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Provider Update: April 30, 2019

To:                   All ADvantage and State Plan Personal Care Providers

Subject:          Weekly Harmony Status Updates

The Medicaid Services Unit is 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

As always, if there are areas that could be included in this report that would support you in your service to our Members, please let us know.

Thank you.

Service Plan Processing
  • Oldest working date for MSU-ADvantage is 4/12/2019
    • Over the past three weeks, SPA has halved its turnaround time!
    • If there are any plans/plan revisions in a review status prior to this date, please advise via Provider Question (PQ).  Include identifying member information and plan number.
  • Oldest working date for MSU-SPPC is 4/24/2019
  • Forms Updates
    • Date of Visit on UCAT III
      • The Date of Assessment field has been removed from the UCAT III document as it is now an option on the document Header.  Removing this field from the UCAT III document prevents the user from having to enter the same information twice.
    • Monitoring/Progress Note Update
      • When the user selects a note type of Progress Notes, the following fields will no longer load as they do not apply to a Progress Note:
        • Location of Monitoring Visit
        • Status of PCA Service
        • Member has a copy of current Member Plan?
      • These fields will continue to load on the Monitoring Note.
  • The state of Oklahoma must come into compliance with section 12006 of the 21st Century Cures Act by implementing EVV for all home and community-based services (HCBS) waiver members.
  • ADvantage is well set for this implementation as all home care services (except self-direction) are currently required to use EVV for claims development and submission to OHCA.
  • The Oklahoma Health Care Authority (OHCA), our state Medicaid agency, has chosen to have an open model for EVV implementation.  This means that each state agency will use the EVV vendor(s) of their choice for their waivers.
    • ADvantage will continue to use First Data (Authenticare) for our non-self-directed members.
    • ADvantage will need to come into compliance by bringing EVV to the CD-PASS (self-directed) population.
      • ADvantage leadership has been working with OHCA, DHS Finance and Contracts personnel to establish the necessary relationships for implementation of EVV for CD-PASS.
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