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1. Welcome! The Getting Support After Go-Live Webinar will begin shortly. While you are waiting, please check your audio settings 1 You can dial in using a telephone. Long-distance charges may apply.

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3. Webinar Tips Attendee Control Panel Asking Questions 3

4. Attendee Control Panel Hiding the Control Panel Toggle Auto-Hide On/Off Use this panel to: Set your sound preferences Ask Questions and view answers Your microphone should always be muted Do not use the hand raising icon We are not monitoring this feature 4

5. Asking Questions You may ask questions anytime during the Webinar Click the Questions option in the Webinar toolbar Type in question Click Send Selected questions will be answered during the Webinar � time permitting Questions will be reviewed for inclusion in future communications from DSHS 5

6. Getting Support After Go-Live Copy of this presentation located at http://hrsa.dshs.wa.gov/providerone/Webinars/OperationalSupportWebinar.ppt� Links to all resources located later in the presentation

7. After Webinar you can: Get Support After Go Live Find and use the best �self-service� resources to meet your needs as we stabilize ProviderOne Keep an eye on new discoveries or system defects Monitor the percentage of your claims being paid and compare to your payment history Take advantage of �just in time� training Know where to call if you need assistance Subscribe to a NEW email distribution list for ongoing policy and operational updates Use new One-Stop Shopping Provider Website 7

8. Support after Go Live Testing environment through June 9th Temporary Help Desk through August 9th Dedicated to ProviderOne transition steps (security, registration and testing) Permanent Medical Assistance Customer Service Center Supports claims and payment questions (same as today) Check website before calling Daily Bulletins for known issues Billing and Resource Guide On Demand Webinars E-Learning and Self Paced Provider Tutorials 8

9. Monitoring and Communication After Go-Live Daily DSHS meetings to monitor claims loading, adjudication, payment and other critical activities Daily �ProviderOne Bulletin� on the web identifies new discoveries (defects, training issues or system changes) Includes ETA, impact and workaround Bi-weekly conference calls with several provider groups to gather additional feedback On demand Webinars Provider Claim Processing Reports Stay Informed Sign up for ProviderOne email distribution list Sign up for new operational email distribution lists 9

10. Following ProviderOne Progress 10

11. Daily DSHS Meetings Monitor claims loading, adjudication, payment and other critical production activities Gather data from critical operational areas �what are they seeing on the floor� Analyze data gathered and Identify new system or process discoveries Report new discoveries and status of previously identified discoveries daily to Department staff Collect information to include on the daily Provider Bulletin 11

12. Daily Provider Bulletin Please Check ProviderOne Website Before Calling For help Daily updates on how implementation is going Lists known issues and defects Gives estimated time for fix Identifies planned system updates and changes http://hrsa.dshs.wa.gov/providerone/providers.htm 12

13. Bi-Weekly Conference Calls Meetings with 6 provider advisory groups Pre-selected cross section of providers Represent all billing methods Direct Data Entry Electronic Batch WINASAP Users Managed Care Pharmacy Point of Sale ProviderOne Task Force Enables us to keep a pulse on how things are going and identify operational barriers Identifies communication needed for other like providers 13

14. Monitor Provider Claims Profile Historical legacy MMIS (�before� picture) By tax ID for FY09 (7/1/08 � 6/30/09) Profile shows dollars paid, # claims paid, paid %, denied %, # of days between date of service/billing date, # of days between billed/payment date ProviderOne Information (�after� picture) By tax ID the same information, except instead of a full fiscal year, it is for each week after Go Live Based on testing experience, providers should see an improving �after� picture each week Compare to historical � before picture to determine when you hit �Normal� 14

15. �On Demand� Webinars Webinars will focus on topics needed most Webinar topics will be identified through: Provider Feedback during Operational Conference Calls Analysis of Claim Denial � Chronic issues Call center - provider call reasons Changes and New discoveries Webinar schedule will be posted on ProviderOne webpage http://hrsa.dshs.wa.gov/providerone/providers.htm 15

16. 16 Self Service Resources ProviderOne Billing and Resource Guide Program Specific Billing Instructions ProviderOne System User Manual E-Learning and Self-Paced Tutorials New Enrollment Application Tracking

17. The Purpose Of Each Resource Billing and Resource Guide Step by step instructions for checking eligibility, billing FFS and determining what you got paid for. Applies to nearly all provider types. Program Specific Billing Instructions Program specific material explains policies, limitations, rates and procedures. ProviderOne System User Manuals Technical system manual that shows system functionality and detailed screen shots. E-Learning and Self-paced Tutorials Training materials for new staff or refresher training 17

18. Billing and Resource Guide ProviderOne Billing and Resource Guide: Responds to provider requests for step by step billing materials; Serves as foundation for program specific billing instructions; Covers the end to end billing process, including steps using ProviderOne Replaces General Information Booklet Includes extensive set of new appendixes Guide is designed for provider staff who: Schedule appointments or check in clients; Submit fee for service claims to DSHS; and Post and reconcile DSHS payments. 18

19. Billing and Resource Guide Current chapters available Basics about Medical Assistance Verify Client Eligibility, Benefit Packages And Coverage Limits Submit Fee for Service Claims Obtain and Reconcile the Remittance Advice Additional chapters under development Enroll As A New Provider Set Up and Maintain System Users in ProviderOne Maintain Provider Records On Line 19

20. Billing and Resource Guide 20

21. 21 Client Eligibility, Benefit Packages, and Coverage Limits The Key Steps Determine If Your Patient Has Medical Assistance Coverage Determine the Primary Payer Review Your Patient�s Benefit Service Package Determine if Medical Assistance Covers the Service and if the Service Requires Prior Authorization Determine If your Patient�s Benefit Limitations Have Been Met

22. Submit Fee for Service Claims to Medical Assistance The Key Steps Determine Claims Submission Method Determine if Claim Needs Backup Submit New Claims and Backup via: Direct Data Entry into ProviderOne Online Batch Claims Submission Paper Submit Medicare Cross-Over Claims Inquire about the Status of a Claim Adjust, Resubmit, or Void a Claim

23. The Remittance Advice The Key Steps Retrieve Remittance Advice Review Updates and Key Messages Review Summary Review Paid Claims Review and Research Denied Claims Review Adjusted Claims Review Suspended Claims

24. Billing Guide Vs Billing Instructions Program Billing Instructions cover the �what� Primarily policy content Payment methodology Specific procedures covered Program Limitations Authorization requirements Specific Billing Information that only applies to the provider type or program Billing and Resource Guide covers the �how� Step-by-step reference guide outlining how to complete actions necessary to submit a clean claim How to use ProviderOne as a tool as part of the overall process for doing business with Medicaid Stand Alone Training materials How providers use information located in program billing instructions, fee schedules, WAC�s etc 24

25. Changes to Billing Instructions Limited policy changes during implementation General information moved to Billing Guide Reduced size � easier to locate policy content Updated terminology Patient Identification Code to ProviderOne Client ID Provider Number to National Provider Identifier Medical ID Card (MAID) to Client Services Card Claim Number from Internal Control Number (ICN) to Transaction Control Number (TCN) 25

26. Program SpecificBilling Instructions 26

27. ProviderOne System User Manual Key Sections Getting started in ProviderOne Maintaining ProviderOne User Accounts (Security) Managing Provider Information Individual Billing; Group; Tribal Health; Servicing; Facility, Agency, Organization, Institution Billing Agent Clearinghouse Submitting Professional Claim Submitting Dental Claim Submitting Institutional Claim Submitting and Retrieving HIPAA Batch Transactions Managing Claims Verifying Client Eligibility Managed Care 27

28. ProviderOne System User Manuals 28

29. On-Line Training Self Paced Tutorials offer Practice Introduction to ProviderOne Security Administration Registration - Group and Individual Submitting Claims Confirming Client Eligibility E-Learning Offers Short Learning Segments Provider Essentials (navigation; change password) Security Administration Client Eligibility Fee-For-Service Claims 29

30. 30 E-Learning Offers Short Segments

31. New Enrollment Application Tracking New Medicaid Providers will enroll online via ProviderOne beginning May 9th Existing providers adding a new NPI will also enroll online at http://hrsa.dshs.wa.gov/ProviderEnroll/ Providers will be able track the status of their online application. You will need the application ID and FEIN/SSN of the provider enrolled. 31

32. Links to Self Service Resources 32

33. Links to Self Service Resources 33

34. Where to Call If You Still Need Help 34

35. Provider Call Matrix 35

36. 36 New Communication Infrastructure Provider Feedback about Communication New Operational Email Distribution Lists Provider Website �One Stop Shopping�

37. Operational Support Survey Provider Survey Themes Providers want simple step by step instructions and �just in time� training for new billing staff Electronic communication preferred over mailed postcards Updated billing instructions are needed to submit clean claims Provider staff want more self service resources Provider staff want single provider website 37

38. What Has Been Done Billing and Resource Guide serves as simple step-by-step training materials Program specific billing instructions streamlined and updated Developed new long term email distribution lists for improving communication Developed full range of system training materials provider staff can access as needed 38

39. New Operational Email List ProviderOne Listserv http://listserv.wa.gov/archives/providerone_provider_readiness.html Excellent tool for sending messages during ProviderOne readiness activities More than 11,000 subscribers General messaging on ProviderOne Readiness Activities and Key Updates Will be �retired� following the stabilization of ProviderOne New Operational Email Lists https://fortress.wa.gov/dshs/hrsalistsrvsignup/ New series of email distribution lists have been established to support Operational Messaging 21 provider specific lists your staff can subscribe to Used to communicate critical policy and billing information to specific provider types/groups Replaces postcard notification process 39

40. New Operational Email Lists 21 specific lists to align with business needs Subscribe to topics you are interested in Email Distribution Lists offer many benefits Members can add and remove themselves at anytime Critical operational information delivered via email Easy to distribute through your organization No cost to provider organizations to subscribe Replaces postcard notifications DSHS will no longer send out postcard notifications after June 2010. 40

41. Operational Email Topics Clearinghouses Billing Agents Clinicians/Performing Physicians Family Practice/Chiropractic/EPSDT DME/Medical Supplies/Oxygen/ Prosthetic/Audiologists Dental FQHCs/RHCs Family Services/Maternity/Family Planning HRSA Policy Changes Hospice/Home Health Hospitals/Institutions/Dialysis/ Inpatient-MH/MH-Rehab Laboratories/Blood Banks/Radiology Managed Care/Health Plans/Prepaid Health Plans Mental Health/RSNs Nursing Homes Pharmacy Physical/Occupational Therapy/Speech School-Based Medical Substance Abuse/Chemical Dependency Transportation/Interpreters Tribal Vision/Hearing Other (if you select this topic you will receive all messages) 41

42. New Provider Website � One Stop Shopping 42

43. Summary Continue testing through June 9th Check website before calling Daily Bulletins for known issues Billing and Resource Guide Recorded Webinars Other e-Learning resources Review Updated billing instructions Save Link to Billing and Resource Guides Use temporary Help Desk through August 9th Dedicated to ProviderOne transition steps (security, registration and testing) 43

44. Ending the Webinar To close the webinar Click the X button in the control panel 44