Beginning Wednesday, November 1, 2023, Carolina Complete Health will allow Providers to edit rates in HHAeXchange. All claims billed to Carolina Complete Health will be billed at the current rate set by the health plan, and claims are paid according to your contracted rate with Carolina Complete Health. If the rate in HHAeXchange does not match your contracted rate, then you can manually update the rate. Refer to the Rate Management Job Aid for instructions and details.
Moving forward, your Agency is responsible for managing the rate (including any contractual updates) if the rate is updated.
**If additional offices are linked with Carolina Complete Health in the future, rates will default to $0 and must be updated by your agency prior to billing.
Note: EDI Providers must coordinate with their EVV Vendor to ensure rates are being sent. Once confirmed, open a ticket with EDI Support to request your configurations be updated.
For further information concerning the contents of this notification, please open a ticket with HHAeXchange Customer Support.
Please Note: Claims including Home Health (HH) services and supplies must be split. HH services must be billed through EVV, while HH supplies should be billed directly to Carolina Complete Health. If providers submit a claim including HH services and supplies, the claim will deny.
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
What does the HHAeXchange Portal provide to homecare agencies?
Your agency will receive login credentials for the HHAX Learning Management System when your portal is created. Your team should use the LMS to review videos, documents, and test questions to ensure an understanding of the HHAeXchange Provider Portal. Access the LMS system.
*Login credentials were emailed to the user who completed the portal creation survey. Please submit a ticket via the HHA support portal with any questions regarding credentials.
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:
Optimize Customer Support Experience: To best support our customers, HHAeXchange highly encourages users to submit requests via the Client Support Portal. The Client Support Portal is the fastest method for us to answer and address issues. Through a simple set of questions and selections, we can easily determine assignment and answer questions directly online without waiting.
For more information, please refer to the Client Support Portal Job Aid (PDF) for step-by-step instructions and videos on how to
Provider Portal Resource Page:
The soft launch pay and report period for the implementation of EVV for HHCS began April 1, 2023. NC Medicaid has closely monitored provider adoption and readiness for the hard launch. Since provider adoption has been low and to give providers additional time to prepare for hard launch, the soft launch has been extended through Sept 30, 2023. During the extended soft launch timeframe:
To prepare for this hard launch, HHCS providers are expected to use EVV effective immediately for home health visits. To ensure that the provider community complies with this mandate, Carolina Complete Health partners with HHAeXchange as its EVV solution.
For additional information you may view the latest Medicaid Bulletin issued on the EVV Requirement for Home Health Care Services
Do you have a Carolina Complete Health member who is in need of initial PCS?