Provider Services Portal (PSP) Enrollment & Functionality Manual Provider Services Portal (PSP) Enrollment & Functionality Manual

Transcription

1 Provider Services Portal (PSP) Enrollment & Functionality Manual 1

2 Table of Contents PSP Website Home page... 3 PSP Enrollment... 3 E-Authentication Identity Proofing... 3 User Password Security and Protection... 4 Security Q & As... 4 PSP Password Requirements... 4 PSP Home Announcement Page... 5 FAQs... 5 Beneficiary Eligibility Lookup & Results... 5 Claim Status Lookup & Results... 6 Reopening, Redetermination & Overpayment Refund Form Submission... 7 Same/Similar Lookup & Results Includes A, L & V HCPCs... 7 Remittance Lookup & Results... 8 Additional Determination Requests (ADR) Inbox & MR Service Center... 8 MR Service Center Lookup & Submit... 8 NHIC Forms... 9 NHIC Forms Lookup... 9 PSP Research Library PSP Website Support ForeSee Survey Updating Your Portal Participant Information Common PSP Messages

3 PSP Website Home page To access the Provider Services Portal (PSP) website, click on the following link: PSP Enrollment Prospective participants must complete and submit the E-Authentication Identity Proofing Documentation form. In addition to completing the E-Authentication Identity Proofing form, prospective portal participants must undergo a vetting process before they are allowed to access the portal. The PSP Team verifies that the provider meets the requirements below. All providers participating in the PSP must be in good standing with the Medicare program. Providers staff requirements: o Each user is required to have an individual business address. o Each user is required to actively use the PSP website.(at least once every 60 days) o Each user must complete annual privacy & security training provided by the business/provider. o Each user must be physically located in the U.S. One authorized/delegated official for the provider s office must complete the identity proofing process for both him/her and for the PSP office contact and users. This person is also responsible for adding new users and for completing the annual validation process. To maintain PSP website security, all users are required to obtain a Login ID and password. This ID and password must not be shared, and the password must never be divulged to anyone else. One person from each provider group must be designated as the PSP Office Contact. Typically, this would be an office manager or billing supervisor. This person becomes the liaison for the organization and the NHIC PSP program. E-Authentication Identity Proofing The process for identity proofing consists of the provider/supplier completing the NHIC Provider Service Portal E- Authentication Identity Proofing Documentation form. To begin the enrollment process, the individual designated as the authorized official must complete the NHIC E-Authentication Identity Proofing Documentation - Point of Contact section of the form. This portion of the form must be notarized. The notary is required to check the picture on the authorized/delegated official s valid, current license or passport to confirm that the picture matches the authorized official. The notary attests to the Point of Contact s identity by signing and notarizing the form with their commission information. A notary stamp or seal is required. The next step of the identity proofing process is to have the Point of Contact identity-proof the PSP office contact and the users who will be accessing the PSP website on his/her behalf. This is done by completing the NHIC Provider Services Portal E-Authentication Identity Proofing Documentation - Users section of the form (pages 2 & 3). Page three of this form must be signed by the authorized/delegated official once the information below has been verified. 1. For the PSP office contact and each of the PSP users listed above, the identity proofing point of contact has verified the individual s information from a current, valid, government issued driver s license or passport and verified that the picture matches that person. This information is on file at the business/provider s office. 2. The name(s), physical business address, phone number and unique business addresses listed are accurate. No users are listed with the same address. 3. The PSP office contact and each of the PSP users listed have been educated that the PSP team assigns access to individuals and not directly to the business office. PSP users will not share their PSP Log-in ID and password as this is a security violation and the business may be removed from the PSP. All PSP users participate in an annual privacy & security training provided by the business/provider. 3

4 4. The PSP office contact and the PSP users listed have been educated that they must log into the PSP once every 60 days in order to maintain their access and meet CMS security regulations. It is the responsibility of the PSP office contact to remove users when access is no longer required. Once the form is completed, all 3 pages should be mailed to NHIC PSP Communications at the following address: NHIC PSP Communications 75 Sgt. William Terry Drive Hingham, MA User Password Security and Protection Each user of the PSP will be assigned his/her own Login ID and password. This ID and password must not be shared. No one else may use your Login ID to access the PSP. Unusual password activity is monitored, as well as any attempt to use the same Login ID, at the same time, on more than one computer. PSP access can be restricted or removed if appropriate password security practices are not followed. CMS requires that all users access the PSP once every 60 days. If you do not meet the usage requirements then your access will be disabled or removed. **Passwords should not be stored, written down, ed, or otherwise made accessible to anyone at any time. If forgotten, passwords can easily be changed or reset using the PSP application or by contacting the PSP Help Desk. To maintain PSP website security, all users are required to obtain a unique login ID and password. It is against the PSP security regulations to share your login ID or password. If you believe your password has been compromised, change it immediately and contact the PSP Help Desk via at nhicpspcommunications@hpe.com, or by calling Security Q & As During your first log on attempt, the PSP will prompt you to set up security questions and answers. These questions are system generated. Answers cannot contain special characters, numbers or spaces. No answer can be duplicated. Your security questions and answers may be used for our automated password reset functionality. Simply click the Forgot Password link and you can reset your own password during the log-on process. PSP Password Requirements The following Login ID/password requirements must be followed: o The password must be at least 8-12 characters in length o The password must contain at least one number. o The password must contain at least one upper case and lower case letter. The password must contain at least one special character. The special characters are defined or #. The password will expire every 60 days. If you had a previous password then the new password must differ by at least 4 characters. The password must be different than the previous 6 passwords. The password can only be changed once every 24 hrs. The Login ID will be locked after 3 consecutive, unsuccessful attempts. o The Login ID will remain locked until reset by the user through Automated Password Reset (APR) by clicking the Forgot Password link, or reset by the Help Desk. APR will randomly display 2 system questions. Follow the prompts on the screen to reset your password. APR will lock after 3 consecutive, unsuccessful attempts and can only be unlocked by the Help Desk. Requests to reset passwords should be ed to the PSP Help Desk at nhicpspcommunications@hpe.com. 4

5 Please read the PSP Home page announcements each time you log on for up-to-date information. **It is a CMS requirement that all users access the PSP at least once every 60 days. If you do not meet this requirement, your access will be disabled. Businesses with no active users may also be removed since usage requirements are not being met. PSP Home Announcement Page Please review the the announcements each time you log on the PSP Website. Contact NHIC, FAQs, Privacy Policy, PSP Guides & Forms and Additional Determination Requests (ADR) Inbox are located at the top of the page. The left hand navigation pane includes Beneficiary Eligibility, Claim Status, Same/Similar, Remittances, MR Service Center, NHIC Forms and PSP Research Library. For each functionality there is a Lookup option and FAQs. User Profile allows you to return to the home page link and update your security questions & answers. Your security questions & answers may be viewed and updated at any time. Please familiarize yourself with your questions and answers so you may reset your own password. FAQs Frequently Asked Questions are available for each category. Please review FAQs to research questions prior to contacting the PSP Help Desk. Beneficiary Eligibility Lookup & Results Multiple options are available to review beneficiary eligibility.. Billing NPI # is required. You may choose one of the following search options when entering the beneficiary required data. Search Option HICN Last Name First Name DOB 1 X X X X 2 X X X 3 X X X Enter all information as it appears on the Beneficiary s Medicare card. The date of service must be entered. The date must not be > 12 months in the past and 4 months in the future from today s date. You may choose optional check boxes to display different eligibility elements or use the check all box to see All eligibility data. Please review the eligibility FAQs for general eligibility questions. 5

6 The following information is displayed: Billing NPI entered. Beneficiary data including: HICN, name, gender, date of birth, beneficiary s address and date of death. Medicare Part A and Part B eligibility. Deductible met for the current & previous year. Data returned will be dependent on the date of service entered on the Beneficiary Lookup page. Medicare Part C Managed Care Organizations (MCO) indicates if the patient has assigned their Medicare benefits to a Health Organization and does not have traditional Medicare. Medicare Secondary Payer (MSP) indicates if Medicare is primary or secondary. Visit the Eligibility FAQs for a list of MSP codes. Home Health Episodes displays start and end dates of home health episodes, DOEBA/DOELBA dates, contractor name and number, NPI of the home health agency and home health certification dates. Medicare Part D Prescription Drug Plan is displayed. Therapy Caps are displayed for occupational, physical and speech therapy. The PSP displays the amount USED. Preventative Services are displayed. These results include the procedure codes and description, the next eligible date and financial liability information for the current year. Dollar amounts in a field means the procedure code may be applied to the beneficiary s deductible and coinsurance. Inpatient Hospital Spell results are displayed. This includes the inpatient spell date range, remaining days, copayment remaining days and DOEBA/DOLBA dates. (The exact inpatient admit & discharge dates and the facility NPIs are not available in the CMS HETs system therefore it cannot be displayed in the PSP.) Skilled Nursing Facility (SNF) Spell results are displayed. This includes the SNF spell date range, remaining days, copayment remaining days and DOEBA/DOLBA dates. (The exact SNF admit & discharge dates and facility NPIs are not available in the CMS HETs system therefore it cannot be displayed in the PSP.) Hospice data is displayed including start, end dates and NPI number. Claim Status Lookup & Results The following is required for claim status lookups: Billing NPI #. Beneficiary HICN, First Initial and Last name. For claim status details the date of service is required but you may also choose to include the billed amount, procedure code or the ICN/CCN. Click on the ICN/CCN number for claim detail information. At the bottom of the page is an option to submit reopening, redetermination and overpayment requests. From the results page you can print, perform a new search or go back to the previous page. 6

7 Reopening, Redetermination & Overpayment Refund Form Submission To submit a reopening or a redetermination you first must go to the claim status details. At the bottom of the page you will find the following steps: 1. Choose your request form. You may also refer to the checklists as a resource. It is not necessary to submit the checklist form. When completed save the form to your desktop. 2. Select your request type: Reopening, Redetermination or Overpayment Refund form. 3. Enter the 10 digit PTAN. 4. Upload your form to the PSP. 5. Upload supporting documentation if necessary. You can skip this step if you do not have supporting documentation. 6. Complete the attestations statement to electronically sign your request. 7. Upload. When completed you will be provided with a DCN # that you may use to track that status of your submission. Same/Similar Lookup & Results Includes A, L & V HCPCs To display results: Enter the billing NPI number. Enter beneficiary data using the same options used for beneficiary eligibility. You may choose to enter a HCPCs code or an A, L V HCPCs. You also have the option of entering the first letter of the HCPCs followed by * to display all HCPCs billed for that range (I.e.*) or * to see all HCPCs billed for a beneficiary that involve same/similar. Click on the A, L & V HCPCs chart for the codes available. Beneficiary eligibility data will be displayed. When the HCPCs code is found certificate of medical necessity (CMN) & billing information is displayed. 7

8 Remittance Lookup & Results The website contains a 180 day history of remittances. The PSP begins to gather this 180 day history when your business enrolls. Remittances are only available to businesses that receive electronic remits. If your business only receives paper remittances then this functionality will not be available. Prior to printing a remittance, modify the margin settings as follows: 1. Go to the File menu in Internet Explorer and select Page Setup. 2. Make a note of your existing default margin settings. 3. In the Page Setup dialog box set the Left and Right margins to 0.25 and the Top and Bottom margins to 0.5 as indicated in the example to the right. Based on your actual results when printing on your printer, you may need to adjust these settings. 4. Click OK. To display results: Enter your billing NPI number. Optional search criteria is available. Entering your NPI number only and clicking lookup will return a complete history of your remittances. Locate the remittance you want to print and click Print. Once you have initiated the print process, the word Print will change color and the Printed column will populate with the word Yes. It may take a minute or two for the PSP to gather your data. A message will appear indicating the data is being gathered. To complete the process, click on Print on the printer selection screen. The print job processing time can vary from 10 to 120 seconds Additional Determination Requests (ADR) Inbox & MR Service Center To display Inbox results: ADR requests will automatically be display for your NPI numbers. ADR requests will display for 90 days. MR Service Center Lookup & Submit You may search Additional Determination Requests (ADR) on the MR Lookup screen by: Billing NPI #, ADR Letter Date, CCN, and HICN. There is a link to the MR Decision Desktop at the bottom of the page. 8

9 To submit an ADR request you will follow the steps listed on the screen: 1. Open and save the ADR letter. 2. Select the request type. 3. Enter the NPI number and CCN. 4. Upload the ADR letter. 5. Upload supporting documentation if necessary. 6. Complete the attestations statement to electronically sign your request. 7. Upload. When completed you will be provided with a DCN # that you may use to track that status of your submission. NHIC Forms Links for all NHIC forms available for submission in the PSP are included. Follow the 6 easy steps Have your NPI & PTAN # available. Upload your form and additional documentation. You may upload up to 4mg of documentation. Electronically sign your submission. NHIC Forms Lookup Click on the My DCN List buttons to see a list of all DCNs submitted by you by form type. You can switch to view each form type. Enter data in the DCN Status Search For detailed status information for a particular request. For detailed status you must enter the Billing NPI, DCN and PTAN. 9

10 PSP Research Library The PSP Research Library contains helpful links available to assist with your Medicare research. PSP Guides & Forms: E-Authentication Documentation form and the Update User form. NHIC Medicare Website Decision Desktop Self Service Tools: links to DME Fee Schedules, Helpful Websites, Local Coverage Determinations, NHIC Bulletins, Self-Service Calculators. PSP Website Support Due to HIPAA guidelines, please do not send Personal Health Information (PHI) via to the PSP support mailbox at For support issues that include PHI, please use our secure fax. Please remember to include your full name, business name, and phone number. Secure fax number: If you have problems or questions concerning this website, please your questions to the help desk at Include your full name, business name, and phone number on your request. You may also call us at Please allow up to 24 hours for a response. Calls and messages are returned in the order that they are received. Please do not call and . One contact to the help desk is sufficient. If you have questions about specific Medicare claims or eligibility information that you have received on the PSP web site, please contact your local Customer Service Representative at the number below: DME Jurisdiction A Customer Service Telephone Inquiries ForeSee Survey The PSP values your opinion. While using our website, please take a few moments out of your day and tell us how much you like the PSP. ForeSee survey results are reporting to the PSP team and CMS. Updating Your Portal Participant Information The office contact or identity proofing point of contact should FAX or a completed User Update Form for the following scenarios below. A change in the office contact. A change to a PSP user s name, address or telephone number. To remove a user from the PSP. The User Update Form can be found in PSP Guides & Forms. To add new users you must complete pages 2 and 3 of the E-Authentication Identity Proofing Documentation form. The form does not need to be notarized. The form must be signed by your PSP Point of Contact (Authorized Official) on page 3. Please only list new users that you would like to add. Existing users do not need to be included. You can find this form on the NHIC website in the PSP section or under PSP Guides & Forms on the PSP website. 10

11 Common PSP Messages All error messaging appears in Red font when performing look up transactions. Session has timed out: You will receive a time-out message if there is no PSP activity for 30 minutes. You will get a reminder at 28 minutes. An Eligibility error has occurred: Please check your beneficiary data. The beneficiary information cannot be found with the data keyed. Your session is locked: Your PSP session is locked for 30 minutes if you do not use the logout option in the PSP. Never close your PSP browser by clicking on the x. Always choose Logout on the left hand navigation pane. Note: All users should access the PSP via Internet Explorer. 11