3. The website for exprs is accessed using this website link:

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1 How to Create & Submit Service Delivered Billing Entries as a Personal Support Workers (PSW) or Independent Contractor PSW (IC-PSW) Provider (Revised 11/30/15) As of April 1, 2015, services to individuals with I/DD not living in residential placements are now authorized in exprs via the Plan of Care (POC) structure. This includes services delivered to individuals using I/DD from Personal Support Worker (PSW) and Independent Contractor PSW (IC-PSW) providers. With this full implementation of exprs/poc, the PSW and IC-PSW providers will need to have the dates/time they worked entered into exprs for the services they are authorized to provide to generate claims for payment. This new POC data element for date/time worked is called a SERVICE DELIVERED (SD) billing entry. These SERVICE DELIVERED billing entries are the preliminary data component needed for POC claims processing. It is highly encouraged for all PSW and IC-PSW providers to enter their SERVICE DELIVERED billing entry data directly into exprs themselves. This How To guide will provide instructions for this process. To do this work directly in exprs, PSW and IC-PSW providers must have the following: 1. Use of a computer or mobile device with internet access and an internet browser program. exprs is an internet based program, and can be used with any device that can access (ie: surf ) the internet. Examples of internet browser programs include: Internet Explorer, Google Chrome, Firefox, Safari, Microsoft Edge. 2. Be enrolled with an exprs User Account that gives the provider secured user access to the exprs system to enter their SD billing data. 3. The website for exprs is accessed using this website link: Page 1 of 12

2 To create/submit SERVICE DELIVERED entries as a PSW/IC-PSW provider: 1. Using the website above and your user login ID and password, login to exprs. 2. From the left-hand, navigation menu, click on the blue box labeled Create Service Delivered Entries from Single Service Authorization. This will take you to a new page to find the services you are authorized to provide, and submit SERVICE DELIVERED entries against once you have worked. 3. You will now be on the Create Service Delivered Entries from Single Service Authorization search page. This page will allow you to search for service Page 2 of 12

3 authorizations that have been set up for you by the CDDP or Brokerage for a specific date range. These service authorizations are what you will bill against. At least one piece of search criteria is required to successfully search. PRO TIP: PSW/IC-PSW providers need only to search using a date range. Effective Date = the first date in the date range that billings need to be entered for; defaults to 1 st day of the current month, but can be changed. End Date = the last date in the date range that billings need to be entered for; defaults to the last day of the current month, but can be changed. Click Find to get a list of accepted authorizations to bill against. Even though a date range is all that is needed to search, more criteria can be used, if desired. The more criteria you enter the more specific or narrow your search results will be. If providers wish to use them, the additional search criteria fields are defined as below: Page 3 of 12

4 Client Prime = the prime number for a specific client. Service Location/PSW SPD Provider ID = the PSW/IC-PSW s SPD Provider ID number. DHS Contract Num = the biennial contact number for the CDDP or Brokerage who authorized the POC services for the client. Service Element = the service category for the services authorized. You may select an option from the drop down menu, if you wish. Some providers may only have one option in this menu. Procedure Code = the specific service procedure code assigned to the authorized service. You may select an option from the drop down menu, if you wish. Svc Modifier Cd = the applicable service modifier code that works with the procedure code from the previous dropdown. You may select an option from the drop down menu, if you wish. You may have no options in this menu, depending on what you selected in the Procedure Code dropdown. 4. The list of service authorizations returned (if any) are the authorizations that are in accepted status, meaning THEY ARE ACTIVE for you to work and to bill against. From this results list you can do two things: You can print a blank timesheet for each service authorization by clicking on the printer icon next to each service authorization. This blank timesheet can be used to manually keep track of your dates/time worked providing that service, if you wish. You can enter your SERVICE DELIVERED billing data for each service authorization by clicking the $ icon. This will take you to a new page to enter the dates and start/end times you provided that service to your customer-employer. Page 4 of 12

5 5. To print a BLANK timesheet for a specific service authorization, click on the printer icon on the far right side of that service authorization line. When you click the printer icon, a new window will open with a copy of the timesheet. It will be a pdf document. From that, you can print it out to complete by hand, and then sign to submit for payment. 6. To enter SERVICE DELIVERED billing data for a service authorization, click on the $ icon to the far right of that service line. PRO TIP: right-click on the $ icon to open in a new tab or window. This will allow you to easily return to your original search results list. Page 5 of 12

6 7. You will be taken to the Service Delivered by Service Authorization page to enter your SD billing data. There is an important message as part of this page that all providers should read! The service authorization(s) shown indicate the total hours authorized for an individual's service. If the individual you provide services for has multiple providers, check with the employer to determine how many hours you are authorized to provide before providing service. For providers who share authorized hours of service for an individual with other providers, it is not guaranteed that you are authorized to work and receive payment for 100% of the limit shown. Services Delivered (SD) time entries should only be for actual dates/times worked providing the authorized service, which may be less than the limit shown on the authorization. You can now add the dates and start/end times for when you worked to provide that service to your customer-employer. Click Save All after each entry to add a new row of blank fields for more SD billing entry lines. The data field will show with RED text if information is entered incorrectly. Corrected information will show as BLACK text. Page 6 of 12

7 8. The start/end time fields do not require the colon, spaces or the full AM or PM when keying in your time data. Users can simply enter the numeric time data and a or p without spaces, and the system will auto-format that entry to the correct time format needed. Examples: 8a will be auto-formatted to be 8:00 AM 917p will be auto-formatted to be 9:17 PM ** Time data entered without the p added will be auto-formatted as AM hours. 10 will be auto-formatted to be 10:00 AM Page 7 of 12

8 5. NEW DATA FORMAT FEATURES as of the Dec 2015 system update: For Hourly services: The system will now accept exact time entries, and will no longer autoround to the nearest quarter-hour. To support this exact time entry change: Billings with a 0 15 minute overlap with OTHER PROVIDER billings will be allowed to facilitate transition time between providers. Billings that overlap 16 minutes or more will continue to suspend as suspected duplicate services to the client. For Mileage: The system will now accept mileage entries to the one-tenth of a mile (00.0) and will no longer auto-round to the nearest quarter-mile. 9. For services delivered in a group of clients at the same time by the same provider: Providers should enter the SERVICE DELIVERED entries for each client, documenting the date and actual start/end time each client received the service. Then, check the group box next to the applicable SD entry if all or part of the time for that SD entry was provided in a group (along with other clients). In the claims aggregation cycle, the system will pro-rate the units billed and total cost for each client s entry submitted by the number of clients in the group. 10. With the SERVICE DELIVERED data entered and saved to draft status, providers have 2 options: Close the page; the entries in draft status will be saved and will be available for you to submit at a later time. Add a check to the left-hand box for the SD entries you wish to submit for payment, and then click the Submit button at the bottom. Page 8 of 12

9 Actions available: Submit = will submit the draft entries checked for payment processing. Delete = will delete a draft entry and remove it completely from the system. 11. Once the SD entries are submitted, the status should change for the SD entries, showing the results of the action. If the SD entries clear all processing edits, they will move to pending status (shown below) for the CDDP or Brokerage to review against your signed timesheet information. If when submitted, the SD billing entry moves to either suspended or denied status, providers can click the triangle next to the status to expand and view the reason. Page 9 of 12

10 12. IMPORTANT: Please remember that PSW and IC-PSW providers will need to also submit their signed timesheets/invoices to the CDDP or Brokerage for review. Providers can print this completed timesheet to include the SD data they have submitted and are in pending status, if they wish, or submit their data on another timesheet form that has been approved for use. 13. To print a completed timesheet ready for signatures and submission to the CDDP or Brokerage that includes the SD entries that have been submitted and are in pending status, click the Print button above the SD entry lines. IMPORTANT: please remember, the timesheet printing feature from this page will ONLY print the SD entries that are in pending status. 14. The completed timesheet, that includes the pending SD entry lines, will open in a new window. You can click the print button in this new window to print a hard copy of the completed timesheet for signatures and submission to the CDDP or Brokerage. Or you can export the timesheet to an electronic form format (such as PDF or Word) to save electronically. Page 10 of 12

11 IMPORTANT: Only SD entries that are in pending status will appear on this timesheet view. If you do not have SD entries in pending that section of the timesheet will be blank. 15. Users can now close the window/tab they were working in to enter the SD entries to return to the search results. From the original results list, select another client/service by clicking the $ icon next to another service authorization line, as needed. 16. Repeat steps #6 #14, create/submit/print timesheets for new SERVICE DELIVERED entries or Mileage entries for other clients/services. 17. SERVICE DELIVERED entries that have been submitted, reviewed and moved to approved status for claims/payment processing will be processed by the system in 2 scheduled cycles each month for the corresponding pay periods: Pay Period System claims processing Date 1 st 15 th of the month ~ the 23 rd /24 th of that month 16 th last day of the month ~ the 8 th /10 th of the following month Please refer to the payroll time tables released by ODDS for specific dates as to when SD data and timesheets must be submitted, and when paychecks can be expected to received for each processing cycle. Page 11 of 12

12 When the claims process is completed, the approved claims data will be sent to TNT Fiscal Intermediary by the system for processing and distribution of providers paychecks/payments. Page 12 of 12