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Accessing the OHIP Data Portal October 15, 2012. Introduction to the Portal.
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Accessing the OHIP Data Portal October 15, 2012
Introduction to the Portal • The purpose of the OHIP Data Portal is to facilitate communication between the New York State Department of Health (DOH) and the Health Home Data Management Providers (DMP) regarding the status of Medicaid members eligible for Health Home services as outlined in the Health Home Patient Tracking System Specifications Document
Introduction Con’t • DOH will release to each Managed Care Plan (MCP) assignment files containing Health Home eligible members with suggested assignments. MCPs will then review the proposed assignments and submit back to DOH, a file containing final Health Home assignment. • Health Homes will then access one assignment file through the portal that contains both Fee-for-Service and Managed Care Health Home eligible members.
Portal Use by Phase • Phase 1 • All HHs/MCPs have access to the portal and are currently exchanging files through the portal • Phase 2 • All HHs/MCPs now have access to the portal • Start submitting test files to portal • Start submitting Add records for assigned members in converting case management programs in phase 2 counties • Phase 3 • Does not have access yet • DOH is collecting contact information from HHs regarding Portal users
OHIP Datamart Portal • Currently available to Health Homes and Managed Care Plans with Health Commerce System access. • Current Capabilities • Tracking file submission • Recipient look-up • Find member’s HH eligibility, Medicaid eligibility, HH enrollment, and last 5 claims • Enrollment record download (“data dump”) • Creates a file containing all records that a provider has successfully submitted to the portal • Upcoming Capabilities • Assignment file download • Member acuity score file download • Member claim detail report
Accessing the Portal • Follow this link to the OHIP Data Portal: http://192.168.15.109/entPageManager/entPageManager.htmland sign into the OHIP Data Portal using your HCS user ID and Password
Accessing the Portal • Once you are in the OHIP Data Portal, click on the Health Home Tab
Accessing the Portal • There are two sections under the Health Home Tab: • A) HHTS Tracking Files: Providers upload tracking files and download enrollment records or “data dump” • B) HHTS Recipient Search: Providers use member CIN numbers to see member HH enrollment information
HHTS Tracking Files • To upload a TEST file to the Portal, use the browse function to locate the appropriate TEST fixed length text file. Once you have located the correct file, select the “Test Only” box and hit the submit button
HHTS Tracking Files • To upload an actual file to the Portal, use the browse function to locate the appropriate fixed length text file • Once you have located the correct file, hit the submit button
Portal Naming Convention • Please use the following naming convention to name the ACTUAL monthly files you are submitting to DOH (not the test files) • Health Home/Managed Care Plan Name_date the file was submitted • Example of Sunshine Health Home’s Tracking file submitted on July 24, 2012: • Sunshine Health Home_ July 24, 2012 • Please use the following naming convention to name the TEST monthly files you are submitting to DOH (not the actual files) • TEST_Health Home/Managed Care Plan Name_ date the file was submitted • Example of Sunshine Managed Care Plan’s test Tracking file submitted on July 24, 2012: • TEST_Sunshine Managed Care Plan_ July 24, 2012
HHTS Tracking Files • Once you have uploaded your file, you will see below the 1) File ID, 2) File Name, 3) upload date, 4) the status of the file, 5) the process date, 6) owner’s provider ID, 7) # of records that were submitted on the file, 8) the number of lines that were rejected, 9) original file submitted 10) error report, and 11) at anytime you can deleted a file that has not been processed by clicking here
HHTS Tracking Files • To download the enrollment record or “data dump” scroll down to the bottom of the HHTS Tracking Files page and look for the heading: Download Enrollment Records and click on the Download button.
HHTS Recipient Search • Enter the member’s CIN
HHTS Recipient Search • The top section listed below will be visible for all Members enrolled in Medicaid • It shows Medicaid coverage end date, HH that member is enrolled in or that member is not enrolled, Managed Care information, if the member was pre-identified as HH eligible for DOH, and Member contact information
HHTS Recipient Search • The HH Enrollment section shown below will only display if the Member is actively receiving either outreach or enrollment services per tracking file information submitted to the Portal • This section lists what MCP the member is enrolled in (if not FFS), the Health Home, the Case Management Agency (CMA), the type of enrollment, the TCM Indicator (Yes=CMA is a converting program, No=CMA is not converting program), TCM Slot type, and the segment’s begin and end dates (12/31/9999 signifies there is no end date).
HHTS Recipient Search • The section below shows the provider names, addresses, and phone numbers associated with the last five claims or encounters submitted to Medicaid for the individual • This section will only be shown if the member is assigned to your organization