Thursday, March 30, 2017

The Department of Health Care Policy and Financing launched its new Medicaid Management Information System on March 1, 2017. Please follow this link to read the Department's Special Provider Bulletin with helpful information about the interChange.

Providers who cannot access the web portal and bill:
If you are having problems logging in to the Provider Web Portal, please check that you are using the correct provider ID. Please review this Cheat Sheet for more detail.

HPE sent emails with registration instructions to the individuals on file responsible for provider revalidation as of February 6, 2017. Newly approved providers should receive this letter within a few days of receiving enrollment approval. If you do not use the correct Provider ID, you will not be able to submit claims or use many of the Web Portal features.

If you did not get the registration instruction email, please contact the HPE Provider Services Call Center at 1-844-235-2387

Denials and billing cycle:
Providers are experiencing higher than usual claim denial rates. Many claims are denying correctly, even when the same claim would have paid in the legacy system. The interChange strictly enforces many rules that the legacy system may not have. Please verify that you are billing according to the new Billing Manuals. In instances where claims are incorrectly denying, system fixes are being identified and implemented. If you have claim denials from several weeks ago, the Department recommends that providers rebill those claims.

Call Center:
Wait times for the HPE call center persist.

Start all calls to the call center saying you are calling about HCBS Waiver Claims, PARs, and services. HPE has trained certain representatives to handle HCBS calls, and this information helps call center reps provide accurate information.

Also, if you receive either poor service or confusing/contradictory information, please obtain and keep the call tracking number (CTN) for further investigation. 

HCPF Provider Resources
Below are additional resources on the HCPF web page to help resolve individual issues.

Guide to Go Live
Billing Manuals

Provider FAQs (Updated regularly)
Aid Code and Benefit Plan Acronyms
Are you Billing from the Correct Account?
Copy, Adjust, or Void a Claim
Delegate Access Definitions
Pulling your Remittance Advice (RA)
Provider Maintenance
Updating your EFT/ERA Information
Validating a Trading Partner ID (TPID)
Verifying Member Eligibility
Web Portal Registration

Provider Web Portal training