Provider update: August 3, 2020
To: ADvantage Case Management Providers
Subject: Standard Naming Convention
Date: August 3, 2020
This document is provided to serve as a guide for Case Managers on how to properly label documentation within the Harmony system and will be updated as processes and/or requirements change (agencies will be notified at the time that any changes are made). Following this guide (steps provided) should prevent service conditions and authorization delays. This guide is a tool for Harmony users and, when followed, should result in timely authorization of services. The majority of the standardized notes below are Plan specific and will be entered under the Plans tab. Information not associated with a specific plan will be entered under the Notes tab.
Please utilize the following instructions on how to correctly attach documents to a Harmony Note:
Note: The example shown below is for adding the Service Team Release of Information form (STR).
| 1 | Look up Member in the Harmony system |
| 2 | Select the ‘Plans’ tab of the Member Record:  |
| 3 | Navigate to the appropriate Plan Year and click to open |
| 4 | Select ‘Plan Notes’ :
 |
| 5 | Hover over ‘File’ and select ‘Add Plan Note’ – complete as follows (see top of following page):
 |
| 6 | Select ‘Add Attachment’ – this will open something similar to image on the left depending on what type of Internet Browser is being used: |
| 7 | Update the Note Status field to ‘Complete’ once all document have been uploaded and all information has been entered as shown above. |
IMPORTANT:
- Only attach documents as PDF files. Use of other file types such at JPG, TIF or XLS can be difficult to review and can cause significant delays in review time.
- Please include the Plan Year in all Notes. Failure to include the Plan Year causes delays in the review process. See step 5 above regarding where the Plan Year should be added in the note.
- Please include the HCPC code in all Notes. Failure to include the HCPC causes delays when the reviewer cannot clearly identify what service code change the Case Manager is requesting (e.g. End S5170, Add S5100U1, Increase T1019, Decrease A4927 etc.).
The following table identifies the different types of Documents/Forms and Note Types/SubTypes are associated in Harmony:
| Reason for Document: | REQUIRED Document/Form: | Plan Note Type: | Plan Note SubType: | Standard Naming Convention: Minimum requirement to be added to Note section (see step 5 above for reference) | Standard Naming Convention: Use following format when naming attachments (see step 6 above for reference) |
| PLANS | |||||
| New and Reassessment | Signature Page | Documentation | Signature Page | Plan Year – Reassessment Plan Year – New Plan | Sign pg. – RA – Member initialsSign pg. – New – Member initials |
| | Service Team Release of Information (STR) | Documentation | Service Team Release of Information | Plan Year – ReassessmentPlan Year – New Plan | STR – RA – Member initialsSTR – New – Member initials |
| ADDENDUMS / CHANGE IN SERVICE | |||||
| Changing Home Delivered Meal (HDM) Provider | Signature Page | Documentation | Signature Page | Plan Year – Change in HDM Provider | Sign pg. – Change – Member initials |
| | Service Team Release of Information (STR) | | Service Team Release of Information | | STR – Change – Member initials |
| Changing Adult Day Health (ADH) Provider | Signature Page | Documentation | Signature Page | Plan Year – Change in ADH Provider | Sign pg. – Change – Member initials |
| | Service Team Release of Information (STR) | | Service Team Release of Information | | STR – Change – Member initials |
| Request to Add new ADvantage Service | Signature Page | Documentation | Signature Page | Plan Year – Add service (Plan 1 – Request to add S5170 to plan) | Sign pg. – Add HCPC – Member initials |
| | Service Team Release of Information (STR) | | Service Team Release of Information | | STR – Add HCPC – Member initials |
| Request to End an ADvantage Service | Signature Page | Documentation | Signature Page | Plan Year – End service (Plan 2 – Request to End S5170) | Sign pg. – End HCPC – Member initials |
| Adding ADvantage Hospice Service | Plan of Care | Documentation | Hospice Plan of Care | Plan Year – New Request | HPOC – New Request – Member initials |
| Change in existing service (increase) | Signature Page | Documentation | Signature Page | Plan Year – Increase (Plan 3 – Increase T1019 from 20wk to 40wk) | Sign pg. – Increase HCPC – Member initials |
| Change in existing service (decrease) | Signature Page | Documentation | Signature Page | Plan Year – Decrease(Plan 4 – Decrease T1019 from 36wk to 32wk) | Sign pg. – Decrease HCPC – Member initials |
| TRANSFER | |||||
| CM Transfer | Transfer of CM Agency | Transfer | CM Agency Transfer | Plan Year – CM Transfer | CM Transfer – Plan Year – Member initials |
| HC Transfer | Transfer of HC Agency | Transfer | HC Agency Transfer | Plan Year – HC Transfer | HC Transfer – Plan Year – Member initials |
| CD-PASS | | | | | |
| Transition andReassessment | Budget Worksheet | CD-PASS | CD-PASS Budget Worksheet | Plan Year – Transition or RA Budget | Budget – Transition or RA – Member initials |
| | Pay Rate | CD-PASS | CD-PASS Pay Rate form | Plan Year – Pay Rate form – Employee Name/s (may have more than 1 Pay Rate form attached to a single Note) | PR form – Transition or RA – Member initials |
| | Designation of Authorized Representative | CD-PASS | CD-PASS Designation of AR form | Plan Year – Transition/RA/Change to AR | AR form – Transition/AR – Member initials |
| ASSISTED LIVING | |||||
| New AL Request and Reassessments | AL Contract | Assisted Living | AL: Service Agreement | Plan Year – New AL Contract – Facility Name | AL Contract – New – Member initials |
| | | | | Plan Year – RA AL Contract – Facility Name | AL Contract – RA – Member initials |
| Re-Tier Request | AL Facility Re-Tier, AL Re-Tier, & Updated UCAT ADL's/IADL's | Assisted Living | AL: Retiering Request (auto submits to MSU) | Plan Year – Retier Request – Facility Name | Retier – Facility Name – Member initials |
| Reason for Document: | REQUIRED Document/Form: | Plan Note Type: | Plan Note Sub-Type: | Standard Naming Convention: Minimum requirement to be added to Note section (see step 5 above for reference) | Standard Naming Convention: Use following format when naming attachments (see step 6 above for reference) |
| DME | | ||||
| Incontinence Supplies denied by SoonerCare benefit | Physicians Order for Incontinence Supplies (HCA52A) | Documentation | Order for Incontinence Supplies | Plan Year – New Plan or Reassessment | Incont. Order- New / RA – Member initials |
| | DME Denial Notice | | Title TXIX DME Denial | Plan Year – Denied – Add HCPC / Change HCPC | Denial- Add / Change – Member initials |
| Bathroom Grab Bars | Request for Bathroom Grab Bars | Documentation | Request for Bathroom Grab Bars | Plan Year – New Request | Grab Bar- New Request – Member initials |
| Nutritional Supplement | Order for Nutritional Supplements | Documentation | Order for Nutritional Supplements | Plan Year – New RequestPlan Year – Change request | Nut. Order- New Request – Member initials |
| Disposable Gloves | Bids as appropriate | Documentation | DME/Environmental Mods/ Bid Sheets | Plan Year – New Request – Gloves >$10 | Bid – Gloves – Member initials |
| Environmental Modifications (EM) | As Requested by MSU | Documentation | EM Verification of Service Delivery | Plan Year – New Request – Verification of Service Delivery for EM | VOSD-EM Request – Member initials |
| Non-bathroom Grab Bars | Permission to Modify Property | Documentation | Permission to Modify Property | Plan Year – New Request | Modify Prop.- New Request – Member initials |
| AUDIT | |||||
| New Plan orReassessment | Provider agency 'legals' | Orientation | Orientation Signature Page | Plan Year – Agency orientation documents (attach/upload all agency documents) | Orientation Docs – New or RA – Member initials |
| Reason for Document: | REQUIRED Document/Form: | Note Type: | Note Sub-Type: | Standard Naming Convention: Minimum requirement to be added to Note section (see step 5 above for reference) | Standard Naming Convention: Use following format when naming attachments (see step 6 above for reference) |
| additionals, which are to be added under the Notes tab | |||||
| Power of Attorney /Legal Guardian | POA / Legal Guardian | Documentation | Power of Attorney/ Legal Guardian paperwork | POA / LG = Name/s of all parties listed on document | POA – Member initials ORLG – Member initials Note: Update 'Relations' tab |
| Advance Directive | Advance Directive | Documentation | Advance Directive | AD = Name/s of all parties listed on document | AD – Member initials Note: Update 'Relations' tab |
| Do Not Resuscitate | Do Not Resuscitate | Documentation | DNR | Do Not Resuscitate (DNR) | DNR – Member initials |
| Negotiated Risk | Member Negotiated Risk Agreement | Documentation | Member Negotiated Risk Agreement | Plan Year – Negotiated Risk | Neg. Risk – Member initials |
| Safety Agreement | Service Provider Safety Agreement | Documentation | Service Provider Safety Agreement | Plan Year – Provider Safety Agreement | Safety Agreement – Member initials |
| Eligible Provider Exception Request | Eligible Provider Exception Request | Eligible Provider Exception Request (Auto submits) | EPE Annual RequestEPE Initial Request | EPE Request | EPE form – Member initials |
| Withdrawal Request | Voluntary Withdrawal Request | Service Termination (auto submits to MSU) | Select Withdrawal as reason for Service Termination | Withdrawal Request Attached | Withdrawal – Member Initials |
| Physician Validation of Member Diagnosis Codes | Request for Physician Validation of Member Diagnosis Codes | Documentation | Request for Physician Validation of Member DX Codes | DX Validation | DX Validation – Member initials |
