Provider Update: August 10, 2016
URGENT PROVIDER COMMUNICATION:
MSU is pleased to announce that our Application for a §1915(c) Home and Community-
Based Services Waiver was approved. The use of the Electronic Visit Verification (EVV) system has been in state policy for more than 5 years. The ADvantage Waiver effective July 1, 2016, includes performance measure requirements, specifically; we must now ensure that all providers are using the EVV system for financial management and recordkeeping.
We are required to achieve 100% on all performance measures in order to stay in compliance with our federal partners. You are receiving this 'Special Edition" bulletin, because First Data has advised that your agency does not appear to be using the EVV system, (as of August 8, no claims have been created), and therefore, MSU is unable to ensure waiver compliance.
You must immediately begin to utilize the AuthentiCare EVV system for financial management no later than August 17, 2016, or your agency will be removed from the Certified Agency Report. Failure to demonstrate that your agency is utilizing the system by this date will result in MSU sending you a certified letter advising that you have been removed from the Certified Agency Report for 90 days, pending full compliance with this requirement.
If there is an appropriate reason for failing to utilize the EVV system it is imperative that someone from your agency with decision making authority respond immediately to firstname.lastname@example.org. Please include a plan detailing steps that will be taken to complete the onboarding process and what date you will fully engage the system.
- 835 remittance files are now to be received by the provider and uploaded into the EVV system as of 7/1/2016 as a mandatory waiver requirement for all Case Management and Home Care Providers, both serving ADvantage and State Plan Personal Care Members.
- If your Provider Agency is not receiving electronic 835s, you must apply with the Oklahoma Health Care Authority (OHCA) to receive electronic remittance advice (RA) as soon as possible. The completion of an EDI application must occur prior to receiving RA in this format. Please contact your area OHCA representative, should you need assistance in applying to receive the 835 file. Begin uploading 835 remittances into the AuthentiCare system as soon as possible.
- Mandatory Case Management Scheduling will begin 9/1/2016. Please make certain your Case Management is scheduled in the AuthentiCare System. We understand that requirement is a great concern to Providers, and we want reporting for our program to maintain its data integrity. Provider cooperation with this mandatory requirement is necessary for data accuracy.
- All correspondence containing Member PHI must be sent via secure emails. (Member I.D. name/I.D. numbers) The First Data SmarterMail address, it is email@example.com.
Please contact us with any questions/concerns at