2013 Medicaid Highlights HP Enterprise Services



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Transcription:

2013 Medicaid Highlights HP Enterprise Services 2013 Hewlett-Packard Development Company, L.P. The 1information contained herein is subject to change without notice 2013 Annual Medicaid Conference

HP Enterprise Services (HPES) HPES is the Fiscal Agent for the Fee For Service (FFS) portion of the Nevada Medicaid Program Claims Processing Provider Call Center Prior Authorizations Provider Enrollment Third Party Liability (TPL) Pharmacy Provider Services (Provider Services Field Reps/Training) Electronic Data Interchange HPES follows the Policies and Guidelines of the Nevada Medicaid Program 2

Total Enrolled Providers Nevada Medicaid has 22,192 enrolled providers, as of 10/01/2013. This includes: In State providers, Out of State providers, Fee For Service. 3

Total Claims Paid Find quarterly claims payment information in the Nevada Medicaid and Nevada Check Up Quarterly Newsletter, located at www.medicaid.nv.gov, on the homepage or from the Providers tab, select Announcements/Newsletters. January 2013 through October 11, 2013, total claims payment made: $1,438,605,424.32 4

New Claim Forms New Professional and Dental claim forms are being released. Be sure to visit www.medicaid.nv.gov to check for Web Announcements concerning the new claim forms. 5

Web Portal Enhancements Provider Web Portal Upgrade Completed (Web Announcement 613) Enhancement to Online Prior Authorization Search Using Service Date (Web Announcement 566) Enhancements to Online Prior Authorization Search Options (Web Announcement 556) 6

Provider Services Field Representatives 7

Provider Services Field Representatives The HPES training team has heard from many providers that having dedicated representatives to assist you one-on-one with your Nevada Medicaid issues would decrease the amount of time you spend on research and improve the overall experience. As a result, HPES is pleased to inform you about the Provider Services Field Representative Team. 8

2013 Provider Training 935 providers registered for 45 provider workshops and we provided more than 1000 hours of training year to date. Workshops were held onsite in Reno, in Las Vegas at the Grant Sawyer Building and using our virtual rooms. Topics included: New Provider Training; Prior Authorization Submission; Claim forms; and Allscripts-Payerpath 9

November/December Provider Training Virtual Room (Access details will be returned to you in an email 3 days prior to the session) Date Time Topic November 6 10:00 to 11:30 a.m. Introduction to Becoming a Nevada Medicaid Provider and Using the Medicaid Services Manual November 12 1:00 to 2:30 p.m. November 21 9:00 to 10:30 a.m. December 10 1:00 to 2:00 p.m. December 12 10:00 to 11:00 a.m. New Provider Training Claims Appeals and Special Batching ICD-10 Overview ICD-10 Overview 10 Please review the dates, times and topics and register by using the 2013 Provider Training Registration Form (FA-41). For questions, contact the HPES Training Department at NevadaProviderTraining@hp.com or (877) 638 3472, option 2, then option 0, then option 4.

Provider Services Field Representatives These representatives are available to you assist you with a wide variety of areas and topics including: Claim inquiries Submitting a claim for special handling Submitting a claim appeal Correct completion of claim forms Submitting claims electronically via Allscripts- Payerpath Provider enrollment and re-enrollment 11

Provider Services Field Representatives Training on self-service tools: Use of the automated Audio Response System (ARS) Navigation of the Provider Web Portal (PWP) Use of the Electronic Verification System (EVS) for Eligibility and Prior Authorization submission Representatives are not able to assist with coding claims or clinical information. 12

Contact Us Providers may contact their assigned field representative by telephone or email (NevadaProviderTraining@hp.com) with inquiries. On-site visits at your Nevada professional place of business, and virtual room sessions can also be scheduled by contacting your field representative. Requests for on-site visits must be made at least two weeks in advance. Please allow a minimum of 48 hours for telephone calls and emails to be returned. In addition, the Customer Service Center and scheduled training courses remain available to you and your staff members. 13

Provider Services Field Representative Team Provider Services Manager Jennifer Shaffer Office: (775) 335-8585 Cell: (775) 313-2811 Northern Nevada Kim Teixeira Cell: (775) 323-9667 Shanna Lira Cell: (775) 343-9929 Nedra Daugherty Cell: (775) 233-1226 14

Provider Services Field Representative Team Provider Services Manager Jennifer Shaffer Office: (775) 335-8585 Cell: (775) 313-2811 Southern Nevada Tiffany Hart Cell: (702) 266-6923 Jassamine Haughton Cell: (702) 274-6616 Hasani Jackson-Carroll Cell: (702) 239-4933 15

Questions? 16

Thank you for your attention 17