Pennsylvania Home Health Information Center
Claims Billing and EVV Implementation for Pennsylvania’s Home Health Care Services (HHCS)
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.
What are the key benefits of the HHAeXchange Portal to homecare agencies?
The HHAeXchange Portal provides a direct connection from the agency to the PHP/Tailored Plan for:
FREE Electronic Visit Verification (EVV) tools
Open Model EDI Integration with 3rd Party EVV Vendors
Real-time, two-way messaging with each plan
Receive recipient demographics, authorizations, and plan of care electronically
Pre-bill scrubbing to ensure clean claims and accelerate revenue cycle
Your Agency’s EVV Options
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. Refer to the EDI Process tab for more details or reach out to the HHAeXchange EDI Integrations Team – email@example.com.
What Services are a part of the Program?
Home Health Services
EVV Mandate: January 1, 2023