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Florida SMMC Information Center

Provider Portal Questionnaire

EVV and Claims Billing for Florida’s State Medicaid Managed Care Program

Starting on April 3rd, 2023 Florida Community Care Providers are required to use HHAeXchange to submit confirmed visits and bill directly through the free HHAeXchange Portal.

As of December 1, 2018, Humana and Sunshine Health, Children’s Medical Services, Molina Healthcare (the “MCOs”) require providers to use HHAeXchange to submit confirmed visits and bill directly to each MCO through the free HHAeXchange Portal.

The first step in effectively working with the MCOs is to fill out the Florida SMMC Provider Portal Configuration Questionnaire for your organization. The answers from your questionnaire will allow HHAeXchange to configure your agency’s portal. Please note that you only need to fill out the questionnaire once, regardless of how many MCOs you are contracted with.

EVV Mandate Updates

In accordance with the AHCA reporting requirement, please report any technical difficulties to HHAeXchange and our partner MCOs—Florida Community Care, Humana, Molina Healthcare, and Sunshine Health—by completing this form.

What are the key benefits of the HHAeXchange Portal to homecare agencies?

  • FREE Electronic Visit Verification (EVV) tools
  • Open Model EDI Integration with 3rd Party EVV Vendors
  • Real-time, two-way messaging with each MCO
  • Receive recipient demographics, authorizations, and plan of care electronically
  • Pre-bill scrubbing to ensure clean claims and accelerate revenue cycle

Your Agency’s Billing Options

Option 1, Free HHAeXchange EVV: Our agency wants to use HHAeXchange’s free EVV system, provided by the MCOs. Great! If you’ve indicated that you’d like to use HHAeXchange’s free EVV system, the contact person listed on your questionnaire will receive more information in the coming weeks on how to set up your agency’s 800 numbers, upload caregivers into the HHAeXchange Portal, and begin processing EVV and claims.

Option 2, Use my Current EVV System: Our agency has an existing EVV system that we’d like to keep. It’s simple to connect your existing EVV system to the MCOs through the HHAeXchange Portal. Ensure that you’ve completed the questionnaire, and the HHAeXchange Integrations Team – [email protected] – will coordinate with you to create an interface to process your existing EVV visits and claims.

What Services are a part of the Program?

  • Attendant Care
  • Companion Care
  • Homemaker
  • PDN – LPN
  • PDN – RN
  • Personal Care
  • Respite (Home)

Florida Community Care Implementation & Onboarding Process

Agencies currently using HHAeXchange Enterprise: You currently pay for the HHAeXchange Full Enterprise platform. With Florida Community Care, you will be able to continue using HHAeXchange.

Agencies currently using HHAeXchange’ s Free EVV tools: You had a free HHAeXchange portal created through completing an enrollment questionnaire for a previous implementation. You will be able to continue using HHAeXchange, utilizing the system’s linked contract functionality.

Agencies currently using another 3rd Party EVV Solution (Existing EDI Providers): You had a free HHAeXchange portal created through completing an enrollment questionnaire for a previous implementation. Schedule and visit data will be imported from your 3rd party system into HHAeXchange to be billed to Florida Community Care. Please work with your EVV Vendor to determine requirements to set up this interface and refer to the EDI Process tab for more details.

Agencies not currently using HHAeXchange: You will receive a free HHAeXchange Portal as part of this Implementation. Please complete the Provider Portal Questionnaire Form to ensure our team can create your unique credentials for access. Providers will have the choice to either use the free HHAeXchange EVV tools or select to integrate with their existing third party EVV system.

The Information Sessions for the Florida Community Care Implementation were held for all in scope providers to share key details regarding this implementation, including workflow changes, system benefits, and next steps. The information sessions concluded on February 8, 2023. The recording and slide deck can be found below:

Recording | Slides

Previously Implemented MCO’s Information Sessions

Please refer to the links below to access videos and presentations from the Provider Info Sessions, held in Florida in October 2018.

These sessions provided a high-level introduction to the HHAeXchange System (including system demos), as well as MCO-program specific information.

Provider Information Sessions (English)

HHAeXchange Provider Information Session (60 min) VIDEO | SLIDES

MCO Provider Information Presentations:

Provider Information Sessions (Spanish)

HHAeXchange Provider Information Session (45 min) VIDEO | SLIDES

MCO Provider Information Presentations:

Upcoming Webinars

  • Wednesday, February 14th @ noon EST:  EVV Call Dashboard – Fixing Exceptions
    • Audience: Homecare Provider Agencies using HHAeXchange EVV
    • Description: This webinar will help Provider Homecare Agencies who are using HHAeXchange EVV functionality to address exceptions appearing in the Call Dashboard. Specifically, this webinar will focus on how to identify the most frequent exceptions that appear on the EVV Call Dashboard, and the best practices for how to address each one in order to clear them from the Call Dashboard.

Florida Community Care Pre Go-Live Webinar:

March 28th 2023. This webinar reviewed Go-Live preparedness tasks to ensure all providers have the information needed to successfully begin using the HHAeXchange System at Go-Live.

Pre Go-Live Webinar Recording | Slides

Florida Community Care Provider System User Training

Provider System User Training will be provided via the HHAeXchange Learning Management System (LMS). Live System Training was completed February 24th, 2023.

Providers will have to log on the Learning Management System to complete their training to understand the use of the HHAeXchange Provider Portal along with its functionalities. This training is required to ensure you have a clear understanding of the functionalities available to you in the HHAeXchange Provider Portal. The courses include a variety of videos, documents, and tests to help ensure you have a clear understanding of the different aspects of the Provider Portal to use for your EVV benefits.

Use the Learning Management System (LMS):

  • An email will be sent to the contact that completed the Florida Community Care Provider Enrollment Form or the individual who is designated on the HHAeXchange contact form.
  • One Username will be sent to your Agency to use. Username can be distributed amongst all members of your agency to complete the assigned courses.
  • Login to the LMS website using the provided credentials in the email.
  • Work on completing the courses by viewing the videos and materials included. The course will only be completed once the knowledge quiz is taken for each module.
  • Your training for this implementation will only be considered complete once you have passed all the courses contained within the Florida Community Care training module. 
  • For any questions or concerns, all providers can use our Client Support Portal to find answers to questions and create support requests.

Florida Community Care EDI Post-Integration Webinar: Through this webinar, providers will receive an overview on how to integrate your agencies EDI management software with HHAeXchange. EDI Post-Training Webinars concluded March 24th, 2023. Please refer to your agency’s Learning Management System for training.

EDI Provider Resources

EDI Provider Rebilling Job Aid: This job aid provides guidance to the various rebilling scenarios for EDI Providers. This aid can also be found in the provider portal resources page in the HHAeXchange support center.

Importing Caregivers into HHAeXchange

(Note: This is not required for agencies using an EDI Import file to integrate with their 3rd Party Agency Management System)

To assist organizations with a large census of Caregivers, HHAeXchange has created a Caregiver Bulk Import tool to expedite the entry process.

Please CLICK HERE to access the Caregiver Bulk Import Process Guide, which provides instructions for how to:

  • Access and Save the Caregiver Import Template
  • Prepare the Caregiver import File for your Agency
  • Please follow these instructions in order for the EDI team to receive your file. Go to hhaexchange.com/supportrequest, from the support portal page please click on 3rd party integration support and submit a caregiver import request.

EDI Overview (Integrating with a 3rd Party Agency Management System)

Thank you for your participation in working with HHAeXchange on the Electronic Data Interchange (EDI) project for your agency. Below you will find information about the general requirements and steps to take to successfully integrate your Agency Management System with HHAeXchange.

HHAeXchange coordinates directly with the Managed Care Organizations (MCOs) to ensure members and, if desired, authorizations are passed directly into the HHAeXchange system. Once this data is in the HHAeXchange system, a unique member key is created which HHAeXchange will pass to your Agency Management System to ensure seamless processing of member information between the systems. HHAeXchange will also give you a unique Provider Agency ID to include in all files used in the EDI processes.

In order to integrate between your Agency Management System and the HHAeXchange, you will need to create the EDI files corresponding to the HHAeXchange specifications found in the following documentation (links below):

To obtain 835 Remittances that correspond to claims generated out of HHAeXchange for our five linked Payers, please refer to the Obtaining 835 Remittance Job Aid.

CLICK HERE to access the HHAeXchange Provider System FAQ Document (check back often for updates to this document).

What is HHAeXchange?

HHAeXchange is the premiere homecare management software solution for the Medicaid LTSS population. We act as the single source of truth in connecting payers, providers, and patients through our intuitive web-based platform, enabling unparalleled communication, transparency, and visibility.

What are the benefits of the HHAeXchange Portal?

  • FREE Electronic Visit Verification (EVV) tools
  • Open Model EDI Integration with 3rd Party EVV Vendors
  • Real-time, two-way messaging with each MCO
  • Intelligent case broadcasting for new referrals / cases
  • Receive recipient demographics, authorizations, and plan of care electronically in real-time
  • Pre-bill scrubbing to ensure clean claims and accelerate revenue cycle

What if we’d like to use HHAeXchange’s Free EVV System?

Great! If you’d like to use HHAeXchange’s Free EVV system ensure that you’ve completed the HHAeXchange Portal Configuration Questionnaire. The contact person listed in your response will be contacted by HHAeXchange to set up your agency for EVV.

What if we have an EVV System that we’d like to keep?

It’s simple to connect your existing EVV system to the MCOs through the HHAeXchange Portal. Ensure that you’ve completed the HHAeXchange Portal Configuration Questionnaire, and the HHAeXchange Integrations Team will coordinate with you to create an interface to process your existing EVV visits and claims. EDI Process Guides can be found in the EDI Process tab, above.

What information will the MCOs send to my agency through the HHAeXchange Portal?

The MCOs will send placements, authorizations, plan of care, and all communication through the HHAeXchange Portal. MCOs may send additional information as they deem necessary.

How will my agency bill to the MCOs?

All claims will be created through the HHAeXchange Portal and sent electronically via an 837 eBilling file. Agencies will then receive an 835 eRemittance file back into the HHAeXchange Portal.

Can I check my claims before submitting them to each MCO?

Yes. The HHAeXchange Portal provides a Pre-billing Claims Scrubbing module designed to ensure that your claims are compliant with the authorization and MCO contract.

Will I need a separate Portal for each MCO?

No. You’ll only need one Portal to connect to Humana, Staywell, and Sunshine Health for placements, authorizations, communication, and billing.

Can I schedule my caregivers through the HHAeXchange Portal?

Yes. You’ll be able to schedule your caregivers through the HHAeXchange Portal either by creating schedules based on the authorization provided by the MCO, or through automatic creation of schedules based on EVV data imported into the HHAeXchange Portal from your 3rd party EVV system.

How will I be trained on the HHAeXchange Portal?

Please see the User Training tab, above.

Can I Import and Export data into the HHAeXchange Portal?

Please see the EDI Process tab, above.

In accordance with the AHCA reporting requirement, please report any technical difficulties to HHAeXchange and our partner MCOs—Humana, Molina Healthcare, Staywell and Sunshine Health—by completing this form.