Member Call Center. Network Providers Training on New Enrollment & Slot Scheduler

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1 Network Providers Training on New Enrollment & Slot Scheduler, (MCC) will no longer approve enrollments prior to making a referral to our Network Providers. MCC will begin to utilize the hand over to provider function for new member enrollments. This will ensure that the providers are able to access the member s screening and triage information as it relates to the referral. Frequently Asked Questions Can I change any non-clinical information in the Enrollment once it is handed off from MCC? Will a provider be able to view the member s New Enrollment within the Alpha system? Will the provider continue to receive existing Enrollment PDF files via from MCC? Can both a provider and MCC manage / drive the Scheduler at the same time? Any information that MCC staff enters into the enrollment should NOT be changed or altered. Yes. Once the MCC selects the hand over to provider option, the provider will be able to view the Enrollment, including triage & presenting problem information. No No; the Scheduler will be managed by one or the other [depending on provider s open access status].

2 How does a provider create appointments on their Scheduler? Go to Provider Scheduler Select the Site Select Get Site Schedule Select date/time double click Complete required fields Save *providers can create appointment recurrences How does a provider drive their Scheduler when they are a walk-in crisis center and manage appointments? How does a Crisis Walk-in Center manage their Scheduler when they do NOT manage appointments? How should a Mobile Crisis provider manage their Scheduler? Please refer to Network Operations webinar training titled Eastpointe Alpha Scheduler Training The provider will need to create an appointment titled Walk-in in the subject line. This appointment episode can have multiple slots. This will allow MCC staff to connect members to a provider as a walk-in. The Crisis Walk-in Center should be in open access status so that MCC staff can drive the Scheduler and connect members. The provider will need to create an appointment titled Mobile Crisis in the subject line. This appointment episode can have multiple slots. This will allow MCC staff to connect members to the Mobile Crisis provider. OR The Mobile Crisis provider can be in open access status so that MCC staff can drive the Scheduler and connect members.

3 How does a Walk-in Clinic or Mobile Crisis provider become open access status? Does a provider put internal appointments on the Scheduler? Can a provider delete an appointment from the Scheduler? What happens if a provider schedules an appointment internally and needs to remove the appointment from the Scheduler? What happens when MCC staff schedules an appointment on the Scheduler that is not a true appointment? What does the provider need to do if MCC calls the provider to obtain an appointment? Please contact Network Operations at No. The Scheduler is only for MCC to utilize in the referral process. If it is an open/available appointment, YES. If a member is already scheduled in the appointment slot, NO. The system will not permit this action. If the appointment is still available within the Scheduler, the provider needs to delete the appointment slot to prevent double-booking of the appointment. If an appointment already exists within the Scheduler, the provider should not schedule internally. The MCC cannot manage a provider s Scheduler if they are not identified as open access status. Therefore, if MCC schedules an appointment on the Scheduler, that means that the provider created the appointment for MCC staff to utilize. The error is not on the side of MCC. The provider needs to create the verbal appointment on the Scheduler in order for MCC to connect the member. The subject line needs to reflect that the appointment slot is already filled [ex. Appt. Taken ]

4 Does a provider need to add members to the Scheduler if the member accesses the agency directly (meaning NO MCC referral)? When does the follow-up need to be completed? Where will providers find the member s triage level? Do providers need to add existing members on the Scheduler in order to report appointment follow-up information? No again, the Scheduler is only for MCC use to make referrals to providers. Depends on the triage level: Routine within 24-hours of the appointment Urgent by the end of the business day of the appointment New Enrollments: Triage level is identified as the Need Severity Existing Members: Triage level will be found within the Presenting Problem and entered within the Notes section in the Scheduler. NO appointment follow-up information is only needed for initial access to care referrals. Providers do not need to report follow-up information on concurrent appointments. Why are we receiving referrals from members that do not have any insurance? After 6/8/15, enrollments will or will not be approved? FAQ from Webinars June 3-4, 2015 Remember: if member reschedules initial appt., this follow-up information is needed. If MCC staff schedules an IPRS member in a Medicaid appt slot, please contact MCC so the member can be rescheduled appropriately. For appt follow-up status, please select Referral Not Accepted MCC staff will NO longer approve new enrollments. Once it is handed over to the provider, the provider will complete the enrollment & submit to Medical Records; this dept. will review for approval.

5 How do you prove income for Medicaid recipients? I thought DSS does that? Are we to ask for check stubs, etc. for Medicaid members to verify income? There are no changes if the member comes to use directly, correct? Is new member enrollment only for IPRS patients or Medicaid patients as well? For the appointments that were in the old system, how do we let Call Center know if they showed or no showed? What do we do if the Call Center schedules an appointment and we have a conflict with an already scheduled appointment? How do you know when to do a client update or the enrollment? What will we be using in place of the STR? DSS is responsible to gathering income information as it relates to Medicaid eligibility. This is different than the income question on the New Enrollment. Per Medical Records, We want as accurate information as possible but we have taken the members word. Therefore, you can enter the verbal income information given to you, or ask for proof via check stubs. This will be determined on your agency s protocol. Correct. If member accesses a provider directly, MCC does not need to be involved in the enrollment process. The provider will continue to be responsible to completing the New Enrollment and submitting to Medical Records for review. New Enrollment process should be completed for IPRS and Medicaid members. You can call MCC with this follow-up information. The MCC cannot manage a provider s Scheduler if they are not identified as open access status. Therefore, if MCC schedules an appointment on the Scheduler, that means that the provider created the appointment for MCC staff to utilize. The error is not on the side of MCC. Please see response to FAQ, What happens if a provider schedules an appointment internally and needs to remove the appointment from the Scheduler? Please refer question to Network Operations and/or Medical Records. MCC will document STR information within the New Enrollment and/or Alpha Call Base. Please see response to FAQ, Where will providers find the member s triage level?

6 For walk-in crisis, how will we report back who has come in for services? Can Call Center see the description section of the scheduler? When you give providers the rights for member enrollment, will we be able to make our own changes without going through client update? What is the best way to search if the member has an enrollment in Alpha? How do we select Medicaid and state funding for one appointment; it only allows us to pick one or the other? In the past with ProviderConnect, we were able to add appointment slots for JJSAMHP referrals, how we will be able to do this now with the Scheduler? Via the Scheduler Yes No information completed by MCC on a New Enrollment should be changed, edited, or altered. For New Enrollments, the enrollment ID number should be available on the Slot Scheduler. It should be part of the information that Alpha filters in from the referral process. You can also search using the member s name, DOB, and/or SSN. For old enrollments, providers cannot access this information in Alpha. You can select all funding and notate Medicaid & IPRS only in the description. List JJSAMHP in the subject line. If you have any additional questions, please contact Network Operations at