Please see the following synopsis for Day 2 of the rollout:
Issues: Providers are experiencing difficulty verifying eligibility via the Portal as well as through the Interactive Voice Response (IVR) and interactive 270 transactions.
Actions taken: HPE has tripled the number of eligibility software services and increased the processing capability. HPE continues to analyze its infrastructure and software, and continues with performance remediation actions.
Expected resolution: Eligibility verification transaction time frames are beginning to stabilize; monitoring continues.
Issues: Providers are experiencing difficulty reaching customer assistance representatives and leaving voice mail messages due to large call volume.
Actions taken: All available staff are being utilized to take incoming calls and make outgoing return calls. Please be patient when making calls to the customer assistance line at 1-800-457-4584. Inquiries may also be sent via email to email@example.com.
Claims and PA transactions:
Issues: At this time, fee-for-service claims and prior authorization request submissions through the Portal have been suspended. Trading partners can continue to submit electronic data interchange (EDI) transmissions; HPE is accepting these transmissions, but not processing them at this time.
Actions taken: HPE and the FSSA are monitoring the system. Providers should watch News and Announcements for updates. Providers can continue to submit PA requests to Cooperative Managed Care Services (CMCS) via fax at 1-800-689-2759.
Expected resolution: Providers can be assured that this week's financial cycle will run as normal; payment for claims processed last week will pay as expected February 14, 2017. We anticipate the financial cycle for next Tuesday, February 21, 2017, will run as planned with payment for claims submitted this week.
They will continue to monitor the system to stabilize its performance. They appreciate the patience and help of the provider community in making that happen. Please continue to contact them at 1-800-457-4584 or by email at firstname.lastname@example.org. Watch for broadcast messages about progress posted to the Portal and the IVR, as well as regular new alerts posted to the indianamedicaid.com.
To view the announcement, click here. We hope this information is helpful. If you have questions or need additional assistance, please contact the INARF office.