DSHS Provider Registration Webinar Slides

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Provider Registration Webinar

        November 2008

ProviderOne Training Team

  Chris                     Melodie

  Sandy                     Dave

Objectives and Agenda

   After this webinar, you will be able to:
   –   Describe the registration activity and process
   –   Anticipate the work effort
   –   Register a Group Provider
   –   Register Servicing/ Performing Providers
   –   Submit your registration for DSHS approval

   –   ProviderOne Registration Process                 -   30 min.
   –   Provider Registration Demonstration              -   30 min.
   –   Break                                            -   10 min.
   –   Provider Registration Demonstration (cont.)      -   35 min.
   –   Next Steps and Conclusion                        -   15 min.

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   –   Additional sources of information
   –   Additional training available

         Provider Registration

- What is ProviderOne?
- Schedule Update
- Terminology
- Define the Registration Process
- Describe Why Registration is Important
- Demonstrate Provider Registration

What is ProviderOne?

   DSHS is replacing its current Medicaid Management
   Information System with a new payment processing system
   named ProviderOne

   When fully implemented ProviderOne will:
   – Serve as DSHS’ primary provider payment system
   – Consolidate the agency’s health-care and social service provider
     billings and payments and
   – Pay 100,000 providers who serve 1 million people each year

   You can find more information on ProviderOne at

   A follow up email will contain all links referenced in this
ProviderOne Schedule Update
Medical and Nursing Home Claims Release

   Now testing hundreds of scenarios and thousands of claim
   variations in ProviderOne - User Acceptance Testing (UAT)
    – Started this round of testing 6 weeks later than planned to correct
      and retest defects revealed during earlier testing (as expected)

   We are no longer projecting a December implementation
    – Our approach has been to reassess implementation dates at
      planned checkpoints

   A new projection will occur as we near completion of UAT.
   We expect to finish UAT in late December
    – For your planning purposes, we believe there is at least 3-4 months
      of work ahead of us to get through UAT, provider testing and training

   Individual Provider / Sole Proprietor
   – An individual who owns his/her own practice

   Individual / Servicing Provider
   – Providers who provide services through a group practice
     or organization

   Group Providers
   – An organization of individual providers who offer medical,
     dental or other services

Provider Registration Process

   DSHS has moved a copy of existing provider records from
   the old Medicaid payment system to ProviderOne

   Providers “register” in ProviderOne
   and validate data

   Register your organizations and servicing providers

   Electronic Batch Submitters must complete Registration and
   sign new Trading Partner Agreement before testing

Security set up must be complete before
you can access ProviderOne to register

   The person who manages security access for your
   organization must:
    – Obtain security credentials
    – Set up security administrator
    – Set you up with the “file maintenance” profile so you can access
    – Give you the ProviderOne logon and password
   Security webinars are available should your staff still need to
   complete this activity
    – Monday, Nov 17, 2008 8:00 AM - 9:00 AM PST
    – Wednesday, Nov 19, 2008 8:00 AM - 9:00 AM PST
    – Thursday, Nov 20, 2008 8:00 AM - 9:00 AM PST
The Registration Process

    Security Staff       Complete                 Group with                   Complete Registration
   assigns you EXT   Registration Steps            Servicing             Yes    Steps for Group(s) &
     Provider File    in ProviderOne              Providers?                    Servicing Providers
                                                                                 Submit Completed
                                                               No                  Registration
    Obtain LogOn
                                                                               to DSHS for Approval
    and Password
      from your
    Security Staff                            END                                   Electronic
                                          Wait for DSHS             No                Batch
                                          Approval and
                                           Notification                             Submitter?


                                                                                   Sign and Mail
                                                                                   New Trading

National Provider Identifier (NPI)

   National Initiative                                     Importan
   NPI Mapping Activity in 2007                                       t!
    – Your organization reported your NPI to DSHS
      and mapped each NPI to existing Medicaid Billing Numbers
    – Some consolidated multiple billing numbers under a single NPI,
      others choose to assign an NPI to each old number
    – Your new structure in ProviderOne will reflect the results of this
      mapping activity
   Many providers have multiple locations under a single NPI.
    – During registration you will choose one location to serve as your
      “base location”
    – Base location represents where payment will be sent

Benefits for Providers

   Verify addresses where payments will go -
  – Identify your base location

   Validate data for your servicing providers

   Report missing data that could affect payments
  – National Provider Identifiers for servicing providers

   Indicate how you will submit and receive transactions

   Update provider file before go live
  – End date servicing providers no longer associated with your group

Staging Provider Registration

- Registration “Sessions” and Schedule
- When You Should Register
- Sizing the Effort

Three Registration Sessions Planned –
Projected Schedule Only

 •   Multiple sessions needed for volume of providers
 •   Timing based primarily on how you submit transactions

      Session 1                               Session 3

                       Session 2

When Should You Register?

   Session 1:
   – Billing Agents and Clearinghouses
   – Managed Care Organizations
   – Regional Support Networks
   Session 2:
   – Providers Using Billing Agents and Clearinghouses
   – Electronic Batch Submitters
         Using EDI software or File Transfer Protocol (FTP)
   – Nursing Homes submitting through WINASAP
   – Tribal Health Clinics
   Session 3
   – Pharmacy POS System users
   – Providers who will enter individual or batch claims through direct
     data entry into ProviderOne (replacing WAMedWeb)
   – Paper Submitters

Sizing the Effort

   To avoid full scale re-enrollment, DSHS moved a copy of
   your records from old system to ProviderOne
   We recognize this is not a “no cost” activity
   Providers complete registration for each group NPI and
   each servicing provider working for a group
   For most providers registration is straightforward
    – Registering a single organization can take 30 – 40 minutes
    – Registering a servicing provider can take 15 - 20 minutes
   Setting up security and completing registration is most
   complex for providers who do a high volume of Medicaid
   business AND have
    – Many NPI’s with multiple locations for each; or
    – Many servicing providers associated with their group

ProviderOne Provider Registration

     – Log into and out of ProviderOne *
     – Navigation of ProviderOne *
     – Registration of a Group Practice Provider *

       * Using a simulated environment

ProviderOne Navigation Tips

   Don’t use Browser Back Button

   Turn Off Pop-Up Blocker

   Use <Ctrl>c to copy, <Ctrl>v to paste
   – Use Notepad if Desired

   ProviderOne System Timeouts

Provider Registration Demonstration

   Log into and out of ProviderOne *
   Navigation of ProviderOne *
   Registration of a Group Practice Provider *

   * Using a simulated environment

10 Minute Break

Welcome Back!

Summary of Topics Covered

   Defined the Registration Process

   Outlined Timing of Registration Activity

   Demonstrated Registration Activity
   – Register a Group Provider
   – Register Servicing Providers
   – Submit the Registration for DSHS approval

Additional Resources

   Online Help

   Instructional Materials
    – Available at http://maa.dshs.wa.gov/ProviderOne/Registration.htm
        Provider Security Administration and Registration Manual
        On-line Provider Tutorials
        Provider Registration Checklist
        List of Clearinghouse and Billing Agent Submitter numbers

   New Trading Partner Agreement
    – Available at http://maa.dshs.wa.gov/providerenroll/

   More Training to Come
    – DSHS will deliver detailed system training two months before go live


   Access ProviderOne at https://waproviderone.org

   Additional Questions?
   – Email us at ProviderOne@dshs.wa.gov

   You can find more information on ProviderOne at

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