ISSUE DATE: June 3, 2016 ODP Communication Number: 036-16 1

AUDIENCE: Administrative Entities (AEs), Supports Coordination Organizations (SCOs), All Direct

Service Providers (Waiver and Base Providers), and Other Interested Parties

PURPOSE: This Office of Developmental Program (ODP) communication is intended to provide guidance to AEs, SCOs, and direct service providers during the fiscal year (FY) 2016-2017 Individual Support Plan (ISP) renewal period.

The following topical areas will be addressed in this communication:

Anticipated FY 2016-2017 changes in the Home and Community Services Information System (HCSIS)

FY 2016-2017 estimated waiver rate load schedule

Rate load dependencies

P/FDS Waiver Cap

Enhanced Communication Services

Supplemental Habilitation (SH) and Additional Individualized Staffing (AIS) services (Also referred to as ‘SH/AIS’)

Transportation Mileage Rate

R2E: Reserve to Encumbrance

Reminders and Resources

ODP Announcement

Preparations for the Fiscal Year (FY) 2016-2017

ISP Renewal Period

ODP Communication Number: 036-16 The mission of the Office of Developmental Programs is to support Pennsylvanians with developmental disabilities to

achieve greater independence, choice and opportunity in their lives.

ISSUE DATE: June 3, 2016 ODP Communication Number: 036-16 2

The items in the table below represent changes that will be executed in HCSIS on Saturday, June 25, 2016. Final implementation of these items is contingent on CMS approval of the Consolidated and P/FDS Waiver Amendment #5 and the final budget by the General Assembly anticipated to be effective June 30, 2016.

CHANGE DESCRIPTION OF CHANGE RECOMMENDED ACTION

Supports Broker Services

Supports Broker services, procedure code W7096, plus any applicable modifiers, will no longer be included in the P/FDS cap for FY 2016-2017.

The following screens and reports will be impacted with the HCSIS 8.1 release on 6/25/2016 to exclude the Supports Broker Services from the P/FDS cap limit of $30,000:

1.) Service Details (Plan) screen - This screen will reflect the correct P/FDS funding stream total when Supports Broker Services are excluded from the P/FDS cap.

2.) Plan Authorize Services and the Financial Authorize Services screen will no longer add the cost of Supports Broker service into the Plan Budget Total.

3.) Waiver Enrolled Individuals Using Base Funding report and Potential Impacts of Mass Change Rate Change for Waiver Service report will not include the cost of Supports Broker services

NOTE: This service is limited to a maximum of 1040 (15-minute) units per individual per fiscal year based on a 52-week year. This service is also limited to individuals who are self-directing their services through an Agency With Choice (AWC) or Vendor Fiscal (VF)/EA Financial Management Services (FMS). See the section of this communication titled, “CAP FOR THE P/FDS WAIVER ISPs”, for information regarding the P/FDS cap.

ISSUE DATE: June 3, 2016 ODP Communication Number: 036-16 3

CHANGE DESCRIPTION OF CHANGE RECOMMENDED ACTION

Targeted Services Management “(TSM) - Transition Activities (T1017)

Updates were made in both PROMISeTM and HCSIS to support ODP’s identification of targeted services management activities that relate to transitioning individuals to a home and community based setting. HCSIS Changes: The term “TSM -Transition Activities” has been added to the following areas in HCSIS and will be visible on Saturday, June 25, 2016:

Added as a selection to the Service Type drop-down menu located in the Service Note screen in HCSIS.

Added to the Service Note Advanced Search window

Added to the Service Note Extract Criteria/ Search screen and report.

Added to the Service Note help pop-up. PROMISeTM Change/SCO: SCOs billing for “TSM -Transition Activities” should bill using procedure code T1017 along with the modifier HQ. This will enable SCO and ODP to associate claims submitted with T1017 HQ to a service note in HCSIS.

SC ACTION: After an SC renders Targeted Services Management (T1017) related to transition services, the SC should document the service delivery in the Service Note screen in HCSIS by selecting “TSM-Transition Activities”. SCO BILLING: SCOs should bill T1017 along with the HQ modifier when the SC renders TSM -Transition Activities –. The HQ modifier was set up for billing purposes only and will not appear in HCSIS.

Reference the ODP Communications related to TSM Transition

045-14 Ann Money Follows the Person.pdf

023-15 Info Memo Clarification on Information Packet 045-14 Money Follows the Person (MFP) Initiative Billing for Start-Up and Supports Coordination .pdf

Service Name Change

“Visual/Mobility Therapy” will be updated to read “Orientation, Mobility and Vision Therapy” in the document connected to the “Service Definitions” hyperlink found on the HCSIS Welcome screen.

Name revision anticipated to be executed in HCSIS on 6/14/2016

All instances in HCSIS where this name appears and all HCSIS reports that contain this service will be updated to reflect the revised service name, “Orientation, Mobility and Vision Therapy”.

ISSUE DATE: June 3, 2016 ODP Communication Number: 036-16 4

FY 2016-2017 ESTIMATED WAIVER RATE LOAD SCHEDULE

The FY 2016-2017 estimated rates are anticipated to be viewable in HCSIS by the second week of June 2016. The estimated FY 2016-2017 waiver rates are subject to the Centers for Medicare and Medicaid Services (CMS) approval of the Consolidated and P/FDS Waiver Amendments #5 and the final amounts appropriated by the General Assembly for FY 2016-2017.

ANTICIPATED DATE ACTIVITIES TO SUPPORT IMPLEMENTATION OF FY 2016-2017 ISPs

AND RATE SETTING PROCESSES

May 23, 2016 Waiver appropriations and county allocations loaded in HCSIS for FY 2016-2017.

Beginning of June 2016 Batch program will run to convert Provisional On-Hold service contracts in HCSIS to Real.

6/09/2016

FY 2016-2017 estimated Department established fees and fee schedule rates loaded in HCSIS. FY 2016-2017 rates visible on service contracts and the ISPs. See next page for “Rate Load Dependencies”.

Beginning of June 2016

Reserve to Encumbrance (R2E) batch is anticipated to be released on this date and AEs may run the R2E. See “R2E: RESERVE TO ENCUMBRANCE” section of this communication for important information related to specific AEs/Counties who have timed out during this process in the past.

ISSUE DATE: June 3, 2016 ODP Communication Number: 036-16 5

RATE LOAD DEPENDENCIES

TASK ACTION

Validate provider type and specialty codes are synchronized

PROVIDER ACTION Providers should review their current service locations, provider types, and specialties in PROMISe™ and in the Provider Access component of HCSIS to ensure that both systems have identical enrollment information. If the provider types and specialty codes do not match exactly in both systems, a rate cannot be loaded for the procedure code (service). To validate the provider type and specialty code associated with each service; go to the Individual Support Plan (ISP) Manual for individuals with an intellectual disability found in Bulletin #00-15-01, Attachment #1. Go to the Bulletin Search window on the DHS website to search for this bulletin.

Provider Qualification

PROVIDER ACTION Direct Service Provider Action (Including Vendors, AWC and OHCDS providers)

In order for services to be authorized on FY 2016-2017 ISPs, all service providers must be qualified in HCSIS for each waiver service specialty they intend to offer. Provisional on-hold contracts will only be converted to real contracts for services that are in “Qualified” status in HCSIS. Services in any other status other than “Qualified” will prevent provisional on-hold contracts from being converted to real contracts in HCSIS, which will prevent the FY 2016-2017 service from being authorized in an ISP. SCO Qualification SCOs are qualified outside of HCSIS and contracts will be created manually. ODP will be generating a list of current qualified FY 2015-2016 SCO contracts to roll forward to FY 2016-2017. If the SCO is having issues with FY 2016-2017 contracts, contact the ODP Regional Coordinator assigned to your region. A list of ODP Regional Coordinators is located on the last page of this communication. See the RESOURCES section of this communication for more information regarding qualification.

ISSUE DATE: June 3, 2016 ODP Communication Number: Announcement # 036-16 6

CAP FOR THE P/FDS WAIVER ISPs The P/FDS Waiver cap will remain unchanged at $30,000 for FY 2016-2017. The individual’s plan budget total on the Service Details screen will not be accurate until after the FY 2016-2017 waiver rates are loaded in HCSIS. AE Action

AEs who have access to the Enterprise Data Warehouse (EDW) should review the ODP AE Performance Dashboard for a list of waiver participants with current FY 2015-2016 authorizations near the waiver cap. To access the AE Performance Dashboard, click on the following link: https://www.dpwrpt.state.pa.us> enter your username and password > click the HCSIS link > click Near Real Time Reports > click ODP AE Reports

AEs should ensure that the Assessed Needs and health and welfare of existing P/FDS waiver participants are addressed within the P/FDS cap. This requirement is found in section 4.3.4 of the AE Operating Agreement. A person’s needs may also be addressed through Waiver services, generic resources, community opportunities and family and natural supports.

ENHANCED COMMUNICATION SERVICES (ECS)

PROVIDER ACTION:

NOTE: Providers should not choose any services that have the modifier ECS attached to a procedure code when updating their service offerings. If a provider has any of these services in their SSD they should be removed.

The U1 modifier and service (procedure code) combination signifies that the associated service is eligible for an enhanced communication rate. The letters “ECS” is attached to the service name in HCSIS and the “U1” modifier is attached to the procedure code. Both “ECS” and “U1” mean that enhanced communication services are eligible with that service.

Information regarding enhanced communication services can be obtained by contacting the Deaf Services Coordinator at ra-ODPDeafServices@pa.gov.

ISSUE DATE: June 3, 2016 ODP Communication Number: Announcement # 036-16 7

SH AND AIS SERVICES The table below lists two scenarios that apply to the prior authorization of SH/AIS services and the FY 2015-2016 renewal ISP. The second column of the table describes the action that will be taken by ODP or the action that is expected for the stakeholder identified. Please review the latest version of the SH/AIS User Guide for more information regarding the prior authorization process for SH and AIS. The SH/AIS User Guide is located on http://www.odpconsulting.net/ under “Resources “ > “Publications and Other Resources”.

SCENARIO ACTION

AIS Resulting from retirement

ODP recognizes that individuals who are prior authorized to receive AIS services, as a result of a retirement, will likely continue to maintain a need for AIS services in future fiscal years. As a result, ODP will use an abbreviated prior authorization process for this specific situation. ODP will automatically approve AIS as a result of retirement for FY 2016-2017 if it is approved for FY 2015-2016. If AIS was approved for less than a fiscal year in 2015-2016, then the units will be calculated for FY 2016-2017 by annualizing the pro-rated units.

1. The FY 2016-2017 prior authorization number will be the same number that is

associated with FY 2015-2016. 2. AE ACTION: When the prior authorization is updated in PROMISeTM, the

individual, provider, SCO and AE will receive the “Notice of Prior Authorization Decision” letter in the mail. Once the AE receives this letter in the mail, they should verify the number of units (Quantity), dates of service for which the authorization is valid (Authorization Period), the assigned AIS procedure code (Billing Code) in the notice is the same as the procedure code in the ISP before the services are pre-authorized. Next the AE should perform the following steps for services that are attached to the FY renewal ISP:

a. Navigate to the Pending Approval/Review screen and click [Approved]. b. When the Authorize Services screen is displayed, the Authorization Status

will be pre-populated with Pre-Authorized and the applicable funding stream.

c. Click [Authorize Services].

SH or AIS that overlap fiscal years

PROVIDER ACTION:

Complete the appropriate sections of the ISP Review Checklist (DP 1050) to initiate the prior authorization request process. Only one ISP Review Checklist (DP 1050) is needed for this scenario. Enter the begin and end date for which the service is being requested in the Reason service for service need/justification of ongoing service need” section of the DP 1050 form and e-mail the completed form to the SCO and AE.

ISSUE DATE: June 3, 2016 ODP Communication Number: Announcement # 036-16 8

SCENARIO ACTION

AE ACTION: Complete and mail two (2) MA97s and two (2) DP1031s; one for the current fiscal year and one for the next fiscal year. When a prior authorization request is approved for overlapping fiscal years, ODP creates two prior authorization numbers in PROMISeTM. These two prior authorization numbers are reflected on two separate “Notice of Prior Authorization Decision” letters. ODP recognizes that HCSIS only allows the service to be authorized on the plan for one fiscal year or a period within a fiscal year.

When a draft fiscal year renewal is created, services previously authorized in the current fiscal year ISP, if any, will pre-populate into the fiscal year renewal ISP. AEs should ensure that once the FY 2016-2017 renewal is created that the units, associated with the SH or AIS services, are adjusted accordingly and reflect the information on the “Notice of Prior Authorization Decision” letter that was sent to them. If AEs are unable to locate the prior authorization decision letter, they should e-mail the ODP SH/AIS section at RA-CentralO.SHAIS@pa.gov for assistance.

SCO ACTION:

1. For FY 2015-2016 prior authorization requests, SCs should attach the service to the current FY ISP.

2. For FY 2016-2017 prior authorization requests, SCs should only update the narrative of the FY renewal ISP to reflect the reason for the need, the service, units requested and length of time the service is needed.

NOTE: If the individual already received SH service authorization for 12 consecutive calendar months, then any new SH prior authorization requests made for the same individual and same provider for a period beyond the 12 consecutive calendar month period will be denied. If the ISP team believes there is a continuing need for enhanced staffing support, a new prior authorization request for AIS should be submitted.

For SH or AIS prior authorization requests that apply to the following fiscal year only, Providers, AEs, and SCs should follow the prior authorization request process specified in the SH/AIS User Guide.

AE Tracking If an AE has inquiries pertaining to the individuals/providers on their internal tracking

systems related to the SH/AIS scenarios listed in this table, please e-mail the ODP

SH/AIS section at RA-CentralO.SHAIS@pa.gov for assistance.

ISSUE DATE: June 3, 2016 ODP Communication Number: Announcement # 036-16 9

TRANSPORTATION MILEAGE RATE Effective January 1, 2016, ODP changed its rate for reimbursement of transportation mile, procedure code W7271, to $0.54 per mile. Only Provider types (PT) 54 with specialties 540 and 541 (Agency with Choice (AWC)/Vendor Fiscal (VF)) and PT 55 (Vendor) with specialty 267 are able to receive payment from the Department for this service.

SCO Action

Supports Coordinators (SCs) should ensure that individuals who receive the transportation mile service, procedure code W7271, have their service unit cost updated to reflect the accurate rate for the full fiscal year.

What “Bid Amount” is entered on the vendor screens in HCSIS for provider type 55 (Vendor Service)?

STEP 1: Login to HCSIS STEP 2: Navigate to Plan > Services and Supports > SSD STEP 3: Select Vendor Services from the Go To drop-down list and click [Go] STEP 4: Enter Provider Name, select County of Service and click [Search] STEP 5: On the vendor screen under the Service Name column select the “Transportation-Mile” link. STEP 6: Enter .54 in the Bid Amount field for Transportation Mile (W7271). STEP 7: Click [Save]. After attaching transportation mile with the updated bid amount of $0.54 to the ISP in HCSIS, SCs should navigate to Service Details screen (Plan > Services and Supports > Service Details). SCs should enter a service end date of December 31, 2015 for the mileage rate of $0.58 and enter a service begin date of January 1, 2016, for the $0.54 mileage rate.

What “Total Amount” is entered on the vendor screens in HCSIS for Provider type 54 (AWC/Vendor Fiscal)?

STEP 1: Login to HCSIS STEP 2: Navigate to Plan > Services and Supports > SSD STEP 3: Select FMS1 Services from the Go To drop-down list and click [Go]. STEP 4: Select the appropriate Business Type:

Agency with Choice – FMS

Local Vendor Fiscal – FMS [this is not applicable for ODP]

State Vendor Fiscal – FMS [Vendor Fiscal model] STEP 5: On the FMS screen in the FMS Name row select the name of the FMS STEP 6: On the FMS screen in the FMS Service Name row select the “Transportation-Mile” STEP 7: Click [Save and Add to Plan] to add the FMS service to the ISP. STEP 8: Navigate to Service Details screen (Plan > Services and Supports > Service Details). STEP 9: Select the AWC/VF service STEP 10: Edit the Total Amount to equal the Total Annual Units multiplied by $0.54. For example, if Total Annual Units is 50 then take 50 and multiply it by $0.54 which equals $27.00 as the Total Amount.

ISSUE DATE: June 3, 2016 ODP Communication Number: Announcement # 036-16 10

Please reference the following document found in LMS for further details: ODP: SC100I Supports Coordination > Chapter 10: ISP Services and Supports v7.0 7/25/09

R2E: RESERVE TO ENCUMBRANCE

IMPORTANT: For the initial processing of R2E request for FY 2016-2017, when multiple AEs/counties run their reports at the same time, the system has been found to time out and fail to process the R2E request. To address this issue, the identified counties PHILADELPHIA, ALLEGHENY, MONTGOMERY, BUCKS, ERIE, and DELAWARE should run their first R2E request during the weekend of June 11, 2016 and their second request on June 18, 2016. Subsequent runs (3rd, 4th, and so on) can be requested at any time of the week after June 19, 2016. Please note that all other counties can request R2E on whichever days they choose. By following this sequence, counties/AEs should not experience any delays in processing R2E request. AE/COUNTY ACTION: Please note that the following actions are contingent upon ODP’s entry of the projected allocation which is anticipated to occur before the end of May 2016.

A. Preparation tasks before running the year end R2E process1 1. Run the Provider Service Status Report (contract types) for FY 2016-2017 and Provisional On-

Hold Contracts: Tools --> Reports --> Reports Request 2. Run the Provider Service Status Report for FY 2016-2017, Real Contracts:

Tools --> Reports --> Reports Request 3. Review the base allocation amount by accessing the Funding Level screen. To make changes,

navigate to the Non-Service Encumbrance, Overbooking and Revenue Adjustment screens. 4. Run the County Funding Level Report for the upcoming FY and all Funding Streams: Tools -->

Reports --> Reports Request 5. Run R2E after:

ODP communicates the R2E batch has been released

There are no incorrect rates for real contracts in the upcoming FY

Providers have service authorizations and can begin providing services B. Enter the Projected Plan Budget (PPB) for Base ISPs

1. Use the last year’s (FY 2015-2016) PPB amounts to populate the PPB amounts for FY 2016-2017. This task can be accomplished by doing one of the following:

a. The county user can use the View / Update Budget Amount By Individual option from the Budget Management Menu screen to enter the PPB amount for one individual at a time - or -

b. The county user can use the Populate Future Fiscal Year Projected Plan Budget Amounts option to auto-populate future fiscal year (target fiscal year) PPB amounts for all the individuals within their scope using existing data from the previous fiscal year (source fiscal year).

1 Resource located in HCSIS > LMS > FM Guidebook and Supporting Materials > “Year End R2E Process Checklist v2.0 06/17/10”

ISSUE DATE: June 3, 2016 ODP Communication Number: Announcement # 036-16 11

2. If the user entered the PPB amounts by copying over the prior year’s funding before ODP entered the FY 2016-2017 funding streams, the FY 2015-2016 funding stream(s) would have been selected. Once the AE runs the Reserves to Encumbrance (R2E), the funding stream(s) will automatically be replaced by the corresponding funding stream applicable for FY 2016-2017. The request to copy over the PPB amounts is processed overnight. The next day, the Populate Future Fiscal Year Projected Plan Budget Amounts Report is made available on the Reports Inbox screen.

3. If manually entering the PPB amounts after ODP entered the FY 2016-2017 funding streams, select the “HUMAN SERVICE DEVELOPMENT FUND - Waiver Ineligible” funding stream.

4. Run the Projected Plan Budget Amount Exceeded Report for FY 2016 -2017: Tools --> Reports --> Reports Request

REMINDERS

Residential Eligible Units on ISPs

FY 2016-2017 ISPs should contain units that accurately reflect the number of residential habilitation eligible day units the participant is anticipated to receive for the plan year. NOTE: The frequency and duration of the outcome action attached to the Residential service should be updated to reflect the accurate number of days. FY 2015-2016 included a leap year which means one extra day was reflected on last fiscal year’s ISP. For fiscal year 2016-2017, AEs and SCOs should ensure the units reflect 365 calendar days instead of 366 calendar days.

Updating the SSD Providers should review their current service offerings in HCSIS and update their Services and Supports Directory (SSD) by making the following changes, where applicable: Adding or deleting service offerings for a particular AE, based on the

provider’s intentions for service in FY 2016‐2017

Replacing any end dated service offerings with alternative service offerings, where applicable

Deleting any services as well as the physical service location addresses in HCSIS where the service offerings have been end dated

Adding specialty codes so that all service locations are aligned with PROMISeTM. Providers should review their current service locations, provider types, and specialties in PROMISe™ and HCSIS/Provider Access to ensure both systems have the same enrollment information. If the provider types and specialty codes do not match exactly in both systems, a rate cannot be loaded for the associated procedure code (service).

When providers ensure their service locations contain accurate information, it will prevent unnecessary completion of re-validation applications.

Non Waiver Service Rates

AEs are responsible for entering rates for non-waiver service codes (base-funded). Rates for waiver-funded services paid for by base funds will continue to be added to the system by ODP. AEs should send those rates to the ODP Regional Fiscal

ISSUE DATE: June 3, 2016 ODP Communication Number: Announcement # 036-16 12

REMINDERS

Officer (RFO) and the RFO will ensure the rates are loaded.

SUTA The State Unemployment Tax Act (SUTA) percentage is determined by the Pennsylvania Department of Labor and Industry. When the FY 2016-2017 SUTA percentage becomes available, the ODP Regional Offices will provide it to the AEs who in turn will distribute it to the SCOs.

Leap Year Adjustment on Draft 16/17 FY Renewals

When the draft 2016-2017 fiscal year renewal is created, HCSIS copies all of the exact information from the existing approved ISP into a new draft ISP. FY 2015-2016 included a leap year which meant one extra day was reflected on the ISP. For fiscal year 2016-2017, AEs and SCOs should ensure the units reflect 365 calendar days instead of 366 calendar days.

“Annual Review Update Date”

Correct completion of this field in HCSIS will ensure that reporting mechanisms in HCSIS related to the ISP data are accurate. During the 2016-2017 FY Renewal period, it is strongly recommended that SCOs confirm that the Annual Review Update Date on the individual’s ISP is accurate as specified in Informational Memo #051-11, issued on April 15, 2011. Informational Memo #051-11, provides the purpose and intent of this field as well as instructions on when to correct the Annual Review Update Date field in HCSIS.

Public Transportation

If a public transportation provider’s rates are set by PennDOT or the Public

Utility Commission (PUC), these providers should be enrolled as a PT55/specialty 267 in both HCSIS and PROMISeTM. If the provider fails to enroll as a PT 55/specialty 267 in this situation, there is a risk that they will not be paid the correct rate. Public Transportation providers whose rates are NOT set by PennDOT or PUC but who submit a cost report may be enrolled as a PT 26/specialty 267 and should not experience any payment issues. Please be sure to check your service authorization notices and rates to ensure that your rates were loaded correctly as cost-based rates.

ISSUE DATE: June 3, 2016 ODP Communication Number: Announcement # 036-16 13

Topical Area Resources/Instructions

Modifying a service offering on your SSD

Visit the Learning Management System (LMS) on the HCSIS website for instructions on how to add a service offering to the SSD. Log into HCSIS. After you reach the Welcome to HCSIS screen, click the Learning Management System (LMS) link. After logging in, click “My Curriculum” on the Welcome to LMS screen. Instructions on how to add a service to the SSD can be found under ODP: PROV100I Provider Materials > Provider Access Registration Job Aid v7.1 01/24/11 (for providers new to HCSIS) or Provider Access Updates Tip Sheet (for current HCSIS providers).

Adding a service

to an individual’s

ISP

Visit the LMS on the HCSIS website for instructions on how to add a service to an individual’s ISP. Log into HCSIS. After you reach the Welcome to HCSIS screen, click the Learning Management System (LMS) link. After logging in, click “My Curriculum” on the Welcome to LMS screen. Instructions on how to add a service to an individual’s ISP can be found under ODP: SC100I Supports Coordination > Chapter 10: ISP Services and Supports v7.0 7/25/09

Provider Qualification

All Direct Service Providers (Including Vendors, AWC and OHCDS providers) that provide Consolidated and P/FDS Waiver services must meet the qualification criteria outlined in the Waiver for the service(s) they currently provide or intend to provide. For waiver services, HCSIS will create a Real Contract if the specialty code associated with the service has a status of “Qualified”. If the specialty code is anything other than “Qualified”, the service will not be converted to a Real Contract after the FY 2016-2017 estimated waiver rates are loaded into HCSIS. If Real Contracts have not been created for one or more service offerings, providers should contact their Regional Office. As a reminder, non‐waiver service contracts will continue to be the responsibility of AEs. Information on the qualification process can be viewed in HCSIS using the following path: HCSIS > Learning Management System (LMS) > My Curriculum > ODP: PROVQ100J Provider Qualification > Provider Qualification - Provider Job Aid - v2.4 - 09/26/14 Providers are required to qualify for a new service prior to adding the new specialty to HCSIS

Adding a specialty

in HCSIS

The provider should add the new specialty code to the site address in HCSIS. After this step has been completed, the provider should fax a Verification Letter to the HCSIS helpdesk using the following fax number: (717) 540-0960. Visit the LMS on the HCSIS website (www.hcsis.state.pa.us) for instructions on how to add a new specialty code in HCSIS. Log into HCSIS. After you reach the Welcome to HCSIS screen, click the Learning Management System (LMS) link. After logging in, click “My Curriculum” on the Welcome to LMS screen. Instructions on how to add a specialty type to your enrollment records can be found under ODP: PROV100I Provider Materials > Provider Access Updates Tip Sheet. (This information is also found on the left side of the Provider Access Screen in HCSIS)

ISSUE DATE: June 3, 2016 ODP Communication Number: Announcement # 036-16 14

Topical Area Resources/Instructions

Adding a new specialty code in PROMISe™ if the associated provider type is already enrolled

Providers who want to add a new specialty code to an existing service location, should complete the PROMISeTM Provider Enrollment Base Application. See the instruction column under “Adding a new provider type in PROMISe™” for the location of the base enrollment application on the DHS website. Providers may fax the completed base enrollment application to the ODP PROMISeTM

Provider Enrollment unit at (717) 783-5141. Providers also have the option to e-mail or mail their base enrollment application to the ODP Provider Enrollment Unit. Licensed providers should list the specialty and start date for the specialty on the application and include a copy of their license along with the base enrollment application.

Adding a Provider

Type in HCSIS

Visit the LMS on the HCSIS website (www.hcsis.state.pa.us) for instructions on how to add a new provider type in HCSIS. Log into HCSIS. After you reach the Welcome to HCSIS screen, click the Learning Management System (LMS) link then click “My Curriculum” on the Welcome to LMS screen. Instructions on how to add a provider type to your enrollment records can be found under ODP: PROV100I Provider Materials > Service Location Tip Sheet v6.0 6/22/08 or ODP: PROV100I Provider Materials > Provider Access Updates Tip Sheet

Adding a new provider type in PROMISe™

Before a new provider type is enrolled in PROMISe™, providers should ensure they have completed the ODP provider qualification process and the registration process in HCSIS. A new service location must be added in HCSIS before the site can be enrolled in PROMISe™. PROMISe™ enrollment will not take place if the registration and provider qualification process in HCSIS is not complete. Only one provider type is permitted per service location in the PROMISe™ system. In order to obtain a new 4-digit service location number for the new provider type, add the new service location in HCSIS and send the HCSIS Verification form to the ODP Provider Enrollment Unit and they will verify the site. Next, complete a PROMISeTM Provider Enrollment Base Application, which is located in the PROMISe™ provider enrollment section of the Department of Human Services (DHS) website. Left click on the following hyperlink to visit the DHS website: http://www.dhs.pa.gov Once the user reaches the home page of the DHS website they should use the following path to locate the applicable provider enrollment application: http://www.dhs.pa.gov > Providers > More > PROMISe > Enrollment Information. Once the user reaches the Enrollment Information screen of the DHS PROMISe™ provider enrollment website, scroll down until you find the provider type you wish to enroll. Click on the Enrollment Application/Provider Agreement hyperlink located to the left of the provider type. Completed applications and supporting documentation for the applications along with any change request forms may be faxed to (717) 783-5141 Attn: ODP Provider Enrollment Unit, or mailed to the ODP Provider Enrollment Unit located at P.O. Box 2675, Room 413 Health and Welfare Building, Harrisburg, PA 17120. NOTE: ODP is not yet participating in the On-line Electronic Provider Enrollment Application System. Please contact the ODP Provider Enrollment Unit before attempting

ISSUE DATE: June 3, 2016 ODP Communication Number: Announcement # 036-16 15

Topical Area Resources/Instructions

to enroll using this method. Viewing service location, provider types, and specialty codes in both HCSIS/ Provider Access

and PROMISe™

HCSIS/Provider Access: Log in to HCSIS and click “View My Application Summary” located on the left sidebar of the screen. A listing of all sites with the provider type and specialty code designations will be displayed. Providers can view the provider types and specialties that are enrolled with each of their service locations in PROMISe™ through ePEAP (Provider Enrollment Automation Project). To access ePEAP, go to the PROMISe™ Internet (PROMISeTM). Next, click the “ePEAP (Provider Enrollment Automation Project)” link, located in the “Other Links” box. A listing of the sites and associated provider types will be displayed based on the provider ID used to log into ePEAP. Click “View Specialties” to view the specialty code for the displayed service location. For more detailed instructions on how to view provider type and service location enrollment information, please reference pages 5‐7 of the ePEAP Manual. The link to the ePEAP webpage is: ePEAP Manual

Contact the ODP Provider Enrollment mailbox with PROMISe™ enrollment questions at ra-odpproviderenroll@pa.gov or toll free at 1-888-565-9435, option 3

INQUIRIES

For general inquiries regarding this communication contact your ODP Regional Coordinators.

Region Regional Coordinator Contact

Central Region Denise Sloand dsloand@pa.gov Northeast Region Shawn Lynn shlynn@pa.gov Southeast Region Shana Wimmer swimmer@pa.gov Western Region Laura Sippos lsippos@pa.gov

ODP Customer Service Line: 1-888-565-9435 TTY number 1-866-388-1114 Monday – Friday, 8:30AM – 4:00PM For all inquiries or complaints regarding services, policies, and Provider Enrollment Provider Enrollment Mailbox: ra-odpproviderenroll@pa.gov

For inquiries and issues regarding claims: ODP Claims Resolution Hotline and e-mail: 1-866-386-8880, ra-odpclaimsres@pa.gov Monday – Thursday, 8:30AM – 12:00PM and 1:00 – 3:30PM

HCSIS Helpdesk: 1-866-444-1264 Monday – Friday, 8:00AM – 5:00PM For inquiries and issues regarding HCSIS

PROMISe™ Helpdesk: 1-800-537-8863 Monday – Friday, 8:00AM – 4:30PM For inquiries and issues regarding PROMISe™