Southeast Pennsylvania Non-Homecare Joint MCO User System Training Webinar

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What is the Non-Homecare Portal?

• Designed to accommodate Providers who offer services outside the Homecare sphere

• MCOs issue Case Authorizations to Non-Homecare Providers• Authorization is in Provider’s portal and can log service to bill for payment• Authorization is pending in provider’s portal, provider accepts the case and logs service to

bill for payment

Member requests installation of (home) ramps

to the MCO

The MCO processes the installation request and

issues a Case Authorization to the Provider

Provider accepts the Case Authorization and logs

associated Service records for payment

HHAeXchange User System Training Agenda

PART 1• HHAeXchange System Introduction• Member Management• Communications (Notes)• Authorizations

HHAeXchange User System Training Agenda

PART 2• Billing• Payment

HHAeXchange System Introduction

HHAeXchange System Introduction

• HHAeXchange System Nomenclature• Member = Patient = Recipient = Consumer = Participant=Client• Provider = Agency = Vendor• MCO = Payer = “Plan”

• Log In Process (www.hhaexchange.com CLIENT LOGIN)• Home Module

• Landing Page• Reviewing Pending Cases, Unread Notes and Recent Communications from

the MCOs

System Support

• Super Users• HHAeXchange Support Center: Documentation Catalog

• Process Guides• Job Aids• Reference Material

• Resource Center https://hhaexchange.com/PACHC/• Register for live training• Review recorded trainings on demand• Review FAQs

Home (The Portal)

Member Management (Placement)

Member Management - Pending Cases

• The Pending Cases section contains any Case Authorizations issued by an MCO to the Provider for consideration and possible acceptance.

• Each one has an associated expiration time. • To view a pending case, click the eye icon to the right of the pending case

summary.

Member Management - Pending Cases

• The Pending Case window contains case details such as • Placement Sent Date and Cut-Off Time• Member Information• Service Location Code• Service Authorization summary.

Member Management – Accept/Decline a Case

Accepting a Service Case• Accepted Cases move into the Recent

Authorizations section (covered in the next section).

Declining a Service Case• The system prompts a User to select a

decline reason from the options provided. • MCO receives notification and the Case

Authorization is then moved back to the MCO for placement with another Provider.

Member Management – Accepted Cases

• Accepted Cases move from Pending Cases to Recent Authorizations.• The top 5 Recent Authorizations are displayed on the Homepage.

Member Search

Locate a Member in the System• Use the search filters and click the Search button to generate results.

• Search by Member’s Last Name, First Name, Member ID, or MCO

Communication & Notes

Message Center

Communication hub between Provider and MCO• Unread

• Remain on the Home screen pending attention. Once read, it moves to the Read box.• Notes are read-only; User cannot reply or forward.

• Sent• Record of Sent messages using the NHP• Users can send a Note from the Sent box

• Read• Record of messages received and read.

Message Center – Reading a Received Note

Received Note• From the Unread box, click on

the message to access.• The Note Detail window opens

indicating the Sender, the Member (if applicable), the Subject, and Note (content).

• Click the Close button or X on the top-right corner to close the window.

• Notes are read-only.

Message Center – Sending a Note

New Note• Click the New Note button.• Complete applicable fields and click the Send button.

Authorizations

Authorizations Page

All Case Authorizations are displayed on this page• Search for Authorizations on the Portal using the available search filters.• View a specific Authorization by clicking the eye icon.

Authorizations Page – Viewing a Case

The details page provides Member Information and Authorization parameters.• To add a Service to a case, click the Add Service button.

Authorizations Page – Adding Service

• The calendar allows for multiple service entry

Authorizations Page – Adding a Service

The Authorization details recalculate as services (invoices) are added.• The added service appears in green indicating that the invoice is within

Authorization.• 3 of the 130 Units are used. Click the Add Service button to add other

invoices.

Authorizations Page – Additional Invoices

Authorized vs. Not Authorized• Invoices that are within Authorization will display in GREEN • Invoice that exceeds the Authorized Units or Authorized Limit will be

displayed in PINK• Users may choose to edit or delete pending Invoices to make adjustments.

Billing

Billing - Summary

View Billing Summary• Use the search filters to view Billing Summary Information.

Billing - Details

View Billing Details• View Billing Details by Service Date for a Member

Payments

Payments

HHAeXchange Provider Resources

• Provider Information Center• www.hhaexchange.com/pachc

• Support• PAsupport@hhaexchange.com