w v } o o u v l ] } v ' µ ] · title: microsoft powerpoint - enrollment guide.pptx author:...
TRANSCRIPT
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CPC Enrollment/Attestation Guide
October 1, 2019Revised October 1, 2020
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CPC Basics• Invitations were sent to the service location email address found inMITS»Under the 7‐digit CPC Medicaid ID if you have an active one»Under the 7‐digit Medicaid ID if there is no active CPC ID
• Providers can participate one of two ways: »Individual entity»Practice Partnership entity
• Medicaid ID vs CPC ID » The CPC ID is only needed for re‐attesting in the MITS portal• Someone must have created a MITS admin account with the CPC ID and pin received in their welcome letter the original year of new enrollment
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2021 CPC Enrollment Timeline
September 2020
October 2020
November 2020
January 2021
*Invitation letters emailed between Sept 18th – Sept 22nd
*Webinar scheduled Oct 22nd @ 2:00pm
*2021 program beings Jan 1st
*Q1 PMPM pymtswill be sent out by FFS & MCPs in Jan
*Enrollment openson Oct 1st
*Mid‐late Oct we’ll outreach to those who haven’t enrolled
*Enrollment ends on Oct 30th
*ODM will finish rest of the approvals and denials
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Who Gets the Invite to Enroll/Re‐attest?DXC runs attribution logic to look for which providers meet our criteria for enrollment
1. ODM uses an “anchor” date which has been 6/1/XX• Essentially this is an end date to start the look back period on previous claims
2. DXC then uses the look back period of 17 months 1/1/XX – 5/31/XX• This is for all FFS claims and encounters received by a specific date
• The 7‐digit Medicaid ID is used, NOT NPI or tax ID• The paid date must be before the cut‐off and the DOS must be within the look back period
3. DXC runs our attribution method and attributes all eligible individuals4. ODM breaks the data down so we know who falls where with eligibility:
• A practice that gets over 500+ members attributed to them can enroll individually• A practice that gets 150‐499+ members attributed to must enroll with a partnership (to equal a total of 500 min)• A practice 149 and under has NO eligibility
2021 enrollment: The lookback was 1/1/19‐6/01/20 for all received by 07/14/20
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Enrollment Process
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A new Individual entity
If joining CPC for the fist time
If participating again but in a different way
A new Practice
Partnership
Who Completes the Enrollment Process?
Either as:
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In CPC today within a partnership but want/need to convene a new partnership
In CPC today individually but want/need to convene a new partnership
In CPC today as a partnership but want/need to become an individual entity for the first time
Never been in CPC before and want to join
Now for the Break Down:
Is this you? If so, follow these next steps
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Enrollment Process, cont.https://portal.ohmits.com/public/Providers/tabid/43/Default.aspx
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Enrollment Process, cont.1. Select to enroll as a CPC Provider
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Enrollment Process, cont.
Application provides details
for CPC enrollment criteria
If a partnership is enrolling, only the convener needs to
complete the enrollment, all other practices do not need to
enroll
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Enrollment Process, cont.
CPC criteria is also listed
2. Once reading all criteria, select “new application”
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Enrollment Process, cont.3a. Select “CPC” for enrollment type;
“99‐CPC entity” for provider type;
Select “yes” or “no” to being new to CPC
(if saying yes click next)
Once available, make sure to document the ATN in order to complete the enrollment application at a later time, as well as check the status
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Enrollment Process, cont.3b. If you need to select “no”, make sure to add the business name exactly the same way/spelling as previously enrolled with CPC
Only a previously participating practice that is now going to the be the convener to a new partnership or a practice that is leaving a partnership to enroll individually should click no and enter previous information
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Enrollment Process, Cont.
4. Select whether contracting with any managed care plans by using the arrows and then click “next”
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Enrollment Process, cont.
Primary specialty 990‐CPC IndividualORPrimary specialty 991‐CPC PartnershipPLUSSecondary specialty 997‐CPC Pediatrics (if eligible/wishing to participate
5. Complete all * fields, select your specialty(ies) and provide the main CPC contact information, then click “next”(note: this contact will need updated if/when it changes)
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Enrollment Process, cont.6. Enter every participating practice’s CPC ID ‐ if no CPC has ever been given then the Medicaid ID needs to be used, click the blank blue line to save your entry, then click “add” to repeat for each one and then once all are entered click “next”
Each specific practice’s information will display here once you click the blue line to save it. Click ‘add’ to continue adding each practice’s ID.
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Enrollment Process, cont.
7. If applicable, click all the appropriate accreditations that apply and then click next
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Enrollment Process, cont.8. Complete * fields then you must attest to the program requirements before submitting the application
There will be a fourth attestation box below for those providers who selected the CPC for Kids
specialty‐ only select it if eligible and wishing to participate
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Finishing the Enrollment Process
9. The “False” StatementAgreement” and “Ohio Medicaid Provider Agreement” must be fully read, select that the terms are agreed to, electronically sign the application, and then click “next”
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Clicked Next and Nothing Happens?
10. If you do not receive the confirmation of receipt page after clicking next, scrollback up to the top of the page because you received an error/denial message
» Either all terms were not accepted, or an application ‘denial’ was received
Refer to troubleshooting section for assistance
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Final Steps for Enrollment of a Practice Partnership
If you receive the pop‐up denial/error message instead of this page,
please refer to the trouble shooting section for help
11. Choose whether you will upload or mail the attestation and acknowledgement forms, then click “submit”
*It is HIGHLY recommendedto upload – both forms can be uploaded individually or as one pdf attachment
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Final Steps for Enrollment of a Practice Partnership, cont.12. If you selected uploadthen click the blue hyperlinkto upload the required forms
*Instructions are also included if you selected to mail them(see next slide for the formdetails)
Acknowledgement & Attestation forms
practice name
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Final Steps for Enrollment of a Practice Partnership, cont.• Each partnership has one convener (a lead practice)• All practices in the partnershipmust complete the appropriate forms and give to the convener:» Acknowledgement forms
completed by everyoneincluding the convener
» Attestation forms byeveryone except the convener There is no CPC Memorandum of Understanding to complete‐only these two forms
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Final Steps for Enrollment of a Practice Partnership, cont.12. Click the line that says “CPC Memorandum of Understanding” to make theupload attachment button available, click “browse” and select your document(s),then click the “upload attachment” button
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Final Steps for Enrollment of a Practice Partnership, cont.
You’ll receive an upload success panel with a tracking number
Name of the documents uploaded will display here
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What Happens After the Enrollment is Submitted?• Provider receives a confirmation of receipt – take record of your tracking #• ODM reviews the application for eligibility• A CPC ID is created – for the individual entity or the whole partnership• ODM updates appropriate specialties to the Medicaid and CPC IDs• MITS auto‐generates and sends the welcome letter – if approved, to the contact
listed on the application
practice name
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Additional Troubleshooting & Tips
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Checking Your CPC Enrollment Status• Click on “check enrollment application”• Enter the ATN and business name exactly as entered on the application• Click search and the status of the application and required documentswill be displayed
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Checking Your CPC Enrollment Status, cont.
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How to Complete an Unsubmitted Application1. Follow the same steps as if submitting a new application by clicking on “provider enrollment”, click the enroll in CPC box, then click “continue application”
The system keeps an ATN active for 72 hours –applications need completed and/or
corrected and submitted within that timeframe to prevent starting over
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How to Complete an Unsubmitted Application, cont.2. Enter the ATN and your business name exactly as entered on the application, then click “search”
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How to Complete an Unsubmitted Application, cont.
3. Once your ATN details are displayed below, click “next” to continue the application
4. Continue the needed steps in order to complete the application
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Troubleshooting an Error/Denial Message
Only eligible under a practice within a partnership (NOT the convener) but attempted to enroll individually
Was not invited to join CPC but attempted to enroll
Not eligible for CPC for Kids but selected the specialty – this can be corrected*
*Go back into the ATN, use the previous buttons to go back to the page to remove the secondary specialty of 997, and complete the rest of the application
Possible reasons to receive the message:
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Re‐attestation Process Log‐in Tips• If you are in a practice partnership, ONLY the convener need to complete one attestation for the whole partnership» The convener MUST log into the account associated with the partnership (convener) CPC ID to attest for the entire partnership
• If the MITS account was never created, that must be done now» A PIN reset for the CPC ID may be needed, if so you must call in and request it
• If the MITS admin for the CPC account was never changed and the current person cannot log‐in, then this has to be done first and can take a few days for processing» For whoever is appropriate to become the new MITS admin for the CPC ID account, must call to request the admin be switched and provide the correct contact information
» The password will need to be changed (the admin userID can never be changed)» The security credentials will need to be updated
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Re‐attestation Process Log‐in Tips, cont.
• If you do not remember your password or it has expired, click the self‐service forgot password link on the MITS log‐in screen to quickly reset your password (calling in is a longer process)» If your email address is not correct in MITS, you will need to call to have that updated before your password reset will work
• If you do not see the cpc tabs, you are most likely logged into MITS with the wrong account userID and password – verify which userID and password you are using
• The MITS admin for the CPC ID account is the only person who can complete a re‐attestation, this is not a function an agent can do
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Re‐attestation Process
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If the practice partnership is
continuing with the same convener
If continuing to participate as an individual entity or
going back to participating that way
Who Completes the Re‐attestation Process?
Either as:
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In CPC today as the convener to a practice partnership and the convening practice is continuing*Even if some of the other practices are joining or leaving
In CPC today individually and continuing that wayIn CPC today within a partnership but the partnership is
dissolving/not continuing for whatever reason:*Prior to the partnership, participation in CPC was individual and a CPC ID had been created with that original enrollment
Now for the Break Down:
Is this you? If so, follow these next steps
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Re‐attestation Process
1. Log into the MITS Secure Provider Portal using the user ID & password associated with the active CPC ID, then click the “cpc attestations” tab» See the Additional Tips & Troubleshooting section if you cannot log in or do not see the cpc attestations tab
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Re‐attestation Process, cont.2. Check the box to all three program requirement attestation statements
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Re‐attestation Process, cont.3. If eligible and wishing to participate select the CPC for Kids option4. Once all appropriate boxes are checked, click “save” – once this process done,it is not possible to log in and change anything
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Re‐attestation Process, cont.5. A message stating “save was successful” will appear» The dates in the bottom corner will be updated if the save is successful – please note the next attestation date that will display is not actually the date of re‐attesting
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What Happens after the Re‐attestation is Done?• Immediately submit your email request for adding and/or removing practices in the continuing partnership – if applicable
• ODM reviews the attestation form• ODM checks the attribution count for CPC and CPC for Kids (if selected)• ODM will add the CPC for Kids specialty of 997 to the Medicaid & CPC IDs• ODM will email the welcome letter and/or denial letter to the contact on file
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Final Steps if New Practice(s) are Joining the Practice Partnership
6. Convener must email the new forms (next slide) and request to add a practice(s)• New practices in the partnership must complete the appropriate forms and give to the convener:» Acknowledgement forms completed by the new ones including the convener
» Attestation forms completedby only the new ones
If there are no changes to the partnership, policy does not require the forms to be done every year
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Reporting Practice Changes for Partnership Practices
REQUEST TO REMOVE – provide the practice name and Medicaid ID
REQUEST TO ADD – provide both
forms completed by the new practice(s)
Must be done right before or after as completing the re‐
attestation
Convener must make the request
Email request and applicable forms
Send email to Ohio‐CPC‐[email protected]
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Questions? Call Provider Assistance 1‐800‐686‐1516