Indiana Health Coverage Programs (IHCP) is in the second week of implementing the new CoreMMIS and Provider Healthcare Portal (Portal). While there have been several performance problems during the implementation, the Indiana Family and Social Services Administration (FSSA) and Hewlett Packard Enterprise (HPE) are reporting progress in stabilizing the new system and are working to resolve outstanding issues as quickly as possible.
As of Wednesday, February 22, IHCP was reporting the following ongoing issues:
- Slow response times have been reported on the Provider Healthcare Portal for claim void transactions, Notification of Pregnancy transactions, and Right Choices Program utilization requests.
- Eligibility information in the managed care entity (MCE) portals may not yet match eligibility information in CoreMMIS. However, all eligibilty information is up-to-date in CoreMMIS, and the MCE portals should be fully updated with current eligibility information, as well as primary medical provider assignments and MCE delivery system information, by the end of the week.
- Provider EFT payments and 835 transactions (Remittance Advices – RAs) from the February 21, 2017, financial cycle were delayed. Those EFT Payments will be released today, Thursday, February 23, 2017, and 835 transactions are being reviewed and providers will be notified when they are available. Providers can view RAs for all claims processed during the February 21, 2017, financial cycle on the Portal through the Search Payment History page. Check payments were not affected by this delay.
As well, IHCP is reminding providers of some best practices and new procedures now that the new CoreMMIS and Provider Portal have been implemented. We’ve highlighted a few of those procedures and practices below:
- LOGGING INTO THE PROVIDER HEALTHCARE PORTAL: To log in to the Portal, IHCP providers must enter the user ID and password that was established during the Portal registration process. The IHCP has received inquiries from providers that are attempting to use their Web interChange user IDs and passwords in error. When an incorrect user ID and password are used, the system may present an incorrect set of security questions in an attempt to identify the user. If you receive incorrect security questions, please return to the login page and confirm that you have entered your Portal user ID and password. If you still receive incorrect security questions, or if you are unable to access the Portal, contact the Service Desk at 1-800-457-4584.
- MCE PA REJECTIONS: CMCS has received and rejected numerous PA requests for members enrolled with an MCE. Providers must complete a two-step process when verifying eligibility. The first eligibility screen identifies the programs for which the member is eligible; clicking on a program link will identify if the member is assigned to an MCE. If assigned, PA requests for that member must be sent to the MCE rather than to CMCS.
- PROVIDERS LINKED TO SPECIFIC LOCATIONS: IHCP policy requires that rendering providers be linked to the specific locations where they render services for a group practice. Further, a rendering provider’s services may not be billed for a service location to which he or she is not linked. Previous processing rules did not edit for a specific service location linkage when processing claims; rather, the system simply verified that the rendering provider was linked to any service location for a particular group provider. In the new CoreMMIS, claims billed for services performed by a rendering provider not linked to the specific service location on the claim will deny. Group providers should review their provider profiles to ensure each group location has the correct rendering providers linked with accurate effective and end-dates.
To report ongoing issues with the CoreMMIS and Portal implementation, contact the FSSA and HPE at 1-800-457-4584 or by email at email@example.com. Also, visit Indiana Medicaid’s News Summary page for progress updates.
— All rights reserved. For use or reprint in your blog, website, or publication, please contact us at firstname.lastname@example.org.