CoreMMIS stabilization: Day 5 Update

CoreMMIS stabilization: Day 5 Update

This week, the Indiana Health Coverage Programs (IHCP) implemented the CoreMMIS and the Provider Healthcare Portal (Portal). The Indiana Family and Social Service Administration (FSSA) and Hewlett Packard Enterprise (HPE) are aware the new system is experiencing some performance issues. It is our intention to resolve issues as quickly as possible. We 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 5 of the rollout:

  • Provider Healthcare Portal:
    • Issue: Portal functionality was down beginning early this morning.
    • Actions taken: HPE worked to isolate the problem and made the necessary fixes. Response times are still a concern and research continues.
    • Resolution: Portal functionality was restored at approximately 2 p.m.
  • Claims transactions:
    • Issue: Fee-for-service claims processing
    • Actions taken:
      • EDI batch claims: Professional, dental, and institutional EDI batch claims continue to process as normal with expected results.
      • Portal claims: Institutional claims submitted through the Portal are now processing as normal with expected results. Professional and dental claims submitted through the Portal continue to process as normal with expected results.
      • Paper claims: Institutional claims submitted on paper are now processing as normal with expected results. Professional and dental claims submitted on paper continue to process as normal with expected results.
      • 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.
    • Resolution:
      • Providers are advised to submit all EDI batch, Portal, and paper claims - professional, dental, and institutional - as normal for processing.
      • The financial cycle for next Tuesday, February 21, 2017, will run as planned except that the time frame will be extended to include claims processed as of 5 p.m. Saturday, February 18.
  • Prior authorization transactions:
    • Issue: Submission of PA requests through the Portal
    • Actions: Prior authorizations can now be submitted through the Portal.
    • Resolution: Providers are encouraged to submit PA requests through the Portal.
  • Presumptive Eligibility:
    • Issue: Presumptive Eligibility application errors are occurring.
    • Actions taken: Research continues to determine a permanent solution. In the meantime, HPE is manually entering Presumptive Eligibility applications submitted by providers.
    • Resolution: Providers having system issues with completing PE applications should send a secure email with applicant information to PresumptiveEligibility@fssa.in.gov.
  • Call center:
    • 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 within 24-48 hours of receipt.
    • 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 incoremmis2015im@hpe.com or through Secure Correspondence on the Portal.

The FSSA and HPE continue to monitor the system to stabilize its performance. We appreciate the patience and help of the provider community in making that happen. Please continue contact us at 1-800-457-4584 or by email at incoremmis2015im@hpe.com. Watch for broadcast messages about progress posted to the Portal and interactive voice response (IVR), as well as regular new alerts posted to indianamedicaid.com.