HP Enterprise Services

HomeTown Health Presentation

Physician Lunch and LearnSeptember 21, 2010

Partnering for Success!

2 / Georgia MMIS Presentation September 2010 HP Enterprise Services

Provider Beta Testing

August 16 – August 20 TuckerAugust 30 – September 3 Cordele

Feedback from Participants?

BETA Testing and Workshops

3 / Georgia MMIS Presentation September 2010 HP Enterprise Services

Web Portal PIN Letters

• Each current Georgia Medicaid provider will receive a Georgia Health Partnership Web Portal registration information letter, mailed last week, indicating their login and temporary password.

• The Georgia Health Partnership Web Portal registration information letter will be sent to the “mail to” address on file.

• Each provider must create a username and password prior to accessing the Georgia Health Partnership Web Portal for any claims related functionality available via the secure area of the Georgia Health Partnership Web Portal.

• Web Portal User Account Management Guide

• Provider Change of Information Form available on readiness website.

4 / Georgia MMIS Presentation September 2010 HP Enterprise Services

Provider Readiness Web Portal

Web Portal Address

http://providerinfo.mmis.georgia.gov/providerprereadiness/home.aspx

CBTs for web portal training and PES software training

Workshop Dates/Locations

Workshop presentations and Institutional Audio (new)

Address changes to reissue PIN (new)

Interim Provider Payments (new)

5 / Georgia MMIS Presentation September 2010 HP Enterprise Services

EDI Helpdesk

EDI Services Phone Number Available after September 1, 2010770-325-9590 or toll free 1 877-261-8785

EDI Email Address: ediservices.gammis@hp.com

EDI PES CBT will be on readiness website by end of week

PES software, which replaces WINASAP, will be available on readiness website on October 1, 2010

Provider Assistance

6 / Georgia MMIS Presentation September 2010 HP Enterprise Services

Billing Manuals will be available via the web portal. The current billing information contained in the DCH Part I Policy and Procedures Manual will be removed.

All Billing Manuals are on the readiness website for review.

Transition Information

7 / Georgia MMIS Presentation September 2010 HP Enterprise Services

Podcast

• DCH has completed the first in a series of stakeholder updates

• The next podcast in this series will cover the topic of DCH’s Interim Payment Plan which DCH may activate should significant payment issues arise.

8 / Georgia MMIS Presentation September 2010 HP Enterprise Services

Professional Header (NEW)

• Related Cause Code 3 Removed.

• Release of Information values removed, leaving I (Informed Consent) and Y (Yes) as the only values.

• Accident Date will be required if Related Cause Code = AA (Auto Accident) or OA (Other Accident).

• Accident State will be required if Related Cause Code = AA (Auto Accident).

• Related Cause Code will be required if Accident State or Accident Date are entered.

5010 and Web Portal-Professional

9 / Georgia MMIS Presentation September 2010 HP Enterprise Services

5010 and Web Portal-Professional

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Professional Detail (NEW)

• Medicare Allowed Amount field removed. This value is being pre-calculated by the system.

• Drug Unit Count and Drug Unit of Measure fields are being added.

• Diagnosis Pointer values changed from 1-8 to 1-12. 5010 will now allow up to 12 diagnosis codes on professional.

5010 and Web Portal-Professional

11 / Georgia MMIS Presentation September 2010 HP Enterprise Services

5010 and Web Portal-Professional

12 / Georgia MMIS Presentation September 2010 HP Enterprise Services

Member Professional Detail (NEW)

• Medicare Allowed Amount field removed. This value is being pre-calculated by the MMIS. Value cannot be displayed that isn’t permitted by HIPAA.

5010 and Web Portal-Professional

13 / Georgia MMIS Presentation September 2010 HP Enterprise Services

Other Payer Header - all claim types (NEW)

• Date of Birth, Gender and Allowed Amount removed. Allowed Amount is pre-calculated by the MMIS.

• Payer Responsibility with 5010 will allow more values. For 4010, we display Primary, Secondary, Tertiary. 5010 expands that to fourth, fifth, sixth, etc.

• Group or Policy Number is becoming an optional field.

• Insurance Company Name is becoming an optional field.

• Relationship and Claim Filing values changing.

5010 and Web Portal-All Claim Types

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5010 and Web Portal-All Claim Types Institutional

Professional

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Member Other Payer Header - all claim types (OLD)

Member Other Payer Header - all claim types (NEW)

Medicare Allowed Amount field removed. This value is being pre-calculated by the MMIS. A Value cannot be displayed that isn’t permitted by HIPAA.

5010 and Web Portal-All Claim Types

16 / Georgia MMIS Presentation September 2010 HP Enterprise Services

Any questions?