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MA Council for Home Care Aide Services. Thursday May 19, 2011. Agenda . Introductions Implementation Strategy Project Calendar Function Of Lead Agency User Support Model Business Process Review Meetings User Request Forms Project Communications On-line Training (Harmony University)

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Presentation Transcript
  • Introductions
  • Implementation Strategy
  • Project Calendar
  • Function Of Lead Agency
  • User Support Model
  • Business Process Review Meetings
  • User Request Forms
  • Project Communications
  • On-line Training (Harmony University)
  • Demonstrate The Application

Contact Info

Jim Ospenson

EOEA Analyst for Home Care/ Clinical

Sean Rogers

EOEA Analyst for Finance

provider direct features
Provider Direct Features

Provider Direct is:

A secure web portal that allows Providers to view real-time agency data:

Looks at the SAMS database used by ASAPs for up-to-the minute updates

Consumer records & relevant information (PHI)

Planned & ordered services

History of service delivery records


Service Delivery Module – post service delivery / electronic invoices

Client-centered messaging for inquiries, follow-up, and task assignment (future)

System that transmits Protected Health Information between providers

Confidential Information


implementation strategy far first then evi
Implementation Strategy: FAR first, then EVI
  • In a nutshell: FAR first, then EVI
  • Assign Provider to Lead Agency
  • Initial exposure to application
    • Schedule of webinars before and after go-live:
      • online demonstrations, watch from your office.
  • Business Process Meetings
    • Provider to meet with each ASAP that they serve
    • Review details of current-state work process
      • Who talks to whom in what situation
  • Providers: Self-training using Harmony University
    • Thirty (30) days of access per user, starting one week before go-live
  • Stage 1: FAR (faxed authos)
    • Provider Users will start off in a production environment, looking at their own real consumer data.
    • First job: parallel processing. Compare HPD’s Change Log to FAR faxes.
    • Next:
      • Agency-Provider communications. What’s different?
      • Reporting
    • Objective: Agency & Provider agree to shut down FAR faxes after approx 3 weeks
  • Stage 2: EVI (Electronic Vendor Invoices)
    • Agency & Provider agree on first HPD billing cycle
    • Provider identifies desired billing functionality: File Upload, Service Delivery Confirmation Wizard, other.
function of lead agency
Function Of Lead Agency
  • A Provider can serve one or more ASAPs.
    • The Lead Agency is (usually) the Agency with the greatest volume.
  • Functions
    • Coordinate user management for that Provider
    • Coordinate application training for providers, especially new staff
      • Distribute HPD user manuals (available from QuickBase)
    • Establish support policies and identify contact staff for Provider Direct
    • Resolve "Tier One" issues related to users:
      • New & terminated users
      • Password resets
      • Application training
      • Basic usage questions related to Provider Direct: list formatting, filter criteria, etc.
      • Reset Silverlight
    • Receive application and bug reports from Provider
      • Train providers in getting screenshots
    • Communicate with SIMS Support as needed
      • Providers will not communicate with SIMS Support
  • Providers will contact other (non-Lead) agencies to resolve questions about specific consumers, or to confirm business processes & contact names
user support model provider direct
User Support Model - Provider Direct
  • Each ASAP will support users for providers where they are Lead Agency.
  • Providers must contact their Lead Agency ONLY for technical issues
    • Lead Agency will resolve or escalate
  • Contact the authorizing Agency about client issues.
business process review meetings
Business Process Review Meetings
  • Between Kickoff & Go-live
    • Agency & Provider to review the current-state processes: the specifics for each of the changes that result in a fax
      • Verbal/phone
      • Staff contacts
      • SAMS Data entry
      • Fax details
      • Issues in current process?
    • Reviewing your current practice will make post-go-live parallel process faster & easier
      • Best as face-to-face meeting, but at ASAP discretion
      • Providers serving multiple agencies should review with each ASAP
    • Notify EOEA of multiple business lines, or other requirements for a provider to view multiple provider records
      • Provider has multiple business lines (certified/non-certified)
      • Recent merges
      • Unusual security configurations
  • 2-3 weeks after go-live
    • Agency & Provider review parallel processing
    • Gauge readiness to shut down FAR (faxed authos)
  • Business Process Meetings between Provider and All Agencies doing business with…
  • Seven (7) Business Processes to replace FAR (faxed authos)
  • New Consumer (Provider has never before served). Includes new service schedule.
  • One-time Only (temporary boost in authorized services)
  • Updated Service Schedule (same units/week)
  • Updated Service Schedule (unit change *or* change in services)
  • Suspension (ASAP notifies Provider *or* Provider notifies ASAP)
  • Resume (after Suspension)
  • Terminate consumer
user request forms pd urf
Lead Agency Manages a Provider's Users

Agency manages only one (1) URF form with information for all of their providers, containing all present and past users.

How Many Accounts?


Each provider may have up to five (5) active userids.

Fields on URF, for each user

Organization Name for User

Must match SAMS provider name

Request Type

New, Update, Terminate, Reactivate

User's First Name

User's Last Name

Four (4) Digit PIN

User's Month (MM) and Day (DD) of birth

User's E-mail Address

User's Office Telephone Number

Accuracy is key

Spelling of names

Email addresses

Timeliness is key

Don’t miss the boat

User Request Forms (PD-URF)
project communications
Project Communications
  • For providers, your main point-of-contact about Provider Direct will be your Lead Agency.
    • User, training, application issues should be communicated to Lead Agency.
    • If there are technical issues that must be escalated, then the Lead Agency will contact SIMS Support.
      • Agencies: Make sure to keep your "five contacts" up-to-date.
      • SIMS Support may contact the Provider in certain situations to collect follow-up information.
  • For providers, your main point-of-contact about specific Consumers will be the consumer's Agency.
    • Questions about individual consumers should go to the Consumer's Agency (whoever created the consumer's Service Plan.
      • Each Agency and each Provider should work out the appropriate Agency staff to respond to any particular item: Case Manager or Supervisor, POS coordinator, Fiscal staff.
  • Email communications from EOEA to two (2) people at each organization
    • the Lead and a backup
    • EOEA will only communicate to providers occasionally
    • Agencies: Please make sure our records are complete
project communications12
Project Communications
  • Massachusetts User Information Portal
    • Objective: this is the first reference for users & user support, for any application, project, or operational materials.
    • Searchable, with date and category archives
    • Categories
        • Announcements
        • Frequently Asked Questions
        • Group 1
        • How-to
        • Issue Reporting
        • Lead Agency Info
        • Manuals
        • Training
        • User Management
        • User Support
    • Let us know if anything is missing or needs to be updated.
harmony university on line training
Harmony University (on-line training)
  • All users will have 30 days of access
billing methodologies
Billing Methodologies
  • EVI Replacement – Service Plans visible in HPD
    • EVI Out Spreadsheet generated from Consumer Monthly Service Plan Report
      • Providers run a HPD report on demand
      • In Production currently
    • EVI In Spreadsheet Replaced by:
      • HPD File Upload
        • Current Status
      • Service Delivery Confirmation
provider direct demo
Provider Direct Demo
  • This is a Test environment based on production: all data is scrubbed. No real consumer info.
  • This user's view is from a real provider in the production environment, for example XYZ Home Care.
  • Security: A Provider Direct user can
    • See (but not edit) selected elements of the base consumer record for consumers with XYZ Home Care service plans (current or historical).
    • See (but not edit) service plans & service schedules where Provider = XYZ Home Care
    • See (but not edit) service orders where Provider = XYZ Home Care
    • See (but not edit) service suspensions where Provider = XYZ Home Care
    • See, create and update service delivery records where Provider = XYZ Home Care (however, service plans and service orders must exist first).
      • We will implement service delivery functionality in the second phase.
    • See, create, and edit rosters where Provider = XYZ Home Care
    • Reports:
      • PD User can run reports and save report definitions (criteria)
      • all data displaying on PD reports is subject to the same security policy
  • Each organization (Agency or Provider) has a unique "view" of the SAMS/ Provider Direct database.
  • ASAP users (in Provider Direct or SAMS) will have a slightly different view of the data than the Provider users they support.
    • Usually this means that the Agency users sees more consumers in the consumer list, more changes in the Work Queue, or service records (plans, orders, deliveries) from other providers.