Information Letter No. 2008-88
July xx, 2008
Page 1
October 30, 2008
To:Community Based Alternatives (CBA) Home and Community Support Services Agencies (HCSSAs), Consolidated Waiver Programs (CWP), Program of All-Inclusive Care for the Elderly (PACE), State of Texas Access Reform Plus (STAR+PLUS) and Integrated Care Management (ICM) Providers
Subject:Texas Department of Aging and Disability Services
Information Letter No. 2008-160
New Provider Workflow Process for Community Waiver Providers
In mid-November 2008, DADS will implement system enhancements to the TMHP LTC (Texas Medicaid Healthcare Partnership Long Term Care) Online Portal to include a Provider Workflow.
Medical Necessity and Level of Care assessments (MNLOCs) will be pended in the Provider Workflow when the nightly batch processing discovers an error in attempting to process an MNLOC assessment. When this occurs, the provider will see a “Provider Action Required” status displayed for the assessment in the LTC Online Portal. The assessment history will include a descriptive message that informs the provider of the error.
The Provider Workflow allows providers to independently manage their assessments when errors in the nightly batch processing occur. Today, all error rejections are managed by DADS. Error rejections directed to the Provider Workflow will involve situations where DADS would have needed to contact the provider for resolution. The new Provider Workflow functionality removes DADS intervention and allows providers to directly manage their rejections which occurred during nightly batch execution. The benefit is shorter resolution time because providers are no longer dependent upon DADS for resolution of these types of errors; thiswill enable LTC providers to make timely corrections. Some forms will continue tobe directed to the Community Services Manual Workflow. In some cases, a phone call to the appropriate DADS contact may be necessary [regional caseworker, CMS coordinator, STAR+PLUS Support Unit, Integrated Care Management Support Unit].
TMHP will host web-based Webinar conference calls on this enhancement to ensure providers have an opportunity to learn how this change will affect them. Material will be posted on TMHP.com by November 10, 2008. NOTE: It is very important for participants to download and review these materials beforeattending a Question-and-Answer Webinar conference call session.
Registration information and dates/times of the conference calls will be posted at Programs.com on or around November 10, 2008. Providers can participate in these sessions from their offices, and due to the importance of this change, spaces for webinars are expected to fill up quickly. Providers are encouraged to register as soon as the webinar dates are posted.
Contact the TMHP Help desk at 1/800-626-4117, option 1 if you have any questions about the Provider Workflow.
Sincerely,
[signature on file]
Gordon Taylor
DADS Chief Financial Officer
GT: mgm