IN-HOME SUPPORTS ASSURANCE SYSTEM I ntro duc tio n What is - - PowerPoint PPT Presentation

IN-HOME SUPPORTS ASSURANCE SYSTEM

I ntro duc tio n

What is ISAS?

• Pho ne -b a se b illing syste m fo r in-ho me c a re pro vide rs

Why do we use ISAS?

• I

nc re a se pro vide r a c c o unta b ility

• De c re a se fra ud a nd a b use
• Simplify a nd mo de rnize the b illing pro c e ss

What have we gaine d by using ISAS?

• I

nc re a se d pa yme nt ra te o n pe rso na l c a re c la ims

ISAS Sy System em Compone

• nents
• Car

e Ve r ific ation Me c hanisms (Voic e Re c ognition and OT

P)

• T

ime ke e ping, Claims Ge ne r ation, and Re por t Monitor ing

Ca re Ve rific a tio n Me c ha nisms

Pr

• vide r

ve r ific ation: Voic e Re c ognition

• Vo ic e -b a se d a lg o rithm kno wn a s “vo ic e print”
• Re q uire d fo r a ll pro vide r c a lls

Par tic ipant ve r ific ation: L

• c ation Re c ognition
• Pa rtic ipa nt prima ry la ndline OR
• Pa rtic ipa nt’ s One -T

ime Pa sswo rd (OT P) de vic e

OT P De vic e Ma na g e me nt

Assign an OT P De vic e

• No la ndline o r po o r c e llula r se rvic e
• T

wo o r mo re pa rtic ipa nts in the sa me ho use ho ld

• Sha re d prima ry numb e r (pro vide r o r pa rtic ipa nt, in

diffe re nt ho use ho ld)

Un- assign an OT P De vic e

• De vic e re po rte d a s lo st, b ro ke n, o r sto le n
• Pa rtic ipa nt de a th

Ca re Ve rific a tio n Me c ha nisms

All c lie nt phone numbe rs must be unique

T ime ke e ping, Cla ims, a nd Re po rts

All pr

• vide r

s dial 1- 855- 4MD- ISAS

• Bo th c lo c k-in a nd c lo c k-o ut
• Use pa rtic ipa nt la ndline OR mo b ile pho ne
• Use pe rso na l mo b ile pho ne with pa rtic ipa nt’ s OT

P de vic e

All pr

• vide e sse ntial infor

mation

• Pa rtic ipa nt MA numb e r
• Pa rtic ipa nt’ s first a nd la st na me
• Six dig its fro m the OT

P de vic e (if a pplic a b le )

• Pro vide r’ s vo ic e print
• Pro vide r I

D numb e r

T ime ke e ping , Claims, a nd Re po rts

Age nc y Pr

• vide r

Claims

• Nig htly pro c e ss run
• Billing c o de W5519
• We e kly pa y sc he dule
• Wo rk a utho rize d b y POS

Inde pe nde nt Pr

• vide r

Claims

• Nig htly pro c e ss run
• Billing c o de W5520
• Bi-we e kly pa y sc he dule (PPL

)

• 40 ho urs/ pa rtic ipa nt/ we e k

T ime ke e ping , Cla ims, a nd Re por

ts

ISAS Se r vic e s Re nde r e d Re por t

• Vie w o nc e pe r mo nth
• T

ime ke e ping tra c ke r fo r e a c h pro vide r

• Use ful to e nsure pro vide r c o mplia nc e

ISAS Claims Re por t

• Vie w o nc e pe r mo nth
• Ba se d o n Se rvic e s Re nde re d Re po rt
• Re fle c ts a djustme nts

T ime ke e ping , Cla ims, a nd Re por

ts

T ime ke e ping , Cla ims, a nd Re por

ts

T ime ke e ping , Cla ims, a nd Re por

ts

T ime ke e ping , Cla ims, a nd Re por

ts

ISAS Process Aw Awarenes ess

• POS Ve r

ific ation (Ac tive , Appr

• ve d, and Ac c ur

ate ) and De tail Vie w

• Missing T

ime Re que st Submission

POS Ve rific a tio n

Ge ne r al plans ar e ac tive , appr

• ve d, and ac c ur

ate

• Ac tive : Pla n is c urre nt
• Appro ve d: Pla n is ve rifie d b y DHMH sta ff
• Ac c ura te : Pla n re fle c ts c o rre c t “E

ffe c tive ” a nd “E nd” da te s

Plan de tails ar e c omple te and c onsiste nt

• E

me rg e nc y b a c kup se c tio n is c o mple te (re q uire d )

• POS Se rvic e c o lumn c o nsiste nt with pro vide r info rma tio n
• T
• ta l ho urs in POS ma tc h to ta l ho urs indic a te d in se rvic e de ta ils

Curre nt pla n is a c tive E xc e ptio n type s: No a c tive POS; Clie nt ha s no ISAS se rvic e

POS Ve rific a tio n

Curre nt pla n is a c c ura te E xc e ptio n type : Pro vide r no t o n POS

POS Ve rific a tio n

POS Ve rific a tio n

Pla n de ta il indic a te s c o mple te E me rg e nc y Ba c kup Pla n info rma tio n

Joe Smith Jane Smith

No te : Ide ntifying info rma tio n is re mo ve d fro m this e xa mple .

Pla n de ta il indic a te s c o nsiste nt se rvic e pro vide r info rma tio n E xc e ptio n type : Clie nt ha s no ISAS se rvic e

Caring Handz, Inc.

No te : Ide ntifying info rma tio n is re mo ve d fro m this e xa mple .

POS Ve rific a tio n

POS Ve rific a tio n

Pla n de ta il indic a te s c o nsiste nt to ta l se rvic e ho urs

No te : Ide ntifying info rma tio n is re mo ve d fro m this e xa mple .

Missing T ime Re q ue sts

Submitting Missing T ime Re que sts

• Ag e nc y pro vide rs sho uld no tify the ir a g e nc y a dministra to r
• Inde pe nde nt pro vide r o ptio ns:
• E

nte r missing time o nline

• Ca ll the ISAS He lp De sk: 1-855-463-5877

L imits for Missing T ime Re que sts

• F
• r a ll pro vide rs
• until two b usine ss da ys a fte r the la st da y o f the mo nth to sub mit
• DHMH a ppro ve s o r de nie s a ll re q ue sts
• Only six re q ue sts pe r mo nth will b e a ppro ve d, with fe w e xc e ptio ns

ISAS Res esources

• He lp De sk Infor

mation

• T

r aining and Re gistr ation Infor mation

• Contac t and Suppor

t Infor mation

He lp De sk

Busine ss Hour s: L ive Ope r ator

• Mo nda y-F

rida y 6 a .m.-8 p.m.

• Auto -dire c te d a fte r thre e fa ile d c lo c k-in o r c lo c k-o ut a tte mpts

Afte r Hour s: Voic e mail Se r vic e

• Afte r b usine ss ho urs, fo llo w pro mpts to le a ve vo ic e ma il
• Auto -dire c te d a fte r thre e fa ile d c lo c k-in o r c lo c k-o ut a tte mpts

855- 463- 5877

T ra ining a nd Re g istra tio n

Ac c e ss to T r aining

• T

ra ining we b ina r: www.ltsstra ining .o rg

• Re q ue st I

SAS tra ining DVD: 855-463-5877 (He lp De sk)

ISAS Re gistr ation

• Re g iste r fo r syste m a c c e ss: c a ll He lp De sk a t 855-463-5877
• Re g iste r vo ic e prints : c a ll 888-963-4727
• Ag e nc y pro vide rs sho uld re g iste r two e -ma il a ddre sse s
• SPAs sho uld jo in I

SAS list-se rve : isa she lpde sk@ fe isyste ms.c o m

• Re c e ive impo rta nt upda te s a nd time -se nsitive g uida nc e

Co nta c ts

T e c hnic al Suppor t and Ac c ount Se t- up

• I

SAS He lp De sk: 855-463-5877 (He lp De sk)

ISAS Polic y and Payme nt Suppor t (inc luding OT

P de vic e o rde rs)

• dhmh.isa she lp@ ma ryla nd.g o v (inc lude o nly pa rtic ipa nt I

D numb e r)

Waive r Polic y/ Pr

• vide r

E nr

• llme nt/ PPL

Suppor t

• dhmh.c o pro vide rs@ ma ryla nd.g o v

Plan of Se r vic e Suppor t

• dhmh.po sunit@ ma ryla nd.g o v