Frequently Asked Questions Navigating IBHIS for LA County DMH Contract Providers

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1 DMH Resources Q: Where can I access DMH documents? A: You can find DMH documents by visiting the DMH site at Q: We need additional EFT/SIFT extract training. Who should we contact? A: Contact Michael Chong at DMH via at mchong@dmh.lacounty.gov or by calling Q: When are the next DMH meetings being held? A: There are two upcoming meetings. The DMH Reports meeting is April 2 from 10 a.m. to noon at DMH, 600 S. Commonwealth Ave., Los Angeles, CA 90005, third floor conference room. The DMH CPTT meeting is April 8 from 10 a.m. to noon at Children s Bureau, 1910 Magnolia Avenue, Los Angeles, CA RCI Resources Q: Where can I get a copy of the March 6, Navigating IBHIS for LA County DMH Contract Providers PowerPoint presentation? A: us at rciconsultinginfo@gmail.com and we will be more than happy to send you a copy. You also may access the recorded webinar at Q: Where can I get a copy of the presentation recording? A: us at rciconsultinginfo@gmail.com and we will be more than happy to send you a copy. You also may access the recorded webinar at Q: How do I sign up for the RCI IBHIS Readiness Series? A: You can call or text us at , or send us an at rciconsultinginfo@gmail.com. Q: I am interested in receiving more information about RCI services. How do I contact you? A: You can call or text us at , or send us an at rciconsultinginfo@gmail.com. Check us out online at Q: Are slide presentations available in advance of your webinars? A: Unfortunately, we only are able to provide slide presentations to attendees following our presentations.

2 Reporting & Outcomes Q: You talked a lot about reports. Our EHR system has a lot of reports built in to the system, but we haven't used most of them. We need a lot of help in this area. A. You are not alone! We hear this from MOST agencies. RCI is particularly passionate about reports! Visit the Services page of our website and you'll see that reports are a recurrent theme throughout our offerings. Maximizing your EHR investment (MEI) is all about getting the data you need to manage your business. We can customize a reports workshop for your agency. If there is enough interest, we also plan to offer an RCI Workshop Series related to reports and outcomes. IBHIS Key Features Practitioner Registration Maintenance Application (PRM) Q: How do I access Practitioner Maintenance Application (PRM)? A: You must submit an application to DMH for a password. All members except for those in group five currently should have access. Group 5 access will begin around April 4. Q: The individual who worked on the first phase of the practitioner cleanup no longer is with my agency, and I do not have login and password access to the account that was used. I did create a PRM account for myself and only see a handful of my providers listed. Does this mean that the work done during the first phase is not visible to me? Is it listed in the system under the previous account owner? How do I retrieve this information, or who do I speak with for assistance? A: Contact Joyce Fantroy at jfantroy@dh.lacount.gov for PRM questions. If you are an authorized PRM user (you have an assigned login and password), you should see all practitioners assigned to your legal entity. Based on your statement above, it sounds like not all of your practitioners are reflected in PRM, and therefore not in IBHIS, so you should begin entering missing practitioners prior to claims testing. Contact Joyce for more details. Q: You mentioned that the data we put into PRM is manually input into IBHIS by DMH staff. How do we know the data is entered and accurate in IBHIS? A: You will know the data has been entered into IBHIS when the status says Current in IBHIS." You will use your EFT/SIFT/LE Extract files to verify that the practitioner data in IBHIS matches the data in your EHR. If the data does not match, you may have claims denied. Q: Does PRM verify information from the new BBS BreEZe license verification system, or solely using NPPES? A: DMH only validates information against NPPES no other external licensing system. Your agency may use BBS BreEZe as a license verification method for new staff. Q: How is PRM data validated against NPPES? A: This is performed by DMH electronically using downloaded NPPES data. There is NPPES data listed as, "Last Updated XX/XX/2014 at XX:XX a.m." on the practitioner page, telling you when the data was last updated.

3 Q: My agency is consists of more than one Legal Entity, but I am only seeing data for one Legal Entity. Do I need additional logins to see the rest? A: No. Contact Joyce Fantroy at jfantroy@dh.lacount.gov to have the remaining Legal Entities linked to your login so you can see all Legal Entity data. Q: I have entered data into PRM a month or more ago. The status still says submitted to PSO. How long will it take for the status to change to Current in IBHIS? A: DMH is updating IBHIS with PRM data on a priority basis. When you are ready to start claim testing, you should notify DMH that your PRM data needs to be updated. Q: It looks like only practitioners with a certain license are pushed to PRM, even though they previously were entered. Is DMH adding additional data? A: DMH will not be adding any additional data to PRM. Each Legal Entity is responsible for ensuring all billable staff are reflected accurately in PRM. Q: There is a practitioner who no longer is with my Legal Entity, but still is on a claim in the IS. If I terminate the practitioner in PRM, will this affect my claim in the IS? A: Practitioner Registration Maintenance Application (PRM) does not affect anything done in the IS. Q: After IBHIS Go-Live, will there be a schedule for DMH to enter/update PRM to IBHIS? For example, all new or updated PRM data will be downloaded every Friday and entered into IBHIS every Wednesday. A: After all Legal Entities have migrated to IBHIS, practitioner additions and updates will be entered into IBHIS on a flow basis unless otherwise requested by DMH internal management. Digital Keys Q: Once we get our digital keys, will those be used only for testing, or also for production? A: The digital keys you receive after TPA approval only are for testing. Once you complete the testing script provided by DMH and are certified for production, you will receive a production key. The process of loading digital keys will occur prior to testing and prior to production. Q: Can you clarify how the digital keys are used? Do we need to install them on all end user computers? A: Digital keys (applies to testing and production keys) are installed in two places: 1) on your billing computers that submit and receive EDI 837/835 files. This process is done manually via an FTP (file transfer protocol) process, and 2) on the server that hosts your system for the exchange of web services transactions. Q: DMH mentioned we will be receiving a digital production certificate during testing. Will the digital production certificate be turned on following installation? A: The digital production certificate will be turned on at Go-Live.

4 Community Outreach Services (COS) Q: We have COS funding through DMH. Are you saying that our providers can now enter these services into our EHR and the claims will be created from the system? A: Yes. The other change to COS is your reimbursement rate. This will be changed from 15-minute increments to a per-minute rate. Q: When submitting practitioner time, do we submit time only for the primary provider, or across all providers who delivered service to the client? A: COS claims will work the same as regular mental health services claims, so the total time will be billed under a single primary provider. Depending on how your EHR is configured, you may be able to list additional providers on the documentation for productivity purposes; however, the claim will reflect total time on the primary provider only. Q: How are we going to identify clients as COS clients? A: There will be one client ID for all Legal Entities' COS clients ( ), with a unique LE episode assigned to your Legal Entity. Q: If COS works like all other claims, how do I assign a valid diagnosis code to the claim? A: All COS claims will use a diagnosis code of V7109. Client Service Information (CSI) Q: What is CSI? A: CSI stands for Client Service Information. This data now will be collected in your EHR system and submitted to IBHIS via web services. DMH will continue to send this data to the State on your behalf. Claim Processing Q: Since we will be submitting claims in the IS (date of services June 30, 2014 or earlier) and IBHIS (date of services July 1, 2014 or after), will our system have to maintain two EDI formats, two paysource formats, and two procedure code tables? A: Yes. How this is implemented, managed, and maintained depends on your EHR system setup and your vendor development. You should receive information about this when your vendor deploys these features for testing. Q: Does the Dual Diagnosis Code need to be included in the billing? A: The dual diagnosis code is not required for IBHIS claims or IBHIS web services transactions. IBHIS is standardizing requirements based on State and Federal standards, and dual diagnosis is an L.A. County requirement only. The diagnosis on the claim will be validated against a DMH table of acceptable diagnosis, but not at the client level. Q: It was mentioned at a DMH meeting that we may need to suspend submitting claims for two weeks before Go-Live with IBHIS. Is this correct? A: We currently are requesting clarification. This question may be related to the assignment of P-Auths for agencies that don t hit the July 1, 2014 Go-Live date. P-Auths include your contract amount. If it will not reflect a full fiscal year, the two-week period may be related to a hold to allocate the balance of your fiscal year funding, less the claims submitted.

5 Dictionary Codes Q: Will there be two sets of codes for IBHIS and IS? Who is responsible for setting up and maintaining the codes? A: Yes, there will be different code sets for IBHIS and IS, and in two areas: Procedure codes for billing (many new modifiers) o IS claims = current codes o IBHIS claims = new codes with modifiers Dropdown values o IS required fields = current IS codes manual o IBHIS web services = new dictionary code values Your EHR system architecture and IBHIS rollout strategy will drive the direction of you versus them in terms of setting up all of the new codes. Your EHR system will be required to maintain both sets of codes. Initial setup needs to be done before you can begin testing in IBHIS (claims and Web Services). Q: Are we to program our EHR system with IS fields and the new IBHIS fields due to having to test in IBHIS and DDE in IS from now until the July Go-Live? It was mentioned a task would be mapping these fields. Is this something our vendor should do? A: You will need to add any new IBHIS fields that are not currently in your EHR system as well as maintain IS values in your EHR system. The IS values will be maintained until all IS claims are adjudicated or the IS shuts down whatever happens first. IBHIS fields are needed for claims and web services testing, from IBHIS Go-Live and beyond. Q: Do we need to have our digital key installed in order to update the new dictionary code fields? A: Technically speaking, you can add the new dictionary code values to your system without the digital key installed, but you cannot submit web services transactions to IBHIS until the digital key is installed on your vendor s host server. Whether you configure these fields in your system, or your vendor provides you with a system upgrade with the fields preconfigured, however, depends on your vendor s system architecture and deployment strategy. There is a dictionary code manual on the DMH IBHIS website at Clients: Surviving, Push to IBHIS, PATS Q: Where do I go to see if the clients I have in my EHR system survived the DMH de-duplication? A: DMH released this information in an EFT/SIFT extract titled: LE#####_AvatarExt_o1.mdb. There are seven tables in this extract relating to IBHIS. The V_ClientW AvartarGroup Table shows which clients survived and were pushed to IBHIS. The client # column = Client ID. The Group ID column links all the clients together who were merged into a surviving client. The Avatar Client ID column is the ID generated in Avatar and is what you will use for IBHIS. If the Client Group ID or Avatar ID columns are blank, the client did not get moved to IBHIS. You will need to go through each client and verify, update, and change data in your EHR accordingly. Q: DMH said they did a push of all IS clients on December 18, 2013 and they will be pushing new clients entered into the IS from that date until Go-Live. If information changes on the clients who were pushed to IBHIS on December 18, 2013, will DMH update accordingly? A: DMH only will push new clients to IBHIS. Each LE will need to track changes to clients from December 18, 2013 until Go-Live and push those changes to IBHIS as soon as the LE goes live.

6 Q: When will DMH push new clients created in IS into IBHIS? A: DMH will push data weekly/monthly for new clients added into the IS. There will be a push of data right before Go-Live. Q: When I Go-Live with IBHIS, what do I do with clients who are receiving medications through PATS? A: You will need to maintain PATS clients in the IS regardless of your status on IBHIS until there is a replacement determined for PATS. IBHIS Timeline Q: DMH is saying that the July 1, 2014 IBHIS Go-Live may be extended on a case-by-case basis for LEs that are not ready by that date, and that the LE can negotiate a later Go-Live date not to exceed September 30, Is there a benefit for extending the Go-Live date? A: We recommend that all LEs try to hit the July 1, 2014 Go-Live date. Q: My agency just entered the testing phase of the IBHIS project. We have received and downloaded our digital key and certificate. DMH contacted us letting us know we are ready to start. I have not heard from my EHR vendor. What are my next steps? A: Contact your EHR vendor rep to check the status of web service changes being made to your EHR system for IBHIS testing readiness.