Non-Homecare Services EDI Import Interface Guide · Non-Homecare Services EDI Import Interface Guide Page | 6 February 2020 Required Components for Successful Import Proprietary &

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Non-Homecare Services EDI Import Interface Guide February 2020

The Provider System


Legal The software described in this document is furnished under a license agreement. The software may be used or copied only in accordance with the terms of the agreement. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying and recording, for any purpose without the express written permission of Homecare Software Solutions, LLC. Information in this document may be revised from time to time without notice and is for informational purposes only. Consult with your legal advisor as to your required compliance with all laws and regulations. Copyright ©2020 Homecare Software Solutions, LLC. All rights reserved. One Court Square, 44th Floor, Long Island City, NY 11101 Part number: Non-Homecare Services EDI Import Interface Guide

Document Revision History

Date Description of Revision

04/12/2018 Initial version of the document

10/19/2018 Addition of Procedure Codes Table

12/26/2018 Update Invoice Number description

04/12/2019 Update requirements: Service Reference Number and Invoice Line Item ID

07/18/2019 Update SFTP Requirements and File Format details

Add MCO/Payer ID Code Table

11/06/2019 Update Import Interface – Amount field increased to 8 characters

02/24/2020 Update Procedure Code Table

The Provider System


Table of Contents

Introduction ............................................................................................................................ 1

Audience ................................................................................................................................................... 1

EDI Assistance ........................................................................................................................................... 1

SFTP & File Requirements ........................................................................................................ 2

SFTP Client Configuration Requirements .................................................................................................. 2

SFTP Folder Structure ................................................................................................................................ 3

SFTP Retention Policy............................................................................................................................ 3

Interface Summary .................................................................................................................................... 3

File Format ................................................................................................................................................ 3

Required Components for Successful Import ........................................................................... 5

Naming Convention & File Extension ........................................................................................................ 5

Import Interfaces - Required Fields and Formats ..................................................................................... 6

Non-Homecare Services Import ............................................................................................................ 6

MCO/Payer ID ......................................................................................................................... 8

Procedure Code Table ............................................................................................................. 9

The Provider System

Non-Homecare Services EDI Import Interface Guide Page | 1 February 2020 Introduction Proprietary & Confidential

Introduction The HHAeXchange (HHAX) Non-Homecare Services EDI Import Interface Guide provides guidance and instructions in preparing files for importing from an SFTP. Herein users find the various interface templates indicating required fields and proper format for a successful import. This guide is updated on an ongoing basis as system capacities are implemented and additional functionality becomes available.

Audience This guide is intended for System Users responsible in the Non-Homecare Services importing process at a Client Agency.

EDI Assistance If additional assistance is needed, please submit a ticket to [email protected]. Cases are escalated to the EDI Production Support queue. An available Support Team Members will contact you directly to assist.

mailto:[email protected]

The Provider System

Non-Homecare Services EDI Import Interface Guide Page | 2 February 2020 SFTP & File Requirements Proprietary & Confidential

SFTP & File Requirements Users need a Secure FTP client software to access their HHAX SFTP account. Any standard SFTP client software should be able to connect to the HHAX SFTP (such as Filezilla, CuteFTP, and WINSCP). HHAX provides SFTP credentials once an Agency has validated their file format.

SFTP Client Configuration Requirements The image to the right illustrates the configuration requirements to connect to the SFTP location. • HOST/IP/URL:

sftpprod.hhaexchange.com • Username: Enter the user name received

from HHAeXchange • Password: Enter the password received

from HHAeXchange • Port: 2222 • Connection: SSH/SFTP

SFTP Configuration Settings (Sample SFTP Application)

When transferring files via SFTP, select the BINARY mode in your FTP client application (sample from sample SFTP application shown to right).

Binary Mode in Advanced Settings (Sample)

HHAeXchange does not endorse or technically support any particular 3rd Party software. Some examples and images used within this document are exclusively for demonstration purposes.

The Provider System


SFTP Folder Structure Folders are used to organize the files exchanged through SFTP as follows:

• Inbox – Used to import a file into HHAX. Users can place files into the Inbox folder for automated import into the HHAX system.

• Outbox –For imports, the Response File for each import is placed in the Outbox (after processing) where users can view successful/unsuccessful files.

SFTP Retention Policy The following guidelines address how long files are retained by HHAX before removal from the HHAX SFTP server.

• Files in Inbox folders are retained until successfully processed and moved to the Processed folder.

• All files size 50 MEGABYTES or larger in the Processed, Saved, or Outbox SFTP folders are retained for 3 days.

• All other files in the Processed, Saved, or Outbox SFTP folders are retained for 15 days.

Interface Summary Integration Guide

Interface File Direction SFTP Folder Description

Non-Homecare Services Import Inbox Creates/Updates Non-Homecare Rendered Services

Response File Response Outbox Folder to hold Response Files for processed files

File Format File Format

File Type CSV Text Qualifier Double Quotes Headers are included? Yes Delimiter for end of row CRLF (Carriage Return/Line Feed)

A tabbed text editor application (such as Notepad ++) visually organizes information allowing users to view data as well as hidden formats (such as double quotes and CRLF) to easily identify and correct errors.

Tabbed Text Editor Application (editor sample)

The Provider System


HHAX Non-Homecare Import Interface File Information File Name and Frequency

Interface SFTP Location File Name Frequency (SFTP

Import Only)

Non-Homecare Services

Inbox

Incremental File: LTDIN_AgencyID_NHCServices_YYYYMMDDHHMMSS.CSV Full File: LTDIN_AgencyID_NHCServices_YYYYMMDDHHMMSS_Full.CSV

Incremental: As/When desired by Agency Full File: Every Weekend (Optional)

Note: To minimize errors and ensure system processes are running efficiently, HHAX requests for Agencies to upload the entire file (ALL records starting from go-live date) only on the initial load (first time). Thereafter, all future import files should only contain incremental changes.

The Provider System

Non-Homecare Services EDI Import Interface Guide Page | 5 February 2020 Required Components for Successful Import Proprietary & Confidential

Required Components for Successful Import The below-listed components are required when importing files to HHAX. Although these components are the essential requirements, there are some variations depending on the type of data Users are importing. This section covers each of the required components with the necessary tools and information to assist with the data interchange process.

• Naming Convention and File Extension (.csv) • Required Fields must be completed • File Format Template

Naming Convention & File Extension The table below indicates the File type and the File Name (as per naming convention) for files imported and processed by HHAX. This naming convention is applicable to all import files, as noted in the table below.

Naming Convention Requirements File Type File Name

Non-Homecare Services LTDIN_AgencyID_NHCServices_YYYYMMDDHHMMSS.CSV To elaborate, the following example explains the naming convention:

File Name: LTDIN_123_NHCServices_YYYYMMDDHHMMSS.CSV LTDIN = Hardcoded 123 = Agency ID NHCServices = File type identifier for Non-Homecare Services 20171013 = Date in YYYYMMDD format 080030 = Time Stamp in HHMMSS format

All files must be saved as a “.csv” (extension) file. The system is not able to process or convert any other type of data file.

The Provider System


Import Interfaces - Required Fields and Formats As with the Naming Convention, there are required fields per file document which must be in specific format. The following sections cover each File Type and applicable required fields and cell formats. Each section contains the table of Required Fields and (field) Formats. HHAX Flat File Data Exchange interfaces support the Non-Homecare Services import operations into HHAX.

Non-Homecare Services Import Non-Homecare rendered Services in HHAeXchange based on a flat file given in the following format.

Non-Homecare Services Import Sample Template: Click Non-Homecare Services Import

Save the *.CSV file on your computer, and Open the file using a text editor (such as Notepad) to preserve the formats for each field.

Field Description

Data

Typ

e

Requ

ired

Max

Le

ngth

Cell

Payer ID ID of the MCO in HHAX. Refer to the MCO/Payer ID Table. Number Y 10 A

Agency ID ID of the Agency in HHAX. Number Y 10 B

Patient ID

Member identifier. Possible values • HHAeXchange unique ID • MCO Member ID • Medicaid Number • MR Number

The Agency’s Management System can decide which value to send in the file. HHAX needs to know which value the Agency is sending, before activating data exchange interfaces.

Text Y 50 C

Authorization Number Authorization Number in HHAX Text Y 50 D

Procedure Code

Code related to the Non-Homecare service provided. Procedure Codes in HHAX are related to Rates, and these rates in HHAX determine how the Amount field is calculated and displayed in the Non-Homecare Portal. Refer to the Procedure Code Table.

Text Y 50 E

Service Reference Number Unique Record Identifier in 3rd Party System. Text Y 30 F

Service Date Format: YYYY-MM-DD Date Y 10 G

Units

Number of units of service provided. For Procedure Codes with associated Rates > $0.00, the Amount field is calculated as Units x Rate. Note: If the HHAX Rate associated with the Procedure Code is $0.00, then the units field is ignored when calculating and displaying the Amount field in the Non-Homecare Portal.

Number Y 10 H

Amount

Field calculated based on Procedure Code, associated Rate in HHAX, and Units as listed below: • If the Rate associated with the Procedure Code =

$0.00, or the Procedure Code does not exist in

Decimal S 8 I

https://s3.amazonaws.com/hhaxsupport/SupportDocs/3PS+Sample+Export+Templates/NHC+Sample+Templates/SAMPLE_NHC-Services-Import.csv

The Provider System


Non-Homecare Services Import Sample Template: Click Non-Homecare Services Import

Save the *.CSV file on your computer, and Open the file using a text editor (such as Notepad) to preserve the formats for each field.

Field Description

Data

Typ

e

Requ

ired

Max

Le

ngth

Cell

HHAX, the Amount field supplied in the EDI file record will display in the HHAX Non-Homecare Portal (and the Units field will be ignored).

• If the Rate associated with the Procedure Code > $0.00, then the Amount field supplied in the EDI file record is ignored, and the Amount field in the HHAX Non-Homecare Portal is calculated as (Rate) x (Units)

Format: 999.99 OR 999999 Note Text N 500 J

Invoice Number

Invoice number in the 3rd Party System. *Note: This field is required in order to initiate the billing process, but is not required in other circumstances

Text *N 12 K

Is Deletion

Possible Values: Y (Yes) or N (No) If “Y”, then the service is deleted from HHAX (if the service is not yet Invoiced in HHAX). If the Service is already Invoiced in HHAX, then this flag is ignored.

Text N 1 L

Invoice Line Item ID Unique identifier of the invoice line item in the 3rd party system (if applicable) Text N 30 M

User Field 1 Text N 500 N

User Field 2 Text N 500 O

User Field 3 Text N 500 P

User Field 4 Text N 500 Q

User Field 5 Text N 500 R

User Field 6 Text N 500 S

User Field 7 Text N 500 T

https://s3.amazonaws.com/hhaxsupport/SupportDocs/3PS+Sample+Export+Templates/NHC+Sample+Templates/SAMPLE_NHC-Services-Import.csv

The Provider System

Non-Homecare Services EDI Import Interface Guide Page | 8 February 2020 MCO/Payer ID Proprietary & Confidential

MCO/Payer ID The PAYER ID is the unique identifier for each MCO, sent as a required field in the EDI Import file. The following table provides the MCO/Payer ID Code for each Payer.

MCO/Payer ID Codes Code MCO/Payer 14475 UPMC 16999 PHW 17470 AH 20154 Keystone

The Provider System

Non-Homecare Services EDI Import Interface Guide Page | 9 February 2020 Procedure Code Table Proprietary & Confidential

Procedure Code Table The following table provides Procedure Codes (Service Codes) and descriptions.

Procedure Codes Service Code Description HHAX Service Type

S5102 Adult Daily Living (ADL) Community Socialization S5102U3 Adult Daily Living (ADL) Enhanced - Half Day Community Socialization S5102U4 Adult Daily Living (ADL) Enhanced Community Socialization S5102U5 Adult Daily Living (ADL) Half Day Community Socialization 97532SE Cognitive Rehabilitation Counseling H2019 Behavior Therapy Counseling

S9470AEU4 Nutritional Counseling Counseling W0093 Counseling Services Counseling W1728 Employment Skills Development (1:1) Employment W1729 Employment Skills Development (1:2 or 1:3) Employment W1732 Career Assessment Employment

W1733U4 Job Coaching 1:1 Intensive Employment W1733U5 Job Coaching 1:1 Follow Along Employment W1734U4 Job Coaching 1:2 to 1:4 Intensive Employment W1734U5 Job Coaching 1:2 to 1:4 Follow Along Employment

W1735 Job Finding Employment W1740 Benefits Counseling Employment W1741 Employment Skills Development (1:15) Employment

S5121UD Pest Eradication Environmental Modification S518532 Medication Dispensing and Monitoring Equipment and Monitoring T2025GT Health Status Measuring and Monitoring Remote Equipment and Monitoring T2028GT Specialized Supplies for Remote Monitoring Equipment and Monitoring T2029GT Specialized Supplies DME for Remote Monitoring Equipment and Monitoring W0137 Specialized Medical Equipment and Supplies Equipment and Monitoring W0138 Assistive Technology Equipment and Monitoring W1894 PERS Installation Equipment and Monitoring W1895 PERS Monthly Maintenance Equipment and Monitoring W2024 Equipment Installation and Removal Equipment and Monitoring W2025 Equipment Installation and Removal with Training Equipment and Monitoring W9006 Activity and Sensor Monitoring Equipment and Monitoring W0100 Residential Habilitation 1-3 Habilitation

W0101U4 1-3 SUPP 1:1 Habilitation W0101U5 1-3 SUPP 2:1 Habilitation

W0102 Residential Habilitation 4-8 Habilitation W0103U4 4-8 SUPP 1:1 Habilitation W0103U5 4-8 SUPP 1:2 Habilitation

W0104 Structured Day Habilitation Group Habilitation

The Provider System

Non-Homecare Services EDI Import Interface Guide Page | 10 February 2020 Procedure Code Table Proprietary & Confidential

Procedure Codes Service Code Description HHAX Service Type

W0105U4 Structured Day Habilitation 1:1 Habilitation W0105U5 Structured Day Habilitation 2:1 Habilitation

W1759 Home Delivered Meals - Hot Entrée Meals W1760 Home Delivered Meals - Frozen Entrée Meals W1761 Home Delivered Meals - Sandwich Meals W1762 Home Delivered Meals - Emergency Pack Meals W1764 Home Delivered Meals - Special Meal Meals W0139 Vehicle Modifications Modifications W0140 Home Adaptations < $6000 Modifications W0141 Home Adaptations > $6000 Modifications

W1011U1 LTSS (Service Coordination) Service Coordination W7332 Community Transition Services (Household Suppl) Service Coordination W7333 Community Transition Services (Moving Expenses) Service Coordination W7334 Community Transition Services (Security Deposit) Service Coordination W7335 Community Transition Services (Set-up Fees) Service Coordination W7336 Community Transition Services (Health Safety) Service Coordination W6110 Non-medical Transportation Transportation

Non-Homecare Services EDI Import Interface Guide · Non-Homecare Services EDI Import Interface Guide Page | 6 February 2020 Required Components for Successful Import Proprietary &

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