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UnitedHealthcare Community Plan of NY Info Center

Provider Portal Questionnaire

HHAeXchange & UnitedHealthcare Community Plan of NY Partnership

UnitedHealthcare Community Plan of NY has partnered with HHAeXchange to leverage our platform to implement Electronic Visit Verification (EVV) for Personal Care Services and Home Health Care Services (HHCS).

Through the HHAeXchange platform you will be able to receive new home health aide cases, manage authorizations, confirm visits, and communicate certain types of issues in real-time.

In addition, the HHAeXchange platform offers a robust agency management solution that can help streamline and automate time-consuming agency functions including placement, scheduling, compliance, and billing of services.

What does the HHAeXchange Portal provide to homecare agencies?

The HHAeXchange Portal provides a direct connection from the agency to UnitedHealthcare Community Plan of NY for:

  • Electronic case broadcasting, authorizations, confirming visits using EVV
  • Real-time two-way messaging with UnitedHealthcare Community Plan of NY
  • Free EVV solution for time & attendance and duty tracking
  • Electronic billing along with pre-billing review

Agency Options & Onboarding Phase

Agencies not currently using HHAeXchange (New Providers – EVV option of EDI or Free HHAX): 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. Providers will be going live with the linked UnitedHealthcare Community Plan of New York contract on April 17, 2023.

Once you have completed the Survey and made your EVV selection please be sure to follow additional is your corresponding packet:

For assistance on how to complete the survey, please watch our Provider Portal Questionnaire Survey Webinar Recording Here   Agencies currently using another 3rd Party EVV Solution (Existing EDI Providers): 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 refer to the EDI Process tab for more details. Providers will be going live with the linked UnitedHealthcare Community Plan of NY contract on April 17, 2023.

  • Please click here to view your HHAeXchange & United HealthCare Community Plan of NY EDI Provider Welcome Packet for Enterprise Free Providers Integrating a 3rd Party EVV solution.

Agencies currently using HHAeXchange (Existing Enterprise Providers): You will be able to continue using HHAeXchange, utilizing the system’s enhanced Linked Contract functionality. Providers will be implemented with the linked UnitedHealthcare Community Plan of NY contract on April 17, 2023. Providers will receive a detailed welcome letter in advance, letting them know the go-live date expectations.

Important Dates

  • Provider Information Sessions: Feb 20, 2023 – Feb 24, 2023
  • Go-Live Date: Monday April 17, 2023

The Cures Act Mandate requires all visits for personal care services (PCS) and Home Health Care Services (HHCS) to be timestamped via an electronic verification method utilizing EVV tools to record the member, caregiver, location of the service, date of the service and the type of service performed. To ensure EVV data is being accurately captured, United Healthcare Community Plan of NY will be implementing HHAeXchange.

Information Session Details for All Providers:

The Information Sessions have concluded for all in scope providers to share key details regarding this implementation, including workflow changes, system benefits, and next steps. The info sessions concluded on Feb. 24, 2023. The recording and slide deck can be found below:

Recording | Slides

Ease of billing

  • Quickly enter confirmed visits in a user-friendly interface.
  • Increase billing acceptance rates with real-time pre-claim edit checks.

Efficient communication

  • Reduce payer communication time with real-time, two-way messaging.
  • Increase census by accepting new cases via the broadcasting module.
  • Access real-time authorization and notification of changes to the care plan (increase or decrease of units, change of service code, etc.).

Free tools

  • Free scheduling module to manage schedules online in real-time.
  • Free EVV solution to electronically track time and attendance.
  • Free interface with your agency management system.

Upcoming Webinars

Please click here for Additional Training Webinars

Go Live Support Webinar

The Go Live Support Webinar was held for all in scope providers and covered the updates and changes related to the Healthfirst implementation in the HHAeXchange system. The webinar session concluded on Wednesday April 12, 2023. The recording and slide deck can be found below:

Recording |  Slides

Enterprise Provider Training

The Enterprise Provider Training was held for all in scope providers and covered the enhanced linked contract functionality in the HHAeXchange system. The webinar sessions concluded on March 22, 2023. The recording and slide deck can be found below:

Recording | Slides

New Providers & Existing Enterprise Free Providers

Learning Management System (LMS)

March 14, 2023 – Received LMS Credentials from the HHAeXchange Onboarding Team and instructions to complete the self-paced courses and videos.

  • An email was sent to the contact that completed the UnitedHealthcare Community Plan of NY Portal Enrollment Form or the individual who is designated on the HHAeXchange contact form.
  • One Username was 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 Healthfirst training module. All providers can use our Client Support Portal to find answers to questions and create support requests.

System User Training Webinar

System User Training has concluded as of March 16, 2023. Please refer to your LMS to access any of the videos shown.

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 necessary to successfully integrate your Agency Management System with HHAeXchange.

As part of the EDI project, you can continue to use your existing EVV system for scheduling/visit confirmation.  However, you will need to set up an integration to send the confirmed and billed visit data to HHAeXchange to be passed to UnitedHealthcare Community plan of NY. HHAeXchange coordinates directly with UnitedHealthcare Community Plan of NY to ensure members and 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. To integrate between your Agency Management System and HHAeXchange, you will need to create the EDI files corresponding to the HHAeXchange specifications found in the following documentation (links below):

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.

Training Opportunities for EDI Providers

EDI Onboarding Webinar

  • Our EDI Onboarding Webinars have concluded. You can review the EDI Onboarding Webinar material by logging into your LMS account (starting March 20, 2023)

EDI Post Integration Training Webinar

  • Our EDI Post Integration Training Webinars have concluded. You can review the EDI Post Integration Training Webinar by logging into your LMS Account (starting March 20, 2023).

Please contact the HHAX EDI team via the Client Support Portal:

Portal: https://www.hhaexchange.com/supportrequest

What is HHAeXchange?

HHAeXchange is the premier Homecare Management Software company for the Medicaid non-skilled Long Term Services & Solutions (LTSS) population. We are the leaders in connecting payers and homecare agency providers to enable more collaboration, communication, and workflow efficiencies.

What are the benefits of the HHAeXchange Portal?

Ease of Billing

  • Quickly enter confirmed visits in a user-friendly interface.
  • Increase billing acceptance rates with real-time pre-claim edit checks.

Member & Authorization Management

  • Increase census by accepting new cases via UnitedHealthcare Community Plan of NY Member Placement.
  • Access real-time authorization and notification of changes to the care plan (increase or decrease of units, change of service code, etc.).
  • Reduce payer communication time with real-time, two-way messaging.

Free tools

  • Free scheduling module to manage schedules online in real-time.
  • Free EVV solution to electronically track time and attendance.
  • Free interface with your agency management system.

How will the free HHAeXchange EVV system work?

Through the HHAeXchange Portal, UnitedHealthcare Community Plan of NY is offering free telephony for clock-in and clock-out functionality. Each agency who has indicated they would like to use HHAeXchange’s free EVV system will be set up with a toll-free 800 number to provide to their caregivers.

What if we would like to use HHAeXchange’s free EVV System?

Great! If you’ve indicated that you’d like to use HHAeXchange’s Free EVV system, the contact person listed on your survey 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.

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

It is simple to connect your existing EVV system to Healthcare Community Plan of NY 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. For additional information, please review the “EDI Process Tab.

What information will UnitedHealthcare Community Plan of NY send to my agency through the HHAeXchange Portal?

Healthcare Community Plan of NY members and authorizations, including new placements, will be provided through the HHAeXchange Portal. Relevant communications will also be sent through the portal.

How will the HHAeXchange Portal bill to UnitedHealthcare Community Plan of NY?

All claims will be created through the HHAeXchange Portal and sent electronically via an 837 eBilling file.

Can I check my claims before submitting them to UnitedHealthcare Community Plan of NY?

Yes. The HHAeXchange Portal provides a Prebilling Claims Scrubbing module designed to ensure that your claims are compliant with the authorization and the UnitedHealthcare Community Plan of NY contract.

Will I need a Portal for UnitedHealthcare Community Plan of NY?

Yes. You will to log into UnitedHealthcare Community Plan of NY Provider Portal to access placements, authorizations, communications, and billing.

Can I schedule my caregiver 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 UnitedHealthcare Community Plan of NY, 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?

The person within your organization that filled out the survey will receive more information to identify super users and for training planning. The user who completed the survey will receive the Learning Management System (LMS) credentials for self-paced videos and webinar details with a live Q/A chat option to interact and review this information with the HHAeXchange training team. Please refer to the Training tab on this site for more details.

Can I Import and Export data into the HHAeXchange Portal?

Processes for importing and exporting data from the HHAeXchange Portal can be found on the “EDI Process” tab.

Provider Services in Scope: Please see below all the provider services in scope for this implementation.

Service Code Description
S5130:U3 PCS LEVEL I MULTIPLE CLIENT
S5130:U1 PCS LEVEL I – 15 MINUTES
S5130:U2 PCS LEVEL I TWO CLIENT
S5130:TV PCS LEVEL I WEEKEND/HOLIDAY
T1019:TV PCS LEVEL II WEEKEND/HOLIDAY
T1019:U3 PCS LEVEL II MULTIPLE CLIENT
T1019:U1 PCS LEVEL II BASIC – 15 MINUTES
T1019:U2 PCS LEVEL II BASIC TWO CLIENT
T1019:U4 PCS LEVEL II HARD TO SERVE
T1019:U5 PCS LEVEL II TWO CLIENT HARD TO SERVE
T1020 PCS LEVEL II LIVE-IN
T1020:U2 PCS LEVEL II LIVE-IN TWO CLIENT
T1020:TV PCS LEVEL II LIVE-IN WEEKEND/HOLIDAY
T1020:U5 PCS LEVEL II LIVE IN TWO CLIENT HARD TO SERVE
T1020:U4 PCS LEVEL II LIVE -IN INDIVIDUAL HARD TO SERVE
T1019:U6 CDPA BASIC – 15 MINUTES
T1019:U8 CDPA ENHANCED
T1019:U7 CDPA TWO CONSUMER
T1019:U9 CDPA TWO CONSUMER ENHANCED
T1020:U6 CDPA LIVE IN
T1020:U8 CDPA LIVE IN ENHANCED
T1020:U7 CDPA LIVE IN TWO CONSUMER
T1020:U9 CDPA LIVE IN TWO CONSUMER ENHANCED
H2014:HA COMMUNITY HCBS HABILITATION INDIVIDUAL
H2014:HA:UN COMMUNITY HCBS HABILITATION GROUP OF 2
H2014:HA:UP COMMUNITY HCBS HABILITATION GROUP 3+
S5150:HA PLANNED RESPITE INDIVIDUAL UP TO 6 HOURS
S5151:HA PLANNED RESPITE INDIVIDUAL PER DIEM OVER 6 HOURS
S5150:HA:HQ PLANNED RESPITE GROUP UP TO 6 HOURS
S5150:HA:ET CRISIS RESPITE UP TO 6 HOURS
S5151:HA:ET CRISIS RESPITE MORE THAN 6 HOURS, LESS THAN 12 HOURS
S5151:HA:ET:HK CRISIS RESPITE INDIVIDUAL 12+HOURS, LESS THAN 24 HOURS
S5125 HHA – 15 MINUTES
S9122 HHA – PER HOUR
S5125:U2 HHA TWO CLIENT – PER 15 MINUTES
S5126 HHA LIVE-IN – PER DIEM (13 HOURS)
S5126:U2 HHA LIVE-IN TWO CLIENT – PER DIEM (13 HOURS)
S9122:U1 ADVANCED HOME HEALTH AIDE PER HOUR
T1030 NURSING CARE IN HOME (RN) PER DIEM (13 HOURS)
S9123 RN – PER HOUR
T1002 RN – 15 MINUTES
T1031 NURSING CARE IN HOME (LPN) – PER DIEM (13 HOURS)
S9124 LPN – PER HOUR
T1003 LPN – 15 MINUTES
S9129 OCCUPATIONAL THERAPY – PER VISIT
S9131 PHYSICAL THERAPY – PER VISIT
S9128 SPEECH THERAPY – PER VISIT
G0237 RESPITORY THERAPY– PER 15 MINUTES
G0238 RESPITORY THERAPY – PER 15 MINUTES
S9470 NUTRITIONAL COUNSELING – PER VISIT
S9127 MEDICAL SOCIAL SERVICES – PER VISIT
T1013 SIGN LANGUAGE/ORAL INTERPRETER – PER 15 MINUTES

UnitedHealthcare Community Plan:

Please contact your provider advocate, at [email protected]

HHAeXchange:

All providers can use our Client Support Portal to find answers to questions and create support requests.