AmeriHealth Caritas of North Carolina, Carolina Complete Health, UnitedHealthcare Community Plan of North Carolina and WellCare of North Carolina have partnered with HHAeXchange to provide software that allows providers to have a single login for all plans to access authorizations, communicate, and meet Electronic Visit and Verification (EVV) requirements of the 21st Century Cures Act.
As a result, all the plans have partnered with HHAeXchange to provide you with a free EVV system and billing tool for member placement, scheduling, authorization management, communication, and EVV compliance.
To get started, the first step will be to complete the HHAeXchange Provider Enrollment Form listed below, which will provide you access to your HHA Provider Portal.
Click here to complete the HHAeXchange Provider Enrollment Form
If you’re searching for information on Personal Care Services (PCS), which were implemented in November 1, 2021, go to https://hhaexchange.com/nc/.
The HHAeXchange Portal provides a direct connection from the agency to the PHP for:
Agencies utilizing Free HHAX tools HHAeXchange (New Providers HHAX): Your agency wants to use HHAeXchange’s free EVV tools along with the portal, provided by the PHPs. If you’ve indicated that you’d like to use HHAeXchange’s free EVV tools! You will receive an HHAeXchange Portal in order to receive authorizations and submit claims/invoice data. Please complete the Provider Portal Questionnaire Survey 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 own third party EVV system.
Agencies utilizing their own 3rd Party EVV Solution (Existing and New EDI Providers): Your agency has decided to continue the use of your existing EVV system along with the HHAeXchange portal. It’s simple to connect your existing EVV system to the PHPs through the HHAeXchange Portal. Authorization data will become available in the HHAeXchange Portal, rather than coming by fax. Schedule and visit data will be imported from your 3rd party system into HHAeXchange. Please work with your EVV Vendor to determine requirements to set up this interface and ensure that you’ve completed the questionnaire. Please refer to the EDI Process tab for further instructions.
Home Health Services
EVV Mandate: April 1, 2023
Claim Compliance Requirement: October 1, 2023
HC DHS Bulletin discussing EVV expectations located here.
Information Sessions will be held for all providers to provide them with the key dates and details about this implementation, including key workflow changes, system benefits, and next steps. Please refer to the links below to access videos and presentations from Provider Info Sessions, held via webinar in February 2023.
Recording | Slides
Please find the EDI training held on 3/1/2024 below
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.
(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:
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 your contracted MCO 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):
*Note: Please open each link and save each guide for your records along with sharing it to your third party EVV vendor.
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?
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 PHPs and tailored plans through the HHAeXchange Portal. Ensure that you’ve completed the survey, 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 PHPs and tailored plans send to my agency through the HHAeXchange Portal?
The PHPs and tailored plans will send placements, authorizations, plan of care, and all communication through the HHAeXchange Portal. PHPs and tailored plans may send additional information as they deem necessary.
How will my agency bill to the PHPs and tailored plans?
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 PHPs and tailored plans?
Yes. The HHAeXchange Portal provides a Pre-billing Claims Scrubbing module designed to ensure that your claims are compliant with the authorization and PHP or tailored plans contract.
Will I need a separate Portal for each PHPs and tailored plans?
No. You’ll only need one Portal to connect to Wellcare, Carolina Complete, United Healthcare, and Amerihealth, Partners, Trillium Health Resources, EastPointe, SandHills, Vaya Health, CardinalHealth. and Alliance 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 PHP or tailored palns, 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.
The state released the following bulletin: Home Health Services Electronic Visit Verification Implementation, “NC Medicaid has an established EVV webpage with more information. Home Health providers are encouraged to monitor this webpage frequently for HHS EVV announcements, bulletins, FAQs, stakeholder meetings and other communications.”
Home Health Services in Scope
For questions and issues please contact us by submitting a ticket via the Client Support Portal: https://www.hhaexchange.com/supportrequest