FFS Iowa Health Home Program IMPA

1. FFS Iowa Health Home Program IMPA Pamela Lester RN, BSN Program Specialist March 2019

2. Objectives • Understand how to submit an enrollment request. Update an assessment or dis-enroll. • Learn the reporting functions within IMPA to know when patients are actively enrolled, assessments are coming due and attesting for payment.

3. Enroll a Patient

4. Enroll Patients: Log into IMPA, hover over file and select health home

5. Step 2 • Select the NPI from the drop down list (Not all providers in the list may be health home providers; as the NPI drop down is based on the security and the group they were assigned to.) • Select the address for the provider. This is based on the NPI and address. • Enter the state id and click on Continue.

6. Click on New

7. Verify State ID

8. Identify if the State ID matches the name and DOB

9. Patient is a dual or a waiver

10. Patients on a WaiverMake Quarterly contact with the identified case manager

11. Enter Assessment Date, Tier and Relating DX Codes, click enroll

12. You have just submitted an enrollment request. • An enrollment request must be extracted and then processed before final approval of eligibility is established. Month end processing occurs roughly around the 20thof each month (except February). • An enrollment request can be: • Eligible for enrollment and not assigned by the month end process • Eligible for enrollment and assigned to the health home by the month end process • Not eligible for enrollment at this point in time • Pending enrollment. A pending enrollment request is where an existing request for assignment has not been finalized.

13. Month End Dates 20195th Business day before the end of the Month. • April 24, 2019 • May 27, 2019 • June 24, 2019 • July 25, 2019 • August 26, 2019 • September 24, 2019 • October 25, 2019 • November 25, 2019 • December 24, 2019

14. Types of Waivers • Aids/HIV • Elderly • Health and Disability • Intellectual Disability • Children Mental Health • Brain Injury • Physical Disability

15. Enrollment Request Pending

16. Patient is enrolled

17. Update an Assessment

18. Update an Assessment: Log into IMPA, hover over file and select health home

19. Enter State IDClick SearchClick Select

20. Click Update

21. Enter Date, Tier, Reason and related DX codes.

22. Reasons • Tier Change • Assessment Date Change • Assessment Date and Tier Change

23. Dis-enroll a Patient

24. Dis-enroll Patients: Log into IMPA, hover over file and select health home

25. Enter State IDClick SearchClick Select

26. Click Dis-enroll

27. Select Reason and Click Dis-enroll

28. Reasons • Member Request • A member can request to dis-enroll from the program as this is a voluntary program to participate in. • Provider Request • A provider can request disenrollment on behalf of a member. • Death • Failure to comply • This would be when a member is not abiding by the agreement they signed with the provider. The provider can dis-enroll them. • Unable to assign IHH • This reason is specific for the IHH (will not be used for health homes) • Enrolled in HCBS Waiver • This patient has a waiver that requires them to be in the IHH for TCM services or patient has a care manager and you do not agree to talk to the case manager quarterly.

29. Available Reports • Current Enrollment Activity Report The current report provides information on members for a given NPI (national provider identifier). Any patient that has a change in status or an update will show up in this report. This is only for the current month. • Billing Report The current report provides information on all of your members enrolled in the program. • Assessment Coming Due The assessment coming due report will provide for those state id that are currently enrolled in Medicaid and have an assessment coming due within the next 3 months.

30. Available Reports Continued • Member Roster Report The Assigned report provides a listing of members assigned to a health home or an integrated health home. The Unassigned report provides a listing of members that are no longer assigned or have never been assigned to a health home or an integrated health home. The Not Processed report provides a listing of members that have requested enrollment into a health home or an integrated health home and will be processed at month end processing. • Participating Waiver Members Report This report provides users with a listing of eligible and enrolled members that are also participating in an active waiver program along with their case manager contact information. The information provided in this report is for the current month only.

31. Guide for Health Home Services • This guide helps identify Possible health home services and aligns with PCMH

32. Not Processed Provides a listing of members that have requested enrollment into a health home or an integrated health home and will be processed at month end processing.  Approximately 6 business days before the end of each month. • The information provided on this report are: • State id • Name • Assessment Date • Tier • Assigned • Last Action Date

33. Member RosterNot Processed

34. Assigned Provides a listing of members currently assigned to a health home or an integrated health home The information provided on this report are: • State id • Name • Assessment Date • Tier • Assigned • Last Action Date

35. Assigned

36. Unnassigned Provides a listing of members that are no longer assigned or have never been assigned to a health home or an integrated health home • The information provided on this report are: • State id • Name • Assessment Date • Tier • Assigned • Last Action Date • Reason

37. Unassigned

38. Participating Waiver Members Click on Review then participating waiver members. Enter NPI, select address and click continue.

40. Questions? • Medicaid Health Home Program: • Pamela Lester • Health Home Program Manager • Healthhomes@dhs.state.ia.us • 515-974-3050 • http://www.ime.state.ia.us/Providers/healthhome.html