EHS Processing Platform - wvfh.com · EHS Processing Platform • West Virginia Family Health Plan (WVFH) will transition to the EHS processing platform during 4th quarter 2017. The

EHS – Processing Platform

EHS Processing Platform

• West Virginia Family Health Plan (WVFH) will transition to the EHS processing platform during 4th quarter 2017. The system transition will provide you with improved service and responsiveness by integrating resources and expertise into a single point.

• This upgrade to an innovative and efficient system will allow for more timely and accurate payments and combined operations functionality. We are working closely to ensure that our service standards remain consistent throughout the transition and that this integration is as seamless as possible to both Providers and our members that you serve.

• If you have any questions about these changes, please call us at 1-855-412-8001 to speak directly with a Provider Services representative.

What are the Advantages?

• Application and provider file update processing will be completed in the same manner

• You will receive the same Provider outreach and training

• EDI assistance will still be available

• Enhanced NaviNet functionality and ease of use

• Faster and more efficient, accurate payment processing

• Single point of contact for operational functions

• Commitment to and investment in technology and innovation that will grow with the

business

• Sustainable platform for future development and enhancement

• Responsive solution that offers improved experience

• Evidence of value placed on members and providers with a desire to provide the

highest quality, accessible service, and tools

• You will be able to use the same EDI Number

What will change for

Providers?

• New Member ID Cards: An example of the new West Virginia Family Health member ID cards are shown on slides 5 and 6.

• Addresses: The below addresses go into effect 4th quarter 2017– Medicaid General Correspondence: P.O. Box 890421, Camp Hill, PA

17089-0421– Medicaid Claims: P.O. Box 890406, Camp Hill, PA 17089-0406 – Medicaid Checks: P.O. Box 890408, Camp Hill, PA 17089-0408

Provider Service Center: WVFH Provider Service Center can continue to be reached at 1-855-412-8001

*Please note: You will receive communication once a final date has been identified for the system transition during 4th quarter 2017. Please continue to utilize the current addresses you have on file until you receive notification.

New Member ID Cards

NOTE: New member cards will be effective 4th quarter 2017. Communication to members and providers will sent out once a date is finalized.

New Explanation of Payment

(EOP)

• West Virginia Family Health will be updating the EOP to contain detailed explanation of payment, including:

– Patient Information – including benefit and member type information

– Claim Information – billed services

– Basic payment information – pricing detail, member cost share, etc.

• Based on the current process design, paper checks and EOPs will be included in the same mailing.

EOP Sample

EOP Sample

West Virginia Family Health (WVFH)

Provider Account Liaisons

WVFH Territory Account Assignment by CountiesProvider Relations Provider Account Liaisons are responsible for the servicing, education and training of our

participating provider network. Feel free to contact your Provider Account Liaison for assistance.

WVFH Provider Relations Liaison –Stephanie TwyfordPhone & Fax: 412-918-8569

Cell Phone: 330-509-0132

WV Region I – Brooke, Calhoun, Doddridge, Gilmer, Hancock, Harrison, Jackson, Lewis, Marion,

Marshall, Monongalia, Ohio, Pleasant, Richie, Roane, Tyler, Wetzel, Wirt, Wood,

WVFH Provider Relations Liaison Interim Reps : Kim Hammond & Stephanie Twyford

WV Region II – Kim Hammond : Boone, Cabell, Kanawha, Lincoln, Logan, Mason and McDowell,

Stephanie Twyford: Mercer, Mingo Putnam, Wayne, Wyoming, Clay, Fayette, , Monroe, , Braxton

and Summers

WVFH Provider Relations Liaison –Kim HammondPhone & Fax: 412-255-4819

Cell Phone: 717-649-5282

WV Region III – Barbour, Berkeley, Hampshire, Hardy, , Greenbrier, Jefferson, , Mineral,

Morgan, Pendleton, Pocohontas, Preston, Randolph, Taylor, Tucker, Upsher, Webster,

Raleigh, Nicholas, Grant and