ForwardHealth Resources for Success Lori Hock ::: January 2019 - - PowerPoint PPT Presentation

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ForwardHealth Resources for Success Lori Hock ::: January 2019 - - PowerPoint PPT Presentation

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ForwardHealth Resources for Success Lori Hock ::: January 2019 Agenda o Overview o Resources o ForwardHealth Portal o Portal User Guides o Email Subscriptions o ForwardHealth Updates o ForwardHealth Online Handbook o Provider-Specific

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Lori Hock ::: January 2019

ForwardHealth — Resources for Success

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1

Agenda

  • Overview
  • Resources
  • ForwardHealth Portal
  • Portal User Guides
  • Email Subscriptions
  • ForwardHealth Updates
  • ForwardHealth Online Handbook
  • Provider-Specific Resources
  • Maximum Allowable Fee Schedules
  • Provider Services
  • Provider Relations Representatives
  • Training Opportunities
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2

Overview

This session is intended to create a connection between your facility’s business processes and the resources that ForwardHealth

  • ffers to support them.
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3

Resources

Resources are available to everyone and include, but are not limited to, the following:

  • The Portal
  • Online Handbook
  • ForwardHealth Updates
  • Portal user guides
  • Provider Services
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4

Portal

  • The Portal, located at www.forwardhealth.wi.gov, contains public

and secure information.

  • All resources discussed in this session are accessible from the

public and secure areas of the Portal.

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Portal User Guides

  • Portal user guides provide instructions on different Portal

functionalities, such as: – Maximum allowable fees, email subscriptions (Available on the public area of the Portal.) – Claim submission, enrollment verification (Available on the secure area of the Portal.)

  • User guides can be viewed online and are downloaded as PDFs.
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Email Subscriptions

  • Individual providers, an organization’s staff, or other interested

parties may register for email subscriptions in order to receive email notifications about: – New provider publications. – Upcoming training sessions. – Reminders.

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Email Subscriptions (Cont.)

  • Users are able to select by:

– Program (e.g., Wisconsin Medicaid, BadgerCare Plus, Wisconsin Well Woman Program, or Wisconsin Chronic Disease Program). – Provider type (e.g., physician, hospital, or durable medical equipment [DME] vendor).

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ForwardHealth Updates

  • Updates announce the latest information regarding:

– Policy and coverage changes regarding prior authorization (PA) and claim submission requirements. – Policy is published in an Update and then incorporated into the Online Handbook. – Email subscribers will receive an email notification when Updates are published.

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Updates (Cont.)

  • All-provider Updates are sent to every provider type, whereas

provider-specific Updates are only sent to the affected provider types.

  • Updates can be viewed online and downloaded as a PDF.
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Online Handbook

The Online Handbook:

  • Is updated real-time and contains current policy.
  • Incorporates the information published in Updates, unless

specifically noted otherwise in the Update.

  • Contains program- and provider-specific information.
  • Should be viewed online.
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1 1

Provider-Specific Resources

Provider-specific resources are grouped by provider type (e.g., physician, hospital, DME vendor) and come in multiple formats, such as:

  • Web-based tools
  • Downloadable text (.TXT), PDF, or Microsoft Excel files
  • Links to other areas of the Portal or external websites
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Fee Schedules

Maximum allowable fee information is available on the Portal in the following forms:

  • Interactive fee schedule
  • Downloadable .TXT files of fee schedules

– Note: the Max Fee User guide provides simple instructions on how to convert the .TXT file to excel.

  • Downloadable PDFs of the DME Index and Disposable Medical

Supplies Index

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Provider Services

Provider Services provides information via:

  • Immediate telephone assistance at 800-947-9627
  • Written correspondence
  • Walk-in appointments
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Provider Services (Cont.)

Contact Provider Services for information regarding topics such as:

  • Billing and claim submissions
  • Provider enrollment
  • Coordination of benefits
  • Forms
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Provider Services (Cont.)

  • Remittance information and claim denials
  • Policy clarification
  • PA status
  • Covered services
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Professional Relations Representatives

Professional Relations Representatives focus primarily on provider education, including:

  • Conducting large-group provider training sessions throughout the

state

  • Providing training and information for newly enrolled providers

and/or new staff

  • Participating in professional association meetings
  • Individualized provider training sessions
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Provider Relations Representatives (Cont.)

The Provider Relations Representatives map includes information about the field representatives’:

  • Territories
  • Specialty groups
  • Contact information

It can be found on the Provider’s home page of the Portal and is titled “Find/Contact your Provider Relations Representative”.

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Training Opportunities

  • On-site sessions:

– Statewide – Provider facility based

  • Online (real-time, web-based) sessions:

– Portal fundamentals – Brown bag sessions – Other new and ongoing sessions

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Training Opportunities (Cont.)

  • Recorded webcasts are available on a variety of topics on the

Portal at www.forwardhealth.wi.gov, by clicking on Training.

  • Training announcement are sent to

– Email subscribers – Portal messaging via your secure ForwardHealth Provider Portal account.

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Thank You