This week, the Indiana Health Coverage Programs (IHCP) implemented the CoreMMIS and the Provider Healthcare Portal (Portal). Launching a new system with more modern technology will result in major improvements but is also a major undertaking.
The Indiana Family and Social Services Administration (FSSA) and Hewlett Packard Enterprise (HPE) are aware that the new system has experienced some performance issues. It is their intention to resolve issues as quickly as possible. They also intend to keep the provider community aware of problems that have been identified and the progress being made to resolve them.
Please see the following synopsis for Day 4 of the rollout:
Issue: Call center experiencing high call volume
Actions taken: All available staff are being utilized to take incoming calls and make outgoing return calls. Voice mail messages are being returned in the order in which they are received.
Expected resolution: Providers are encouraged to take advantage of the call center hours available outside the normal business day, when possible: Monday through Friday 8 a.m. - 8 p.m., and Saturday 8 a.m. - 1 p.m. Providers may also find answers to questions by visiting the Indiana CoreMMIS web page. Inquiries can be submitted via email to mailto:firstname.lastname@example.org or through Secure Correspondence on the Portal.
Issue: Submission of PA requests through the Portal
Actions: Contrary to yesterday's update, there continue to be issues with PA request submissions through the Portal. Research into system defects continues.
Expected resolution: Providers are encouraged to submit PA requests to CMCS via fax at 1-800-689-2759 until further notice.
Issue: Fee-for-service claims processing
- Electronic data interchange (EDI) batch claim, Portal claim, and paper claim submissions were released for processing in CoreMMIS at a measured rate to evaluate system performance. All claim types were tested.
- Processing proved successful for EDI batch claims of all claim types, including professional, dental, and institutional.
- Processing proved successful for interactive Portal and paper claims for professional and dental claim types; institutional claims continued to have processing issues and research continues to determine a solution.
- In addition to evaluating system performance, quality reviews of claims processed, have identified numerous claims denials for:
- Claims billed without third-party liability information being reported on the detail level of the claim as required.
- Claims billed for services performed by a rendering providers not linked to the specific service location on the claim
- Providers are advised to submit EDI batch claims - professional, dental, and institutional - as normal for processing.
- Providers are advised to submit Portal and paper claims - professional and dental only - as normal for processing. Institutional Portal and paper claims cannot yet be processed.
- The financial cycle for next Tuesday, February 21, 2017, is expected to run as planned with payment for claims processed this week. Claims processed as of 5 p.m. Friday, February 17, will be included in the financial cycle.
- Providers should refer to CoreMMIS Bulletin BT201667 and Banner Page BR201706 for details and clarification on billing TPL at the detail level.
- Providers should review profiles to ensure the correct rendering providers are linked to the appropriate service locations with accurate effective and end dates.
Issue: Presumptive Eligibility application errors are occurring.
Actions Taken: Research continues to determine a permanent solution; updates will be provided.
Expected resolution: Providers having system issues with completing PE applications should send a secure email with applicant information to PresumptiveEligibility@fssa.in.gov
The FSSA and HPE 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 email@example.com. Watch for broadcast messages about progress posted to the Portal and the IVR, as well as regular new alerts posted to 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.