ConnecticutMedical AssistanceProgram Enrollment/Re-enrollment on - - PowerPoint PPT Presentation

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Presented by The Department of Social Services & HP Enterprise Services

ConnecticutMedical AssistanceProgram

Enrollment/Re-enrollment on the Web Training for Nursing Home and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) Providers

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Training Topics

• www.ctdssmap.com - Enrollment Wizard

–Connecticut Medical Assistance Program (CMAP) Web based Enrollment/Re-enrollment Implementation Overview –Enrollment/Re-enrollment Walkthrough

• Beginning the enrollment/re-enrollment application

–What’s Next –Enrollment/Re-enrollment Tracking –Enrollment/Re-enrollment Notification of Decision –Upon Approval –Web Account Set Up For New Providers –Demographic Maintenance –Re-enrollment Notification/Process/Timeframe

• Resources
• Questions

–Enrollment Wizard Navigation

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CMAP Web Based Enrollment/Re-enrollment Implementation Overview

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CMAP Web Based Enrollment/Re-enrollment Implementation Overview

• In order to receive reimbursement for services rendered to clients, providers

must be enrolled in the Connecticut Medical Assistance Program (CMAP). After initial enrollment, Nursing Home and ICF/IID providers will be required to re-enroll every five (5) years.

– This presentation will provide information needed to successfully enroll/re-enroll in the CMAP network.

• DSS offers an online enrollment/re-enrollment application tool called the

Enrollm llm ent Wi Wizard.

– Providers are req equired ed to use the Wizard to submit their enrollment/re-enrollment applications for CMAP on the public Web site. The Wizard was recently enhanced to allow this community enrollment/re-enrollment access as well.

• Providers can access the Wizar

ard’ d’s enrollment/re-enrollment tracking self- service features from the Web Portal at www.ctdssmap.com.

– Access to this application does not require a log in: any user with internet access can utilize this application. An Application Tracking Number (ATN) (which is mailed to providers) and provider ID will be required to complete re-enrollment applications via the Web portal.

• Provider enrollment/re-enrollment applications must be completed in their

entirety.

– Partially completed applications cannot be saved for future completion (exiting the Wizard before completing the application will require you to restart from the beginning). – Completed applications may not be modified through the Web site. Required alterations must be mailed to the HP Provider Enrollment Unit.

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CMAP Web Based Enrollment/Re-enrollment Implementation Overview

From www.ctdssmap.com go to Provider>Provider Enrollment or Provider Re-Enrollment.

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Enrollment/Re-Enrollment Walkthrough

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Enrollment/Re-enrollment Walkthrough

• Providers submitting an application for the first time or providers due for re-enrollment must

enroll/re-enroll using the Provider Enrollment Wizard located on the CMAP Web site: www.ctdssmap.com

• To begin the enrollment process, select P rov id

ider Enrollm llm ent from either the Provider box

• n the left hand side of the Home page or the Provider drop-down menu.
• To begin the re-enrollment process, select P rov
• v ide

der Re Re- enrollm llm ent from the Provider drop-down menu. You must have your ATN to begin the re-enrollment application. Your ATN can be found on your “re-enrollment due notice” or by contacting the Provider Assistance Center.

• A majority of the required information is automatically populated for you when

completing the re-enrollment application, drastically reducing the amount of time the process takes to complete the re-enrollment application.

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Enrollment/Re-enrollment Walkthrough

• The Provider Enrollment > Instr

tructi tions provides an introduction to the

• nline enrollment/re-enrollment process.

–You are strongly encouraged to read through this page prior to beginning the enrollment/re-enrollment process. –Once you have read the instructions, click Ne Nex t to proceed.

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Enrollment/Re-enrollment Walkthrough

• Application Type

Both Nursing Home and ICF/IID Providers must choose Application Type Organization/Group for enrollment/re-enrollment. Click Ne Nex t to proceed.

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• Initial Enrollment versus Re-enrollment?

– Enrollment – Re-enrollment

Click Next No Note: Sel elec ecting th the Re Re- enrollm llm ent radio io bu button

• n w il

ill direct ct th the pr prov ide der to to th the re re- enrollm llm ent w iz izard “ Log

• g In

In to to You

• ur Re

Re- En Enrollm ent Appl pplicat ation” panel el. Fr From ther ere, e, th the panels ls pres esen ented ed to to th the re re- enrolli lling pr prov

• v ider ar

are th the sam am e. How ev ev er er, th the pan panels ar are pr pre- popu pulat ated w it ith inform at ation

• n that

at curre rrently res esides es in in th the int nterCha hang nge sy sy st stem for

• r that

at pr prov ide der.

Enrollment/Re-enrollment Walkthrough

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Enrollment/Re-enrollment Walkthrough

• If you are enrolling for the first time, you will need to select a Provider

Type and Provider Specialty from the drop down menu.

• If you are re-enrolling, enter the ATN and provider ID from the “re-

enrollment due notice”.

Click Next

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Enrollment/Re-Enrollment Walkthrough

• Before You Continue
• Provides a list of information that will be required (if applicable) during

the enrollment/re-enrollment process. You are encouraged to gather the necessary documentation before continuing with your application. Click Ne Nex t to proceed.

Important! While completing the application, if you receive this symbol, you must correct and/or complete the field before continuing.

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Enrollment/Re-enrollment Walkthrough - Application

Beginning the enrollment/re-enrollment application

• National Provider Identifier Information

–Your NPI and Primary Taxonomy are required. Additional taxonomies may be selected if applicable.

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Enrollment/Re-enrollment Walkthrough - Application

• Identifying Information
• This example shows the requirement for an Organization when enrolling

in the CMAP.

• Enter the date that you wish your contract with CMAP to become effective

(cannot go back more than six months).

• Indicate the language(s) spoken by you and your staff.

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Enrollment/Re-enrollment Walkthrough - Application

• Addresses

– Enter information for the required Serv ice ce Loc

• cation
• n Addr

ddress type: – Please be aware that P.O. Boxes are not allowed in a service location address

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Enrollment/Re-enrollment Walkthrough - Application

– After entering information into the Service Location Address panel you may copy that information to other panels such as: Mailing Address; Home Office Address and Enrollment (Check and Remittance Advice Address and 1099 Mailing Address are also required for organization/group providers. – By clicking Copy Svc Loc Addr., information in the Service Location Address panel will be populated here.

• Example:

–Mailing Address

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Enrollment/Re-enrollment Walkthrough - Application

• Additional Service Location Address

–Fill in all required fields with the appropriate information and click next, if applicable. If not applicable, just click Next.

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Enrollment/Re-enrollment Walkthrough - Application

• Financial Information

–Organizations are required to submit financial information such as their Taxpayer Identification Number and State Tax ID. –Fill in all required fields with the appropriate information and click Ne Nex t.

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Enrollment/Re-enrollment Walkthrough - Application

• EFT (Electronic Fund Transfer) Information

– Organizations must enter information regarding the bank account into which they would like to receive reimbursement for the services they provide. – Fill in all required fields with the appropriate information and click Ne Nex t. If you are re-enrolling, this information will be pre-populated, confirm and click Nex ex t or make necessary changes.

**Making changes to this panel will place the provider in a pre-notification status.**

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Enrollment/Re-enrollment Walkthrough - Application

• EFT (Electronic Fund Transfer) Information

After completing the EFT Information, you may receive the following message if the routing number you have provided is not stored in HP’s database If the routing number is correct please check off then Click Ne Nex t to proceed.

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Enrollment/Re-enrollment Walkthrough - Application

• Additional Information

–Skilled Nursing Facilities must enter in their License number then click

• Next. CLIA number(s) are not applicable to Nursing Homes or

ICF/IID providers, ICF/IID providers will not enter any information on this panel, just click Next

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Enrollment/Re-enrollment Walkthrough - Application

• Attestation

–Click Ne Nex t to proceed.

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Enrollment/Re-enrollment Walkthrough - Application

• Medicare Information

–If you are enrolled with Medicare, you will need to provide your Medicare Number and the date that it became effective. –Click Ne Nex t to proceed.

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Enrollment/Re-enrollment Walkthrough - Application

• Board

Members, Partners

• r

Managing Administrators Information –This panel will only be displayed for Organization/Group providers. –Enter responses to each of the questions. If yes to the last question, supply the Name and Corporate Headquarters Location.

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Enrollment/Re-enrollment Walkthrough - Application

• Board

Members, Partners

• r

Managing Administrators Information-Detail –If you answered Yes to the board members, partners or managing administrators of your organization, you will be required to enter details about that board member(s), partner(s),

• r

managing administrator(s). The panel displayed below appears. –If you answered no, click Next to continue.

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Enrollment/Re-enrollment Walkthrough - Application

• Controlling Interest

– Organization/Group providers must have at least

• ne

person with controlling interest

Click Ne Nex t to proceed.

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Enrollment/Re-enrollment Walkthrough - Application

• Survey

–Answer the questions either Yes es or No No – answering yes to any of these questions will open fields requiring you to submit additional information. Click add add after entering the required supplemental data. The survey questions that you are required to answer may vary based on participation type.

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Enrollment/Re-enrollment Walkthrough - Application

Summary

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Enrollment/Re-enrollment Walkthrough - Application

Additional Information to Mail to HP

This panel will display for additional information that is required to be mailed to HP based on your provider type. Click on the given link to view, save, or print the list of required Follow On Documents.

• You can also refer to the Provider Matrix page of the Web portal to review the list of Follow On

Documents that are required for your provider type/specialty.

• The Application Tracking Number (ATN) that you will receive at the end of the application must be

included on the top of each document.

• Failure to submit the Follow On Documents may result in the denial of your application.

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Enrollment/Re-enrollment Walkthrough - Application

ATN and “Follow on Documents” to be sent to HP, Provider Enrollment Unit

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Enrollment/Re-enrollment Walkthrough - Application

• Application Submitted!

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Enrollment/Re-enrollment Walkthrough - Application

• Application Submitted!

– Provides an address to mail any corrections needing to be made to the application and/or submission of “Follow on Documents”. – Provides an Application Tracking Number (ATN) – Please save this number as it will be required for you to check the status of your application through the Web site. – Provides a link you can use to save a copy of the application for your records. Please do not submit a hard copy of the application to HP. Click on Exit, you will have the option to print the application .

Important! Once you leave the application, you cannot go back and re- print.

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What’s Next?

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What’s Next

• The information on your submitted application will now be reviewed by

HP.

• If any information is missing, invalid, or if HP is unable to process the

application, you will receive a letter that informs you what is required for correction or completion of your application.

• Providers will not be able to correct or modify submitted applications

using the Wizard but will need to submit paper corrections to the following address: HP Provider Enrollment Unit P.O. Box 5007 Hartford, CT 06104

• All additional information sent to HP will need the ATN entered on the

upper right hand corner.

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Enrollment/Re-enrollment Tracking

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Enrollment Tracking

• To check the status of an enrollment application, select P rov id

ider Enrollm ent Track ing from either the Provider submenu or the Provider drop-down menu.

• Enter your ATN and Business Name and click search.
• In this example, HP is reviewing the application that was submitted by

Sue’s Nursing Home on February 17, 2015.

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Enrollment/Re-enrollment Notification of Decision

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Notification of Enrollment Decision

• If all information has been provided and is correct, the completed application is

submitted to the DSS Quality Assurance Unit for review. The entire process typically takes several weeks to complete. – If an approval is received from DSS, the HP Provider Enrollment Unit completes the enrollment or re-enrollment process in the interChange system and sends a Provider Enrollment or Re-enrollment Approval Notice to the provider.

• New providers are encouraged to view the Medical Assistance Program Provider

Manual on the www.ctdssmap.com Web site by clicking on Information then Publications from the Home Page.

– If a denial is received from DSS, HP sends a Provider Enrollment/Re- enrollment Rejection Notice to the provider. This letter outlines the reason(s) the application was denied.

• A provider receiving a denial from DSS' Quality Assurance Unit must follow the

instructions for responding to the denial as outlined in the Rejection Notice. In order to reapply to the Connecticut Medical Assistance Program, the provider must once again submit an application via the online Enrollment Wizard.

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Upon Approval

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Upon Approval

• If the enrollment application is approved, the date submitted in the

Provider Effective Date field of the Identifying Information panel will become the provider’s enrollment effective date. –If a provider submits a Web enrollment application and later wishes to back date their enrollment effective date, the provider must submit this request on the provider’s letterhead with the ATN to HP’s Provider Enrollment Unit.

• Providers re-enrolling will have already established an effective date that will be pre-

populated in the “Identifying Information” panel.

• As a new provider, you will receive your logon IDs via your enrollment

confirmation; Web and AVRS PINs will arrive under separate cover. –Once you receive these letters, you are eligible to submit claims. –Do not attempt to submit claims until you have successfully setup your Web portal account.

• Providers re-enrolling should already be established on the secure Web portal. If you

have questions regarding Web access, you are encouraged to contact your main account administrator and/or the Provider Assistance Center.

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Web Account Set Up for New Providers

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• Welcome page at www.ctdssmap.com

Web Account

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Web Account Set Up

• Secure Your Web Access to www.ctdssmap.com

–Ensure access to the Web portal to utilize the self-service features of interChange

• If your office/company has security measures blocking your access, you

will need to contact the individual responsible for your firewall and internet permissions and request access to the Connecticut Medical Assistance Program (CMAP) Web site

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Web Account Set Up

• Setting Up your Secure Site Account

–Select Secure Sit ite from either the Provider panel on the left or the Provider drop-down menu. Click set etup account

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Web Account Set Up

• Setting Up your Secure Site Account

–Alternately, click on the Provider icon from the main page then click Loggi gging in in for

• r th

the fir irst tim im e? from the Quick Login panel on the right side of the screen

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Web Account Set Up

• Information Required for Account Set Up

–As a new provider, you should receive your logon IDs via your enrollment confirmation; Web and AVRS PINs will arrive under separate cover

• AVRS ID / Initial Web User ID
• Web PIN
• AVRS PIN

–You will need to have the Initial Web User ID and Web PIN on hand when you first access the secure site

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Web Account Set Up

• Enter the provided Initial Web User ID and PIN in the appropriate

fields; click setup account, this will allow you to create a unique user ID and password once initial set up is completed

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Web Account Set Up

• On the Account Setup screen, fill in the fields with the appropriate

information

• **Before clicking submit, be sure to write down the chosen User ID,

Password, and secret question Answer(s) and keep them in a secure location**

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Web Account Set Up

• You have successfully set up your ctdssmap.com Secure Site account

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Demographic Maintenance

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Demographic Maintenance

• The Demographic Maintenance section of the secure site allows you to

alter and maintain demographic information:

• Mail to, Pay to, Service Location, and Enrollment addresses
• EFT (Electronic Funds Transfer) Account (account that receives all CMAP

related reimbursements)

• Access this section by selecting demographic maintenance from either

the Account submenu or the Account drop-down menu

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Demographic Maintenance

• The

Demographic Maintenance page displays the provider information panel as well as a submenu

• Clicking the submenu options will open a panel with related

information:

• Base Information - Ownership
• Service Location - County, Organization Code
• Service Language - Language, Effective Date, End Date

1234567890 15 Main Street Suite 2A Willimantic

203-555-5555

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Demographic Maintenance – Location Name Address

• Specify different mailing, payment, and enrollment addresses

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Demographic Maintenance – EFT Account

• The EFT Account panel allows you to add and maintain bank accounts

into which reimbursements from CMAP will be electronically deposited

• Click add

add; enter the appropriate information; and click sav av e

**This action will place the provider in a pre- notification status, while in this status, providers will receive a paper check**

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Re-enrollment Notification/Process/Timeframe

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• Providers with a Re-enrollment due date March 1, 2016

and later:

• Will receive a reminder letter when they are due for re-enrollment (8) months

prior to the end of their current contract. Providers must complete their re- enrollment application prior to the provider’s “re-enrollment respond by date”

• n the re-enrollment due notice to avoid dis-enrollment from the Medicaid

program.

• Providers are encouraged to successfully complete the re-enrollment

application as quickly as possible upon receipt of their notice.

• Providers with re-enrollment applications that have not successfully re-enrolled
• ne month before the provider’s “re-enrollment respond by date” will receive a

notice warning of pending deactivation. If the provider’s application is not finalized by the “re-enrollment due date”, the provider will be deactivated and the provider agreement will be terminated.

*Please refer to provider bulletin PB 2015–42 for additional details*

Re-enrollment Notification/Process/Timeframe

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Resources

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Resources

• Where to go for help:
• www.ctdssmap.com – From the Home page, navigate to Information >

Publications > Provider Manuals

– Chapter 3 – Provider Enrollment and Re-enrollment – Chapter 10 - Web Portal/AVRS

• https://nppes.cms.hhs.gov – National Plan & Provider Enumeration System
• Provider Assistance Center:

– Monday through Friday, 8:00 a.m. – 5:00 p.m. (EST), excluding holidays – 1-800-842-8440 (toll free)

• Provider Enrollment Unit:

HP Provider Enrollment Unit P.O. Box 5007 Hartford, CT 06104

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Questions Comments

Thank You For Attending the CT Medical Assistance Program Enrollment Wizard Training Workshop

All questions and comments regarding this training are welcome. Please fill out the supplied workshop survey. Your feedback helps us to improve future workshops.