date range and ISP type to search for a ISP.
Accessing Historical ISP Versions
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Click on the icon next to the ISP type to view historical ISPs.
View the Individual Service Plan (ISP)
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Sections of the ISP
ISP History Section
ISP Approval Section
Common ISP Features
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Each page of the ISP has the download and print capability
ISP
Back to Summary (ISP table/ Search page
ISP Effective Date
ISP Expiration Date
Calendar/Download/Print (features)
Current Needs: HRST/SIS Information
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ISP Current Needs: SIS Information
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Click on the sign to expand the Domain and view Comments.
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ISP Current Needs: Support Intensity Scale (SIS)
Click on the hyperlink for each domain to view the full ratings for that domain, along with any comments entered by the SIS Assessor.
Current Needs: Continue view of the Support Intensity Scale (SIS)
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Current Needs: Continue view of the Support Intensity Scale (SIS)
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System populates data from the Individual’s SIS into the Exceptional Behavioral Supports section of the SIS.
ISP Current Needs: Support Intensity Scale (SIS)
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If the exceptional behavioral supports indicate yes for a PBSP/Safety Plan, the SSC/SC enters the due date.
ISP Clinical Recommendations
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Clinical recommendations populate from the clinical assessment completed under the Evaluation tab.
Assessments Tied to Service Decisions
• Social Work
• Behavioral
• Nursing
• Support Intensity Scale- SIS
• Health Risk Screening Tool- HRST
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Individual’s RecordIndividual Service Plan (ISP) Tab:
ISP Goals
Provider
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ISP Person Centered Work Goals
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ISP Individual Goals Summary
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Once the goals are added click on the ISP Individual Goals Summary button to view and print.
Printable version of the ISP Goals Summary
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ISP Service Summary
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The system populates all the services from the clinical recommendations into the service summary page.
Review services
ISP Signature
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The ISP meeting participants are listed in this section.
Note: • The ISP meeting signature page is uploaded and available
to print or download.
ISP: Signature Page
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Hard copy of the ISP signature page.
ISP Clinical Reviewer Approval
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ISP Clinical Reviewer selects to approve or reject ISP.
Following ISP Clinical Reviewer Approval
• SC obtains Individual’s approval of the completed ISP that they were present and helped to complete during the ISP meeting (system required)
• The IDD Connects System generates the Prior Authorization or PA
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Individual Dashboard: Access ISP
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Individual access the portal and clicks on the Approve Individual Service Plan
to review, approve, or reject the ISP.
Individual’s RecordPrior Authorization Tab
Provider
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Prior Authorizations (PA)
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To view existing PAs click on the IDD PA Number.
Click on the Filter icon collapse the section. There are multiple ways to filter information for PAs.
Prior Authorizations (PA)
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The system displays PA detail information.
Individual’s RecordDocuments Tab
Provider
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Documents Providers Upload
• Behavior Support Plans
• Safety Plans
• Healthcare Plans
• Physician’s Orders
• www.georgiacollaborative.com
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Individual’s Record Tab
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Documents
View Documents Upload DocumentsRequest for Removal
of Documents
How can I View Documents?
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Enter a key word to search for a document or use the filtering components below.
Use the filtering Components to View Documents
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Documents By Individual
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Document columns
Legacy documents
What can I do with a document?
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Sending a Document using Email
Sending a Document using Internal Message
How Do I Request for Document Removal
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Select the document to removeEnter reason for removal Submit Request for Removal
Request for Removal
View Documents
Upload Documents
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Document Type & Category
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All required fields (*) must be entered to complete the uploading process
Individual’s RecordOutcomes & Support Notes Tab
Provider
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Sections of the Outcomes & Support Notes Tab
Individual Quality Outcome Measures Review
Referral and Coaching
Clinical Recommendations
Request for Clinical Review
Support Notes
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Referral and Coaching
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The system populates referrals and coaching from the Outcome Review in this section
Referral and Coaching
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Click on the green (+) hyperlink to view the detailed information.
Clinical Recommendations
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Click on the green (+) hyperlink to view the detail information.
Request for Clinical Review (RCR)
• The Request for Clinical Review will replace the current STAR process.
• Support Coordinators will submit Requests for Clinical Review based one the clinical discipline that is specific to the identified need.• Social Work, Behavioral, Nursing
• Support Coordinators can also submit requests for completion of a new SIS and HRST within this module of the system.
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Individual’s RecordServices Tab
Provider
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Services
Service Authorizations & Utilizations
Claims
GCAL (under development)
Hospitalization Admissions & Discharges
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Claims Billing for NOW/COMP
• Still through GAMMIS.
• Only exception is Family Supports which as of July 1 will be using the Beacon system (Provider Connect) to submit claims.
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Provider File Maintenance
Provider
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Provider File Maintenance
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• Communication regarding Provider File Maintenance in Provider Connect
• Active Provider File Excel document
• Attestation verifying the following items are adequate or inadequate• Beacon Provider ID (GAC Number – GAC000012)
• Provider Legal Name (Name used when completing application)
• Georgia Agency Mailing Address (Where you receive mail)
• Vendor Number (ID number specific to site location)
• Vendor Name
• Service Address/Vendor Address (Location where services are provided)
• Approved Service(s) (Services approved by DBHDD and DCH)
• Medicaid Number (Assigned by DCH)
• Fund Source (Comp, Now, SFDD)
Provider File Maintenance
• Complete review and return attestation as soon as possible to Gacollaborativepr@beaconhealthoptions.com
• Inaccurate or incomplete information can impact successful transmission of your agency’s authorizations and timely payment of both Medicaid and State Funded Claims
• If your agency has not received a communication, please email GACollaborativePR@beaconhealthoptions.com immediately. Include the legal name of the agency, primary point of contact name, correct email address and phone number.
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Provider Connect Access
Provider
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An online tool where providers can:
• Verify eligibility for an Individual • Register an Individual for funds*
• Submit Updates to State-funded Individual Demographic Information
• Submit Claims and View Status
• Submit Customer Service Inquiries • Access ProviderConnect Message Center
• Access Provider Summary Vouchers (PSVs) * Limited to Family Support Services
INCREASED CONVENIENCE, DECREASED ADMINSTRATIVE PROCESSESDisclaimer: Please note that screens used in this presentation are
for demonstration purposes only and actual content may vary.
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Account Request Form
• Needs to be completed in order to obtain log in credentials to access Provider Connect.
• Very possible agency has access to Provider Connect, check with IT, Business Office, and UM teams to gain access.
• You will need Direct Claims Submission access to submit claims in portal.
• Registration and claims submission will begin Fall 2019.
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GeorgiaCollaborative.com
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Account Request Form (ARF)
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Review ARF (Pg. 1)
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ARF (Pg.1)
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ARF (Pg. 2)
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ARF (Pg. 2)
IDD Claims
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• State funded claims.
• Submitted through Provider Connect.
• Claims/Encounters paid weekly.
• Providers have 180 days from the date of service in which to submit a claim. Claims submitted outside this timeframe will be denied.
• State Funds Claims submission will begin in 2020.
Enter a Claim
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Select Service Address
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Step 1: Search for the Individual
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May use CID, SSN, or Medicaid number to identify member.
Step 2 Frequency Type
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For frequency type, you will select original.
Prior authorization is
required.
Step 3: Claim Line Entry
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All letters must be
capital.
Summary Page
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Review a Claim
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Search Claims
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Claim Search Results
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Claim Summary
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Service Line Detail
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Change / Reprocess Claim
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If a claim denies, see denial codes, if valid, review claim, and select Change / Reprocess Claim. You will resubmit original claim with corrections.
Change/Reprocess Claim
Corrected Claim
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If a claim pays, but provider recognizes that the information on claim is incorrect (ex. Units, Rate, Paid amount), you will submit a corrected claim, and follow claim submission steps.
Prior authorization is required.
Individual’s RecordIndividual 360: Status History and
Health & Wellness
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Individual’s Record Tab
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Individual 360
Status History Health & Wellness
Status History
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Status updates and request for status changes are tracked in this section
View the Health & Wellness
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Click on the Individual 360 tab to view the status history and the health and wellness information.
Health & Wellness
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Medical
• DNR, Medical Power of Attorney, Guardianship
• Medical Conditions
• Medications
• Medical Alerts/ Healthcare Plans
• Allergies
• Physician/Specialist Info
Communication
Hearing & Vision
Specialty Learning Needs
Adaptive Supplies
Adaptive Equipment
Health and Wellness Tab
• The Health and Wellness Tab provides Health and Safety information about the individual.
• Information from the HRST and HRST Nursing Assessment populates sections of the Health and Wellness section.
• Information populates based upon the most current date. • i.e. If Medical Conditions were updated in the Nursing Assessment
and there has not been an HRST update the information will come from the Nursing Assessment. However, if an HRST has been updated since the last Nursing Assessment, the more current list of Medical Conditions from the HRST will populate.
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Health and Wellness Tab
• There is a text area for the user to enter Additional Information below content populated from the HRST and/or Nursing Assessment (if available).
• Users are to add key information in absence of or in addition to an updated Nursing Assessment or HRST. Content is to be kept current by the Support Coordinator, Office of Health and Wellness, or any other DBHDD staff who become aware of updates to the individual’s health information.
• For each entry in Additional Information, the user is to indicate their name, role and date prior to the text entered.
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Health & Wellness
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Medical information is tracked and easily updated in this section
Health & Wellness
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Health & Wellness
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Health & Wellness
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Health & Wellness
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Health & Wellness
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Health & Wellness
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Thank youFor Georgia Collaborative ASO general inquiry or questions please email:
GACollaborativePR@beaconhealthoptions.com
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