utah prism project - release 3 and icd-10 nursing home association meeting 4/20/2015 presented by:...
TRANSCRIPT
![Page 1: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/1.jpg)
Utah PRISM Project - Release 3 and ICD-10
Nursing Home Association Meeting 4/20/2015
Presented By:Division of Medicaid and Health Financing
![Page 2: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/2.jpg)
• Design, Development, and Implementation – March 2013 to March 2017
– Four Releases• Release 1 (New Medicaid Website and Eligibility Lookup Tool)
– Completed March 30, 2014• Release 2 (HealthBeat)
– Completed August 1, 2014• Release 3 (Provider Portal and Enrollment, eMIPP, Provider Credentialing
Service) – December 2015
• Release 4 (Remaining MMIS) – Summer 2017
PRISM Project Overview
![Page 3: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/3.jpg)
• Release 3 is planned for December 2015• Three Major Components:
1. Provider Enrollment 2. Provider Credentialing Services (which is part of Provider Enrollment)3. eMIPP (Electronic Medicaid Incentive Payment Processing)
• New Medicaid Providers:- Enroll online using PRISM
• Current Medicaid Providers:- Existing enrollment information will be converted to PRISM- Providers will need to validate their enrollment information and make
any needed changes to their information using PRISM• This will occur in the stages prior to Release 4
- Providers will be notified when they need to access PRISM to validate their enrollment information
• Claims will still be paid out of the Legacy MMIS until Release 4 (Summer 2017)
PRISM Release 3 - Overview
![Page 4: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/4.jpg)
The Provider Portal houses data to manage and maintain the status of all providers paid through and/or reporting services rendered to Medicaid members.
Release 3 • Providers enroll online • Automated business processes• Includes automated Provider Credentialing Services • Includes Kofax®, imaging software for managing faxes in
PRISM• Includes Siebel, a customer relationship management (CRM)
system used to capture notes from callers
PRISM Release 3 – Provider Enrollment
![Page 5: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/5.jpg)
Provider Credentialing Services (PCS) provides a real-time one-stop provider credentialing solution for complying with the ACA Provider Enrollment Screening requirement.
• Automatically checks various databases simultaneously to see if the provider has a valid license, and/or any sanctions, criminal charges, etc.
• Available in real-time for the provider enrollment specialist to review and make appropriate decisions
• Provides improved automation and reduced manual intervention
PRISM Release 3 – Provider Credentialing Services
![Page 6: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/6.jpg)
Electronic Medicaid Incentive Payment Processing (eMIPP) supports federal incentive payment programs to encourage providers and hospitals to adopt, implement, or upgrade certified electronic health record technology and use it in a meaningful manner.
• eMIPP will replace the current HIT (Health Information Technology) program
PRISM Release 3 - eMIPP
![Page 7: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/7.jpg)
PRISM Release 3 – Implementation Activities
Provider Outreach• Medicaid Information Bulletin (MIB) article in February
introducing Release 3 functionality, PRISM webpages and [email protected] email
• Attending meetings to solicit providers to participate in system testing (primarily), message input, and material review
• Provider review of training materials: June and July 2015• Provider testing: September 2015• Release 3 messages on the PRISM webpages• Statewide Provider Training: July 28 – October 1• July and October MIB articles
![Page 8: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/8.jpg)
ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO).
• DMHF is on target to process claims for the October 1, 2015ICD-10 deadline
• System testing will occur June – September• An ICD-10 article has been included in the April MIB
ICD-10
![Page 9: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/9.jpg)
Provider participation is primarily requested for: • Assistance with System Testing
• ICD-10: June through September 2015• PRISM Release 3: September 2015
Provider participation is also requested for: • Input into Messaging for PRISM, Release 3
• Ideas on how to word messages to providers• Where the messages should be delivered (e.g., MIB article, other
communication tool)• April – November, intermittently with minimal time commitment
• Material Review for PRISM, Release 3• MIB articles, training materials, etc. • April – November, intermittently with minimal time commitment
PRISM Release 3 and ICD-10 Provider Participation
![Page 10: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/10.jpg)
PRISM Release 3 and ICD-10 Implementation Timeline
Implementation Timeline and Summary of Activities
PRISM R3
ICD-10
April May June July August September October November December
R3 UAT Provider Testing:
September
R3 Provider Training:Oct - Nov
R3 Go-Live:
Dec 2015
ICD-10 Provider Testing: June - September
ICD-10 Go-Live: Oct 2015
![Page 11: Utah PRISM Project - Release 3 and ICD-10 Nursing Home Association Meeting 4/20/2015 Presented By: Division of Medicaid and Health Financing](https://reader035.vdocuments.mx/reader035/viewer/2022062516/56649e315503460f94b22025/html5/thumbnails/11.jpg)
If interested in participating in system testing for PRISM Release 3, or for questions about PRISM, contact:
Email: [email protected]
If interested in participating in system testing for ICD-10, contact:
Email: [email protected]
Participation will be greatly appreciated & beneficial to the implementation of the new systems.
PRISM Release 3 and ICD-10