Transcript Provider Direct Kickoff - Group 1

MA Council for Home Care Aide Services
Thursday May 19, 2011
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Agenda
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Introductions
Implementation Strategy
Project Calendar
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Function Of Lead Agency
User Support Model
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Business Process Review Meetings
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User Request Forms
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Project Communications
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On-line Training (Harmony University)
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Demonstrate The Application
Contact Info
Jim Ospenson
EOEA Analyst for Home Care/
Clinical
[email protected]
Sean Rogers
EOEA Analyst for Finance
[email protected]
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Provider Direct Features
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Provider Direct is:
– A secure web portal that allows
Providers to view real-time agency
data:
– Looks at the SAMS database used
by ASAPs for up-to-the minute
updates
• Consumer records & relevant
information (PHI)
• Planned & ordered services
• History of service delivery records
• Suspensions
• Service Delivery Module – post
service delivery / electronic invoices
• Client-centered messaging for
inquiries, follow-up, and task
assignment (future)
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System that transmits Protected
Health Information between
providers
Confidential Information
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Implementation Strategy: FAR first, then EVI
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In a nutshell: FAR first, then EVI
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Assign Provider to Lead Agency
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Initial exposure to application
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Schedule of webinars before and after go-live:
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online demonstrations, watch from your office.
Business Process Meetings
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Provider to meet with each ASAP that they serve
Review details of current-state work process
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Who talks to whom in what situation
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Providers: Self-training using Harmony University
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Stage 1: FAR (faxed authos)
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Thirty (30) days of access per user, starting one week before go-live
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Provider Users will start off in a production environment, looking at their own real consumer data.
First job: parallel processing. Compare HPD’s Change Log to FAR faxes.
Next:
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Objective: Agency & Provider agree to shut down FAR faxes after approx 3 weeks
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Agency-Provider communications. What’s different?
Reporting
Stage 2: EVI (Electronic Vendor Invoices)
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Agency & Provider agree on first HPD billing cycle
Provider identifies desired billing functionality: File Upload, Service Delivery Confirmation Wizard,
other.
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Project Calendar (1/2)
Week
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Tasks
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Kick-off Meetings – Group 2
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Agencies schedule Provider meetings to discuss current business process
& possible changes
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Agencies collect URF info from Providers
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Provider Webinars start (pre-go-live topics, 2 each week) - EOEA
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Agency/Provider Business Process meetings conducted
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Provider Webinars continue
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Agency/Provider Business Process meetings continue
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Agencies: Notify EOEA of Providers with multiple business lines, or
recently merged providers (unusual security configurations)
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URFs due – IMPLEMENTATION CRITICAL (TBD) – Agency to submit by
end-of-day
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Provider Webinars continue
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Agency/Provider Business Process meetings continue
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LMS (Harmony University) userids transmitted to end-users (TBD) one
week before go-live)
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Providers begin self-training using LMS (1 token per user, token is active
for a thirty (30) day period, starts at first login)
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Provider Webinars continue
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Project Calendar (2 of 2)
Week
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Tasks
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GO LIVE! TBD. Users receive HPD userid & password email
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Parallel Processing begins – Provider/Agency compare faxed authos to
HPD Work Queue
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Trouble-shooting conference call
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Parallel Processing continues: compare faxes to HPD Work Queue
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Webinars continue
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Provider & Agency discuss HPD billing methods (File Upload, Service
Delivery Confirmation, other)
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Providers begin training for billing
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Agency/Providers determine when to cease FAR / faxed authos
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Agency/Providers continue to plan for details of first month’s billing, train
as-needed
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Provider Webinars conclude
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Group 1 Stage 1 (FAR) Implementation completed
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Agency/Providers continue to plan for details of first month’s billing, train
as-needed
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Group 1 Debrief Conference Call
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Agency/Providers continue to plan for details of first month’s billing, train
as-needed
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Function Of Lead Agency
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A Provider can serve one or more ASAPs.
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The Lead Agency is (usually) the Agency with the greatest
volume.
Functions
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Coordinate user management for that Provider
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Coordinate application training for providers, especially new staff
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Establish support policies and identify contact staff for Provider
Direct
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Resolve "Tier One" issues related to users:
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Distribute HPD user manuals (available from QuickBase)
Receive application and bug reports from Provider
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Communicate with SIMS Support as needed
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Lead
Agency
Provider
New & terminated users
ABC
Password resets
Application training
Basic usage questions related to Provider Direct: list formatting, filter
criteria, etc.
Reset Silverlight
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ASAP One
ASAP Two
Train providers in getting screenshots
Providers will not communicate with SIMS Support
ASAP Three
Providers will contact other (non-Lead) agencies to
resolve questions about specific consumers, or to
confirm business processes & contact names
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User Support Model - Provider Direct
Provider
XYZ
Report to Lead
Agency
ASAP
Only through five (5) SIMS
contacts
SIMS
Support
Harmony
Communicate system-wide
issues, announcements, and
status to the network
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Each ASAP will support users for providers where they are Lead
Agency.
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Providers must contact their Lead Agency ONLY for technical issues
– Lead Agency will resolve or escalate
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Contact the authorizing Agency about client issues.
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Business Process Review Meetings
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Between Kickoff & Go-live
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Agency & Provider to review the current-state processes:
the specifics for each of the changes that result in a fax
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New Consumer (Provider
has never before served).
Includes new service
schedule.
2.
One-time Only (temporary
boost in authorized services)
3.
Updated Service Schedule
(same units/week)
Provider has multiple business lines (certified/non-certified)
Recent merges
Unusual security configurations
4.
Updated Service Schedule
(unit change *or* change in
services)
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Suspension (ASAP notifies
Provider *or* Provider notifies
ASAP)
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Resume (after Suspension)
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Terminate consumer
2-3 weeks after go-live
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Best as face-to-face meeting, but at ASAP discretion
Providers serving multiple agencies should review with each ASAP
Notify EOEA of multiple business lines, or other requirements
for a provider to view multiple provider records
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1.
Reviewing your current practice will make post-go-live
parallel process faster & easier
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Verbal/phone
Staff contacts
SAMS Data entry
Fax details
Issues in current process?
Seven (7) Business
Processes to replace
FAR (faxed authos)
Agency & Provider review parallel processing
Gauge readiness to shut down FAR (faxed authos)
Business Process Meetings between
Provider and All Agencies doing business
with…
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User Request Forms (PD-URF)
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Lead Agency Manages a Provider's
Users
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Agency manages only one (1) URF form with
information for all of their providers,
containing all present and past users.
Each provider may have up to five (5) active
userids.
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Request Type
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User's First Name
User's Last Name
Four (4) Digit PIN
User's Month (MM) and Day (DD) of birth
User's E-mail Address
User's Office Telephone Number
New, Update, Terminate, Reactivate
Accuracy is key
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Must match SAMS provider name
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Provider:
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Organization Name for User
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How Many Accounts?
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Fields on URF, for each user
Spelling of names
Email addresses
Timeliness is key
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Don’t miss the boat
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Project Communications
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For providers, your main point-of-contact about Provider Direct will be your Lead
Agency.
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User, training, application issues should be communicated to Lead Agency.
If there are technical issues that must be escalated, then the Lead Agency will contact SIMS
Support.
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For providers, your main point-of-contact about specific Consumers
will be the consumer's Agency.
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Questions about individual consumers should go to the Consumer's Agency (whoever created the
consumer's Service Plan.
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Agencies: Make sure to keep your "five contacts" up-to-date.
SIMS Support may contact the Provider in certain situations to collect follow-up information.
Each Agency and each Provider should work out the appropriate Agency staff to respond to any particular item:
Case Manager or Supervisor, POS coordinator, Fiscal staff.
Email communications from EOEA to two (2) people at each organization
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the Lead and a backup
EOEA will only communicate to providers occasionally
Agencies: Please make sure our records are complete
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Project Communications
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Massachusetts User Information
Portal
– http://providerdirect.800ageinfo.com
– Objective: this is the first reference
for users & user support, for any
application, project, or operational
materials.
– Searchable, with date and category
archives
– Categories
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Announcements
Frequently Asked Questions
Group 1
How-to
Issue Reporting
Lead Agency Info
Manuals
Training
User Management
User Support
– Let us know if anything is missing or
needs to be updated.
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Harmony University (on-line training)
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All users will have 30
days of access
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Billing Methodologies
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EVI Replacement – Service Plans visible in HPD
– EVI Out Spreadsheet generated from Consumer Monthly Service Plan Report
• Providers run a HPD report on demand
• In Production currently
– EVI In Spreadsheet Replaced by:
• HPD File Upload
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Current Status
• Service Delivery Confirmation
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Provider Direct Demo
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This is a Test environment based on production: all
data is scrubbed. No real consumer info.
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This user's view is from a real provider in the
production environment, for example XYZ Home Care.
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Security: A Provider Direct user can
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See (but not edit) selected elements of the base consumer
record for consumers with XYZ Home Care service plans
(current or historical).
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See (but not edit) service plans & service schedules where
Provider = XYZ Home Care
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See (but not edit) service orders where Provider = XYZ Home
Care
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See (but not edit) service suspensions where Provider = XYZ
Home Care
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See, create and update service delivery records where
Provider = XYZ Home Care (however, service plans and service
orders must exist first).
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We will implement service delivery functionality in the second
phase.
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See, create, and edit rosters where Provider = XYZ Home Care
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Reports:
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PD User can run reports and save report definitions (criteria)
all data displaying on PD reports is subject to the same security
policy
Each organization
(Agency or Provider)
has a unique "view" of
the SAMS/ Provider
Direct database.
ASAP users (in Provider
Direct or SAMS) will
have a slightly different
view of the data than
the Provider users they
support.
Usually this means that the
Agency users sees more
consumers in the consumer list,
more changes in the Work
Queue, or service records
(plans, orders, deliveries) from
other providers.
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