Washington State Medicaid EHR Incentive Program (emipp)

Washington State Medicaid EHR Incentive Program (emipp) Eligible Professional (EP) Training Guide for Meaningful Use July 15, 2013

Table of Contents 1 Purpose and Scope 2 1.1 Purpose.. 2 1.2 Scope... 2 1.3 Approach.. 2 2 Eligible Professional Enrollment Year 2 Meaningful Use. 2 2.1 Getting Started.... 2 2.2 Enrollment Year 2 for Meaningful Use. 2 2.2.1 ProviderOne Portal Login. 3 2.2.2 Provider Profile Verification.. 4 2.2.3 EHR Incentive at Links Drop-Down....5 2.2.4 emipp Application...6 2.2.5 CMS Registration ID......7 2.2.6 Federal Information...8 2.2.7 Federal Information Validation..9 2.2.8 Eligibility... 10 2.2.9 Edit Eligibility Information.....11 2.2.9a Tool Tip.... 12 3 Meaningful Use......13 3.1 Meaningful Use Overview......14 3.2 Meaningful Use Core Set.....15 3.3 Completing Objective, Measure, Exclusions...... 16 3.4 Meaningful Use Menu Set...... 17 3.5 Meaningful Use Clinical Core Quality Set..... 18 3.6 Meaningful Use Clinical Menu Quality Set......19 3.7 MU-Overview Validation..... 20 4 Upload Document.....21-22 5 Attestation....... 23 5.1 Attestation Validation.... 24 5.2 Registration Confirmation...... 25 Glossary of Terms..... 26-27 Helpful Hints.....28-29 1

1 Purpose and Scope 1.1 Purpose The purpose of this document is to present Washington-specific training materials for the Washington Medicaid EHR Incentive Program (emipp). 1.2 Scope This training material applies to Eligible Professionals (EPs) during emipp enrollment for Meaningful Use (MU). 1.3 Approach This training material presents and describes the majority of screenshots that an EP might encounter during emipp enrollment for MU. 2 Eligible Professional Enrollment for Meaningful Use This document presents the training screenshots for the Eligible Professional (EP) during enrollment for Meaningful Use (MU) using the emipp Provider Portal. The reader should already be familiar with the procedures and screenshots presented in the earlier document for EPs, Year 1, Adopt, Implement, Upgrade (AIU). 2.1 Getting Started When the EP launches the emipp Provider Portal and is preparing to commence Meaningful Use enrollment, the getting started Log-In procedure is exactly as presented in the earlier EP AIU training materials. The EP launches the emipp Provider Portal and lands on the Log-In page. The EP has previously registered in Year 1(if registered for AIU, provider is not required to apply for AIU and may go straight to MU), and is not required to re-register, and is able to immediately commence Meaningful Use enrollment, when the notification to proceed had been received by the contact person. 2.2 Enrollment for Meaningful Use The following sections will present the screenshots the provider will see when progressing through the various emipp Provider Portal sections and functions for Meaningful Use. This document will present the enrollment process only. Note that the provider will receive an error if they attempt to enroll for Meaningful Use and they are not 90 days or more past the start of the program Year. Similarly, the provider will receive an error if they attempt to enroll for MU Year 2 and beyond, if they are not 365 days or more past the start of the program Year. 2

2.2.1 Login The EP has just launched the ProviderOne Provider Portal and enters the Domain, User ID and Password and clicks Login and lands on the Provider Portal Home page. Fig 2.2.1 3

2.2.2 Provider selects EXT Ext Provider EHR Administrator profile Fig 2.2.2 4

2.2.3 Provider chooses EHR Incentive Payment Program from the Links drop-down in the top right corner of the Provider Portal Page. Fig 2.2.3 5

2.2.4 The EP has just launched the emipp Provider Portal Application and chooses Start from the emipp Welcome Page. Fig 2.2.4 6

2.2.5 EP enters the CMS Registration ID & clicks Search. Fig 2.2.5 7

2.2.6 The EP has logged in successfully and has landed on the Home page Federal Information Tab. The following screenshot is an example, showing that the provider was paid for enrollment Year 1 and is ready to enroll in Year 2 MU. The EP can start enrollment by clicking Payment Year 2 Icon. Fig 2.2.6 8

2.2.7 The EP validates the Federal Information. If the information is incorrect, EP will need to contact or return to CMS. The EP clicks Close. Fig 2.2.7 9

2.2.8 The EP lands on the Eligibility Tab and again clicks the Payment Year 2 Icon Fig 2.2.8 10

2.2.9 Provider lands on the Eligibility Information page and enters the Reporting periord Start Date. emipp will auto fill the End date. The EP will fill out the Patient Volume information using either the Yes/No toggle buttons or entering the information in the boxes. Fig 2.2.9 11

2.2.9 a Tool Tip: At anytime the EP can hover over the (?) tool tip for additional information concerning the information required. EP completes the information and clicks Save. Fig 2.2.9 12

3 Meaningful Use EP lands on Meaningful Use Tab 3. EP clicks on Payment Year 2 Icon and is taken to the MU-Overview Screen. Fig 3.0 13

3.1 Meaningful Use Overview. EP enters the reporting period Start date and End date will automatically populate. This is a typical 90 day period in the current calendar Year. EP chooses either Online or PDF submission. If EP chooses PDF, they click on the Download template Icon. Complete the PDF and then upload the PDF where it states Upload Template below. If the EP chooses to complete the MU infromation online, EP chooses Online and clicks MU-Core Set tab at the top of the screen. Fig 3.1 14

3.2 EP is brought to the emipp MU-Core Set tab. EP will click on each objective entering the required information. You will note a green check mark will appear when the objective has been completed and a red exclamation point will show that the objection has yet to be completed. EP s are required to attest to all MU Core Measures. Review and verify each MU Core Measure. Fig 3.2 15

3.3 When clicking on the individual objectives emipp will give the objective, measure & exlcusion information, along with tool tips explaining Exlusion requriments and Compliance. EP can scroll down emipp MU CORE SET screen completing required MU information and then click Save. Fig 3.3 16

3.4 Continue to MU-Menu Set where EP must complete 5 out of the 10 measures listed. At least 1 of these must be a public health measure, which are noted with an asterisk. Fig 3.4 17

3.5 Continue on to 4 th tab at top of screen called MU-Clinical Core Quality Set. Complete the first three measures. If you do not have any observations, enter 0 in the denominator. If the denominator on any of the first three measures is zero (0), you must continue with measures #4-6 until you have a total of three measures without zero (0) denominators OR you have completed all six measures. Fig 3.5 18

3.6 EP will continue to last tab MU-Clinical Menu Quality Set. At least 3 measures must be completed. A measure is compliant even if you have no patients or enter zero (0). Fig 3.6 19

3.7 EP reviews that the Meaningful Use information has been completed by clicking the MU-Overview tab at top of screen. If the Meaningful Use Reporting Completion Checklist has all measures checked, EP will click Save. Fig 3.7 20

4 Upload Document EP clicks on Upload Document Tab, EP clicks on Upload icon for corresponding Year and uploads the MU supplemental questionaire & any other documentation that is required by browsing for file, entering file description and clicking Upload. Fig 4.0 21

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5 Attestation EP then clicks on the Attestation Tab, reads the notice and chooses to accept the terms and conditions. Provider can print out Attestation by clicking the print icon on the bottom right hand side of screen and then clicks Register. Please have the provider sign it and keep it in your records in case it is requested. NOTE: Attested infromation is subject to audit against Medicaid claims and encounter data as documented in the State MMIS System. If a discrepancy between MMIS Medicaid Claims and Encounter data and your attested data exists, you will be subject to audit. Supporting documentation will be requested to support the attested volume levels. Fig 5.0 23

5.1 emipp validates registration submission to state. EP clicks Ok. 24

5.2 emipp returns EHR Incentive Registration Confirmation. Fig 5.2 25

Glossary AIU DOCUMENTATION: Documents showing a business connection with your EHR system. Documents might include an invoice, proof of payment or signed contract. We request 2 of the 3. It is helpful to upload a copy of your ONC Certification as well. If your system has not changed from the first payment Year, we may not need more documents. We will contact you if more information is needed. If you are attesting for a group and don t want to upload AIU documents in each application. You may use the Documentation Fax Coversheet with the ORGANIZATION or PAYEE NPI. If you are submitting information for the individual applicant, please Upload the document. CHARITY CARE IN FQHC/RHC: Per CMS, Charity Care is defined as part of uncompensated and indigent care. Uncompensated care does not include courtesy allowances or discounts given to patients. [CMS Final Rule, p.144]. Charity care is defined as an inability of a patient to pay for medical care. In comparison, bad debt is an unwillingness of a patient to pay for medical care. FQHC/RHC: Federally Qualified Healthcare Center/ Rural Healthcare Clinic NEEDY PATIENT VOLUME: When a FQHC/RHC must include encounters from Charity, Sliding Fee and CHIP to reach the 30% patient volume. NO COST ENCOUNTERS: Encounters that were not paid (denied or zero-pay) for active Medicaid clients. Denials for no Medicaid Eligibility are not to be included. It is optional to use these encounters. ONC NUMBER/CERTIFICATION: A list of certified EHR systems is available through the Office of the National Coordinator for Health Information Technology at: http://oncchpl.force.com/ehrcert ORGANIZATION NPI: A valid NPI you use in the Eligibility Tab in order to use Group Proxy. PA-LEAD CLINIC: To be eligible for WA State Medicaid EHR Incentive Program Physician Assistants (PAs) need to have at least 50% of encounters over 6-month period in the prior calendar Years in FQHC/RHC setting. Also, PAs should provide verification of either working in PA-led setting or be the Primary Provider (or RHC owner). WA State will accept a signed and dated letter from clinic s Medical Director for the purposes of verification of PA-lead requirement. PEDIATRICIAN DEFINITION: Washington state defines a pediatrician as: A pediatrician is an MD, ARNP, or PA (IF they practice in a FQHC or RHC that is led by a PA) who is either (1) board certified in pediatrics, (2) completed a pediatric residency, or (3) maintained a 26

predominantly pediatric caseload in the 90-day period specified by the EP for purposes of calculating patient volume. This definition includes pediatric specialties like pediatric ophthalmology and pediatric cardiology. PRACTICE PREDOMINANTLY (IN FQHC/RHC): Over a 6-month period, in the previous calendar Year or the previous 12 months. The EP practiced more than 50% of the time in any FQHC/RHC. REPORTING PERIODS: Eligibility Tab: A 90-day period in either the precious calendar Year or the previous 12-months Meaningful Use Tab: For Stage 1, Year 1 and ALL attestations in 2014 (regardless of stage), a 90-day period in the current calendar Year. For all subsequent Stages beyond 2014, use 365 days. UNIQUE PATIENT (Meaningful Use Tab): If a patient is seen by an Eligible Professional more than once during the EHR reporting period, then for purposes of measurment that patient is only counted once in the denominator for the measure. All the measures relying on the term unique patient relate to what is contained in the patients medical record. Not all of this informaiton will need to be updated or even be needed by the provider at every patient encounter. This is especially true for patients whose ecnounter frequency is such that they would see the same provider multiple times in the same EHR reporting period. If you are practicing at multiple locaitons, please verify that unique patients are only counted once. 27

Helpful Hints ENROLLMENT YEARS (STAGES): AIU (not considered a stage, since it can be skipped and is only through Medicaid). STAGE 1 is comprised of 2 Years (STAGE 1, YEAR 1 AND STAGE 1, YEAR 2) STAGE 2 does not start with Washington Medicaid until 2014. You must have 90-days of MU data in 2014 before you can attest. WHEN TO APPLY FOR THE NEXT PAYMENT YEAR: CMS drives the timing. When they determine it is time for you to apply for the next Year they send an interface to us that updates your status in emipp. We then generate an email to the contact on the application letting them know it is time to apply. One more reason to keep your contact information updated at CMS. 90-DAY ATTESTATION DEADLINE: You have 90 days from the receipt of the letter to attest for WA State Medicaid EHR Incentive Program in state EHR Module (emipp). If you are beyond that 90-days, go back to your CMS Registration, make any necessary changes and re-submit. This will start the 90-days over. Wait at least 24 hours before you attest in emipp. LOG ON ISSUES (Password/User ID/Missing Profile): Contact Security at: provideronesecurity@hca.wa.gov ERROR CODES IN EMIPP: If you are getting odd errors or no response when you enter the Registration ID, use the compatability mode: http://windows.microsoft.com/en-us/windows7/how-to-use-compatibility- View-in-Internet-Explorer-9. If it does not fix the issue, let us know. Also, make sure you are using a PC (not a MAC) and Explorer (not another browser). Make sure your POP-UP BLOCKERS are OFF. TRACK v. START: After you enter the Registration number, click on the orange START button. The TRACK button is only for checking status. FEDERAL INFORMATION TAB: Information comes from CMS, so changes/updates have to be made there. Make sure the contact information is current/correct. This is who we contact if there are questions and who the automated emails go to. The Payee NPI and Tax ID. The tax liability goes to the Payee NPI and cannot be changed once payment has been issued. ENROLLMENT TAB: Eligibility dates can be in the previous calendar Year or the previous 12-months. If you use an Organization NPI and are using Group Proxy, that entire group must attest the same way. If you apply as individuals, that entire group must apply in that same way. You may create different group in your organization by location, specialty; etc, as long as it is a logical group. MEANINGFUL USE TAB: Please watch the exclusions, there are different instructions for some of them. Some you will enter a 0 in the denominator others you answer YES/NO. 28

MENTAL HEALTH CLINIC THAT ONLY BILLS THROUGHT THE RSN: Medicaid will accept a letter from the clinic, on letter-head, that confirms that the EP bills their encounters to the RSN. CLAIMS BILLED THROUGH ANOTHER S NPI: To be eligible for WA State Medicaid EHR Incentive program, an EP s Medicaid claim(s) have to be verifiable through the ProviderOne system (except for RSN and Take Charge only providers). If you do not bill WA State Medicaid with you own NPI or not enrolled in ProviderOne as a provider, please contact Provider Enrollment Services at: http://hrsa.dshs.wa.gov/providerenroll/enroll.shtml#provider Phone: 1-800-562-3022 (Ext. 16137) CMS CONTACTS: CMS EHR CONTACT: 1-888-734-6433 (Option 1) CMS SECURITY CONTACT: 1-866-484-8049 (Option 3) 29