CoreMMIS stabilization: Day 8 Update

CoreMMIS stabilization: Day 8 Update

The Indiana Health Coverage Programs (IHCP) is beginning week two of implementation of the CoreMMIS and the Provider Healthcare Portal (Portal). The Indiana Family and Social Service Administration (FSSA) and Hewlett Packard Enterprise (HPE) have made progress in stabilizing the new system but are aware some performance issues still exist. 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 8 of the rollout:

  • Provider Healthcare Portal:
    • Issue: Portal functionality is stabilized.
    • Actions taken: Portal performance continues to be monitored.
  • Claims transactions:
    • Issue: Fee-for-service claim processing is functioning normally for all claim types.
    • Actions taken:
      • Financial cycle for last week ran as planned. Claims processed through 5 p.m. Saturday were included.
      • Electronic data interchange (EDI) files received between 12 p.m. Wednesday, February 8, and Friday, February 17, were processed through the CoreMMIS system twice to ensure that no claims were overlooked. Because of this action, providers may see a high rate of denials for duplicate claims in RAs and on 835 transactions. No action is required by providers.
      • Institutional, professional, and dental claims submitted by EDI batch, the Portal, or on paper continue to process as normal with expected results.
      • Quality reviews of claims processed have identified numerous claim 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 rendering providers not being linked to the specific service location on the claim.
        • Use of incorrect occurrence code for home health overhead - occurrence code 73 should be used for dates of service on or after February 13, 2017.
    • Resolution:
      • Remittance Advices (RAs) will be available to providers Wednesday, February 22. Providers can find the RAs on the Search Payment History page in the Portal.
      • Providers are encouraged to review the billing guidance issued in CoreMMIS provider bulletins regarding claims processed in CoreMMIS. Upcoming IHCP provider banner pages will include reminders and clarifications to assist providers in making claim corrections.
  • Presumptive Eligibility:
    • Issue: A Presumptive Eligibility application errors message is displaying when $0 is entered as the applicant's income amount.
    • Actions taken: A permanent fix for this is underway. In the interim, please report $.01 as the applicant's income amount when the applicant reports no income.
    • Resolution: Watch future announcements for a permanent solution.
  • Call center:
    • Issue: Call volumes have leveled off.
    • Actions taken: Call and voice mail response times continue to be monitored.
    • 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 to 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.