Home Health and Personal Care Services

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Diagnosis Code Changes for Carolina Complete Health Providers Required to use Electronic Visit Verification

Beginning Monday, May 15, 2023, Carolina Complete Health will allow Providers to manage the Billing Diagnosis Code field in the HHAeXchange Provider Portal. As part of this update, the Diagnosis Code does not import on any new authorizations. The Provider is responsible for managing and entering the correct DX Code for the service. Refer to the Provider-Managed Billing Diagnosis Code Job Aid (PDF) for instructions on how to enter the diagnosis codes, moving forward for all Carolina Complete Health Authorizations. A Billing Review hold has been implemented for any authorizations that do not have a DX loaded. This process prevents any submission of blank Diagnosis Codes on a claim.
Note: EDI Providers must coordinate with their EVV Vendor to ensure rates and diagnosis codes are being sent. Once confirmed, reach out to EDISupport@hhaexchange.com to request your configurations be updated.  
For further information concerning the contents of this notification, please contact HHAeXchange Customer Support (support@hhaexchange.com).

Requesting initial Personal Care Services (PCS) for Standard Plan Carolina Complete Health members

Do you have a Carolina Complete Health member who is in need of initial PCS?

  1. The 3051 form is to be completed by member's primary care provider or attending physician. This can be found on the Manuals, Forms, and Guides page.
  2. Fax the 3051 form to Carolina Complete Health Care Management: 833-238-7689
  3. Once this form is received a face to face visit (telephonic outreach due to COVID) will be scheduled within 30 days by CCH Care Manager
  4. After assessment is completed and start of care date is determined, an authorization will be created by CCH and will be shared with the agency. This document will include purchased tasks to be completed by PCS attendant. Agencies will receive the authorization via fax and can also view on the CCH Secure Provider Portal  

This recorded session provides an overview on how to request PCS services, the assessment and authorization process, working with the EVV Vendor, plus Q&A!

Electronic Visit Verification (EVV)

The 21st Century Cures Act requires NC Medicaid to begin using an Electronic Visit Verification (EVV) system for Home Health Care Services (HHCS) and Personal Care Services (PCS). 

To ensure that the provider community complies with the Cures ACt mandate requirements, Carolina Complete Health partners with HHAeXchange as its EVV solution.

HHAeXchange is the premiere Homecare Management Software company for the Medicaid LTSS population. They are the leaders in connecting payers and homecare agencies to enable more collaboration, communication, and workflow efficiencies. Through the use of the HHAeXchange portal, their goal is to make working with Carolina Complete Health easy and efficient.

How HHAeXchange Helps the PHP Meet the Cures Act Mandate​

  • Industry-leading scheduling and billing platform for back-office users and EVV confirmations​
  • Easy-to-use point-of-care visit confirmation tools for caregivers

What does the HHAeXchange Portal provide to homecare agencies?

  • Electronic case placement and authorization transfer
  • Efficient schedule and visit management
  • Free EVV solution for time & attendance and duty tracking
  • Electronic billing

Standard Plan HHCS providers

Effective immediately, it is expected that all providers use the EVV vendor of their choice for every home health visit. Section 7.8 of the Home Health Clinical Policy outlines the EVV requirements for those services subject to EVV. As of April 1, 2023, home health providers who are not connected to an EVV vendor and capturing the required EVV data elements are out of compliance with the EVV requirements noted in the Home Health Clinical Policy. Read the NC DHHS Blog for more information. 

Urgent Reminder: All home health care services claims with service date  07/01/2023 and forward must be submitted to CCH through HHAeXchange EVV system for payment otherwise payment will be denied per state mandate.

Choosing your EVV provider selection and the HHAeXchange platform:

The HHAeXchange provider information center outlines necessary requirements to set up access to the HHAeXchange system. If your agency does not have a portal with HHAeXchange, please complete the Provider Portal survey.

HHAeXchange offers EVV solutions at no cost to providers and data integration options for providers who already have EVV software. Based on your provider set up, below are the options available with HHAeXchange:

  • Option 1 – Agencies currently without an EVV Solution: use the free EVV tools provided by HHAeXchange & Carolina Complete Health
  • Option 2 – Agencies currently using another 3rd Party EVV Solution: use your existing EVV system and import visit data into HHAeXchange – HHA will route visit data to Carolina Complete Health
  • Option 3 – Existing providers that currently utilize the HHAeXchange provider platform will be linked with the new service codes in scope

Have Questions?

If you have questions or need help, please feel free to contact your Carolina Complete Health provider representative at 833-552-3876 or email networkrelations@cch-network.com.

For questions or help with HHAX, please email HHAeXchange at ncsupport@HHAeXchange.com or visit us online.

Tailored Plan providers; how to prepare for the 10/1 launch:

The 21st Century Cures Act (Section 12006a) and The Centers for Medicare & Medicaid Services (CMS) mandate that states begin utilizing an Electronic Visit Verification (EVV) system for Personal Care Services (PCS) and Home Health Care Services (HHCS) that require an in-home visit. 

Trillium and Partners have partnered with  HHAeXchange to provide the EVV tools necessary for designated providers to comply and meet the requirement. HHAeXchange offers EVV solutions at no cost to providers and data integration options for providers who already have EVV software. 

In preparation for the Tailored Plans Physical Health PCS (99509) and HHCS launch date of 10/1/2023, we want to ensure your agency is ready to start using the HHAeXchange Provider Portal for your patients.

If your agency does not have a portal with HHAeXchange, please complete the Tailored Plan HHAeXchange Provider Portal survey.

If you already use HHAeXchange, you can link all payers within the same portal. In many cases, this will happen automatically. However, if you do not see this happen, please submit a support ticket with HHA to have the additional payer(s) linked to your account.

Please view this archived webinar for an overview of the HHAeXchange system.

More information about this mandate can be found here: 

Visit the North Carolina Home Health Provider Info Center for helpful resources and training materials, or contact us at ncsupport@hhaexchange.com