Provider Update: October 12, 2018

Authorization Issues

 
Transitioning to the Harmony waiver management system has presented challenges to both our MSU-AA team as well as our Providers. We are very proud of our Service Plan Authorization (SPA) team as well as our Providers who are successfully overcoming obstacles and demonstrating improvement each day. The SPA team has made incremental increases to their processing time since Harmony implementation, and is currentlyprocessing October 4th. Provider submissions have increased to approximately 200 per day which is consistent with the previous mail submissions.

MSU-AA recognizes there are issues resulting in services not being authorized and we have made resolution of these issues a priority. Overall we have undertaken an extensive step toward restructuring our methods of internal processing for both Clinical Review and SPA with an anticipated outcome of accelerating the authorization process.

Secondly, in an attempt to ease the burden of current issues, we have developed a means by which Adult Day Health, Hospice, Meals, T1002, T1019 and T1001 will be included as part of the rate recycle. Providers will no longer have to request MSU-AA to convert the lines as previously communicated in the bulletin titled "Harmony Rate Conversion", dated 09/21/2018. OHCA has not determined an exact date of this recycle, but we will advise as soon as we learn the date.

We understand the scope and impact of service authorization delays on our provider network and appreciate your continued support.

Thank you.

If you have any questions regarding the information provided above, please send questions through the PQ chapter in Harmony.