HP Enterprise Services Hometown Health Presentation

1. HP Enterprise Services Hometown Health Presentation November 12, 2009 Partnering for Success!

2. Introduction/Background Project Phases Testing Approach Claim Submission Provider Assistance Questions Agenda

3. History in Georgia Georgia MMIS Fiscal Agent July 1, 1987 – March 31, 2003 Georgia Immunization Registry System May 2003 – Present Data Broker March 2008 – Present We’re Excited to be Back…

4. EDS System Development Life Cycle √ Startup √ Design √ Development √ System Testing User Acceptance Testing Implementation Project Phases

5. User Acceptance Testing December 2009 – June 2010 DCH subject matter experts will create and execute test cases designed to thoroughly test the new MMIS. Provider Beta Testing March 2010 – April 2010 Selected provider’s will have an opportunity to participate in testing the new MMIS solution. Electronic Data Interchange Testing February 2010 – May 2010 All providers who submit claims electronically will be required to submit test claims to EDS to ensure they can successfully submit claims prior to July 1, 2010. All clearinghouses, billing services and vendors will be required to submit test claims to EDS to ensure they can successfully submit claims prior to July 1, 2010. Testing Timeframes

6. Operational Readiness Testing March 2010 – May 2010 DCH subject matter experts will create and execute test cases designed to thoroughly all operational areas of the EDS Account. EDS Account staff participate in Operational Readiness Testing, including: Provider Enrollment Member Enrollment Call Center Data Entry Resolution Electronic Data Interchange Mailroom Buy In Teaming Partners Testing Timeframes

7. Web Portal HIPAA X12 837 Format Electronic Data InterChange Clearinghouses Vendors Billing Services EDS Software interChange accepts multiple media, including: Magnetic Tape CD FTP Bulletin Board via PC modem dial up POSnet Internet Paper UB04 Claim Submission

8. Web Portal Computer Based Training Contact Us Claim Status Claim Submission Eligibility verification Provider Enrollment Remittance Advices FAQ Manuals Workshop Locations/Data Provider Assistance

9. Provider Enrollment Team Enrolling Providers Web Portal applications Paper applications Workflow Instant identification of enrollment application in process Automatic routing to next step in enrollment process Provider Enrollment Assistance Member Enrollment Team Enrolling Members Presumptively eligible pregnant women Presumptively eligible newborns, including multiple births Provider Member Enrollment Assistance Provider Assistance

10. EDI Helpdesk Web Portal Password Resets Enrolling Providers in Electronic Claim Submission Testing Provider and Vendors prior to Electronic Claim Submission Assistance EDI related questions Transmission questions WinASAP will no longer be accepted; providers must transition to PES or other electronic software. EDI related questions Provider Assistance

11. Contact Center Automated Voice Response  Claim Status  Check Amounts  Prior Authorization Status  Member Eligibility Member Contact Center 1-866-211-0950 Provider Contact Center 1-800-766-4456 Written Correspondence Team Field Representatives 11 Field Representatives – 1 Hospital Field Representative Attend provider association meetings Presenting training seminars to providers requesting such training Offering on-site visits and training to providers and office billing staff Offering on-site visits for claims resolution assistance Billing Manuals Provider Assistance

12. Field Representative Territories

13. Provider Training Statewide April 2010 – June 2010  166 Workshops Total  28 Institutional Workshops Ongoing training throughout life of contract Association Meetings Medicaid Fairs Provider Training

14. Tentative April Workshop Schedule

15. Tentative May Workshop Schedule

16. Tentative June Workshop Schedule

17. The EDI cut off is noon each Friday. EDS will process fee for service claims each week and continue to issue payments on a weekly basis Each individual working for a provider must have their own password to access the web portal Other Information

18. HP Enterprise Services will mail new Member ID Cards in June 2010 HP Enterprise Services will mail Web Portal PIN letters to providers May/June 2010 Transition Items

19. ACS  Last Claims Cycle - June 25, 2010 Last day to submit electronic claims for processing - June 25, 2010 Last day paper claims are received for processing - June 18, 2010  Last day to receive calls - June 30, 2010 HP Enterprise Services  First Claims Cycle - July 2, 2010 First day to submit electronic claims for processing – June 28, 2010  First day paper claims are received for processing - June 21, 2010  First day to receive calls - July 1, 2010 Tentative Timeframes

20. Any questions? Mary-ann.barndt-williams@hp.com