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Provider Update: March 1, 2019

To:                  All ADvantage and State Plan Personal Care Providers

Subject: Weekly Harmony Status Updates

The Medicaid Services Unit will begin sending out weekly updates on the status of key areas of interest to providers working in the Harmony system.  Our hope is that this information will:

  • Educate providers on the status of requests/service plans submitted to the Medicaid Services Unit (ADvantage and State Plan Personal Care programs)
  • Allow providers to communicate with and better serve program Members
  • Prevent avoidable service disruptions
  • Provide transparency in the assimilation of Harmony as the fully-functioning waiver management information system for both ADvantage and SPPC

Please let us know if there are areas that could be included in this report that would support you in your service to our program Members.

Thank you.

(continued next 3 pages)

Medicaid Services Unit - Serving 18,699 ADvantage and SPPC Members week of 2/22/2019 through the efforts of approximately 1,800 Harmony users
​Priority Level ​Area ​Item Current Status Comments
​High ​System Clean-up ​Correcting rate increase service unit adjustments (spreadsheet process)
  • ​Two (2) temp employees began processing Unit Adjustment spreadsheets on 2/20/2019
  • 24 spreadsheets have been completed to date by either internal or temp staff
  • Six (6) spreadsheets are currently being processed
  • A total of 33 spreadsheets remain to be processed
  • Temps have been assigned the largest of our spreadsheets with thousands of members.
  • Agencies will be informed when their spreadsheet adjustments are completed.​
​High ​Develop Reporting Capabilities ​My Work Report
--Report to allow system users to see key information related to Member service plan and monitoring dates
  • ​Awaiting testing and final approval
  • Planned production date is March 5, 2019
  • Report was demoed in Lunch and Learn on 2/27/2019
​Testing is in progress for this report.
​High ​Develop Reporting Capabilities ​Services Not-Authorized Report
--Report to allow system users to easily identify services that have not been authorized
  • ​Awaiting testing and final approval
  • Ongoing meetings with Vendor for continueing reviews.
  • Production date has not yet been established
​Testing is in progress for this report.
​High ​Develop Reporting Capabilities ​Monitoring/Progress Notes Report
  • ​Deployed
​Training was completed on 2/13/2019

Lunch and learn trainings can be found at http://www.okdhs.org/services/aging
/Pages/lunchlearn.aspx
​High ​Achieve Timelines for MSU-AA Key Areas ​Service Plan Authorization -- ADvantage
  • ​Oldest working date is 1/28/2019
    If awaiting authorization for services set to a Review
    status (SPA, Clinical, etc.) prior to the oldest working date, please check the Member's plan status and:
  • Ensure it was set to some type of Review - if not, set to SPA Review immediately.
  • If the plan is in a Review status with a date prior to our oldest working date, send a PQ to advise and include the date the plan was set at the Review status.
  • ​SPA is receiving on average approximately 225 new ticklers per day for service authorizations
Turnaround times are currently being impacted by four (4) data conversions (closings, branch changes, etc.) that are in
progress.  Each of these requires a service plan amendment for every member in that agency/branch.
​High ​Achieve Timelines for MSU-AA Key Areas ​Service Plan Authorization – State Plan Personal Care (SPPC)
  • ​Oldest working date is 2/19/2019
​SPPC continues to process the changeover of authorizations from calendar year 2018 to 2019.
​High ​Achieve Timelines for MSU-AA Key Areas ​Provider Question ​State Plan Personal Care (SPPC)
  • 100 outstanding PQs, with oldest working
    date 12/20/2019
    ADvantage
  • 300 PQs are assigned to MSU-AA Managers for review and completion
  • Filter changes have changed oldest date to 12/19/2018
​High ​Achieve Timelines for
MSU-AA Key Areas
​Resource Center (returning calls)
  • ​Oldest working date is 2/8/2019
    • There are 182 pending application requests
    • There are 149 requests for information
  • A receptionist/switchboard position was recently filled in the ADvantage Resource Center, so calls should now be answered in real time with minimal exceptions.
​Outside assistance has been obtained from other areas of the
MSU to support Resource Center staff in returning client calls.
Calls are now being answered in real time unless exceptional circumstances are encountered.
​Moderate ​Develop Remaining Program Area Capabilities ​Provider Relations
--Certified Agency Report (CAR) move to Harmony
​The Certified Agency Report will continue to be managed on the ADvantage.ok.gov website until the transition can be made to the Harmony system.
​Moderate ​Provider Engagement ​Initiate bi-annual Provider Meetings
  • ​A Medicaid Services Unit (MSU) Provider Meeting is planned for April 2019
  • A bulletin with the proposed date/time will be sent out a few weeks prior to the event.
​Moderate ​Develop Remaining Program Area Capabilities ​Operationalize audit functionality in the Harmony system
  • ​In progress
​A methodology has been created by MSU Informatics for pulling a random sample from the Harmony system for each provider, as applicable by service type.
​Moderate ​Develop Remaining Program Area Capabilities ​Initiate individual provider trainings by provider type
  • ​Trainings began this week (2/19/2019) for individual case management providers
  • Training is intended to provide focused training to each provider on the issues that are important to/problematic for them
​Case management providers are encouraged to have as many case managers as possible attend this training.Any agencies that have not yet signed up should do so as quickly as possible.
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