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 onents 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 ovide 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 oc 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 •
Ca re Ve rific a tio n Me c ha nisms 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 • All c lie nt phone numbe rs must be unique
ime ke e ping, Cla ims, a nd Re po rts T All pr ovide 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 ovide 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 ovide 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 ovide 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 ove 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 ove 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 o 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 •
POS Ve rific a tio n 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 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 Jane Smith Joe Smith 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 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 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 .
ime Re q ue sts Missing T 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 o 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 ovide r E nr ollme 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 •
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