The state’s Managed Care Organizations (MCOs) – AmeriHealth, Health Partners Plan, PA Health & Wellness, UPMC, and UnitedHealthcare 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 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 Community HealthChoices (CHC) or EPSDT, go to https://hhaexchange.com/pachc/ or https://hhaexchange.com/pa-epsdt/.
The HHAeXchange Portal provides a direct connection from the agency to the PHP/Tailored Plan 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 MCOs. Great! 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: January 1, 2024
Soft Go-Live: August 14, 2023
Information Sessions were held for all in-scope Home Health providers to share key details regarding this implementation, including workflow changes, system benefits, and next steps.
The info sessions concluded on May 9, 2023. The recording and slide deck can be found below:
The Go Live support Webinar has concluded. Below you will find the recording and presentation slide deck for you to reference.
Go Live Support Webinar: Recording | Presentation Slide Deck
System User Training for the PA MCOs implementing Home Health service codes has concluded. These trainings were held on Tuesday and Thursday with a live Q/A chat option available to you for any questions or concerns.
The information listed below provides a role and description for each course. The intended audience for each appears in parenthesis, based on the “role” in HHAeXchange: System Administrator (Admin), Billing Staff (Biller), and Agency Coordinator/Staffing/HR (Coordinator).
Tuesday, July 11 at 10:00 AM: System User Training Day 1 – concluded
Wednesday, July 12 at 10:00 AM: HHAeXchange Introduction to EDI Integration- concluded
Thursday, July 13 at 10:00 AM: System User Training Day 2 – concluded
EDI Provider Rebilling Job Aid: This job aid provides guidance to the various rebilling scenarios for EDI Providers. This aid can also be found on the provider portal resources page in the HHAeXchange support center.
Training Opportunities For EDI Providers
Home Health EDI Post Integration Webinars
In this session, you will receive an overview of how to integrate your agency’s EDI management software with HHAeXchange. Providers will learn how HHAeXchange coordinates directly with the payer to ensure that members and authorizations are passed directly into your agency’s HHAeXchange Portal
(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 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 with 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 plans in PA 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 each plan send to my agency through the HHAeXchange Portal?
Each plan will send placements, authorizations, plan of care, and all communication through the HHAeXchange Portal. Plans may send additional information as they deem necessary.
How will my agency bill to each plan?
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 plan?
Yes. The HHAeXchange Portal provides a Pre-billing Claims Scrubbing module designed to ensure that your claims are compliant with the authorization for each plans contract.
Will I need a separate Portal for each plan?
No. You’ll only need one Portal to connect to AmeriHealth, Health Partners Plan, PA Health & Wellness, UPMC, and UnitedHealthcare 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 AmeriHealth, Health Partners Plan, PA Health & Wellness, UPMC, and UnitedHealthcare 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: 2023 Home Health Care Services In Scope
“EVV is a technology which electronically verifies the delivery dates and times of home and community-based services to the individuals needing those services. EVV uses multiple technologies such as telephonic, mobile applications, and web portal verification inputs to help electronically validate services and prevent fraudulent claims. Federal law (21st Century Cures Act) requires that all state Medicaid agencies implement an EVV solution to manage their personal care services by January 1, 2020, and home health care services (HHCS) by January 1, 2023.”
For questions and issues please contact us by submitting a ticket via the Client Support Portal: https://www.hhaexchange.com/supportrequest
Providers with an existing HHAeXchange portal please use the HHAeXchange Live Chat within your Support Center to receive assistance from a Live Agent. The live chat option is recommended for quicker response times.