DCH-i [Vol. 1, no. 6 (Mar./Apr. 2012)]

Georgia Department of Community Health

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Home DCH-i March/April 2012, Vol. 1 Issue 6
DCH-i March/April 2012, Vol. 1 Issue 6

DCH-i March/April 2012, Vol. 1 Issue 6

DCH-i is the monthly newsletter from the Georgia Department of Community Health for all matters DCH. It provides timely and important information to you as physicians, dentists, hospitals, third-party payers, vendors, health care advocates, consumers and legislators. Our goal is to help create A Healthy Georgia -- together. Write us at DCH-i@dch.ga.gov.
In This Issue
Information Technology Revolutionizes DCH Ask DCH-i
Does the 5010 transactions standard conversion apply to my organization? Is the compliance deadline for ICD-10 being delayed? Why is there only one HP hospital representative for the entire state?
DCH Goes Digital Geomapping Serves Providers, Consumers Integrated Eligibility Portal Simplifies Program Application Process 5010: A Success Story MMIS Certification - What It Means To Providers Speaking Up! Recent Board Actions Meetings and Opportunities for Public Comment
Save The Dates

Tuesday, May 8 Semi-Annual Georgia Medicaid Fair The Classic Center Athens, Ga. Details to come

Thursday, June 28 DCH Health IT Town Hall 2 Peachtree Street Atlanta, Ga. Details to come

Do you have a question or a comment? A special request, perhaps? Tell us what's on your mind at DCH-i@dch.ga.gov.

The IT Transformation: Changing the Way DCH Does Business

Ongoing concurrent IT projects are revolutionizing how the Georgia Department of Community Health (DCH) is using technology to create A Healthy Georgia and to comply with federal health information technology standards. These changes affect DCH's communications and customer service interactions with a variety of stakeholders: physicians, dentists, hospitals, third-party payers, vendors, health care advocates, consumers and legislators. Most of these projects will be completed by the end of 2015.

Sonny Munter

"Because of the diverse and large numbers of people we serve -- from physicians and other providers to Medicaid and State Health Benefit Plan members -- continually improving our use of technology helps us increase efficiency and ease administrative burdens," said DCH Chief Information Officer (CIO) Sonny Munter. "Our current initiatives will enhance health care delivery and provider services throughout the state, enable us to provide better information security, and serve Georgians more effectively."
Here's a sampling of DCH's key IT initiatives:

DCH CIO

Improving the provider enrollment timeline
Reducing the processing and enrollment time from several months to approximately two weeks, DCH has adopted electronic credentialing for Medicaid providers.

"By converting to an electronic application system and eliminating the paper process, most providers are receiving their enrollment approvals in as few as 15 days," said David Ostrander with DCH's Office of the Inspector General. "Because access to quality affordable health care is so important, this conversion has helped us increase the number of providers throughout the state and reduce the administrative challenges they face."

Server consolidation project

DCH is moving the majority of its data servers from their current location at 2 Peachtree to the North Atlanta Data Center (NADC) in Alpharetta. Set to begin in early 2012, this move will be completed in approximately one year.

NADC is a level 4 data center designed specifically for data center operations with uninterruptable power supplies and diesel generators to prevent system downtime due to power outages. Application servers will be moved to virtual servers to reduce the number of physical servers required and to provide business continuity in the event a serious problem is encountered.

Data now stored on individual computers is being moved to a Storage Area Network (SAN) in the NADC, resulting in less wasted storage space and the ability to quickly recover from a disk drive problem. Using a SAN reduces system interruptions to improve business continuity.

Business continuity program

During the past several months, all divisions and offices of DCH have successfully updated the Department's business continuity plan. If there's a fire, weather disaster or other incident that prevents staff from working at our offices, stakeholders can continue to do business with us thanks to this initiative.

"The goal is to be able to continue our essential business operations if there's a disaster," Munter said. "All of these programs, improvements and changes are indeed revolutionizing the way DCH does business."

--Article by Jeffrey L. Holt, DCH Webmaster

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Ask DCH-i
DCH-i answers your questions each month. If you have an issue, a question or a comment, we'd appreciate hearing from you at DCH-i@dch.ga.gov.
Q -- Does the 5010 transaction standard conversion deadline apply to Adult Day Health agencies?
A -- Yes. If your facility provides any services ordered by diagnosis, such as physical or speech therapy, you're subject to HIPAA, and you file electronic claims, you are required to comply with the extended July 1, 2012, compliance enforcement deadline. However, DCH strongly suggests that although the enforcement deadline has been extended, you should proceed to becoming 5010 compliant as soon as possible. Also, any provider who is subject to HIPAA must further upgrade to 5010 in preparation for the transition to ICD-10 in October 2013.
However, paper claims and claims entered directly through the MMIS portal are automatically processed in the 5010 format. DCH is already processing electronic claims submitted using the 5010 transaction standards.
Q -- I heard that the Centers for Medicare & Medicaid Services (CMS) is considering changing the deadline for ICD-10 compliance. What's the story?
A -- Yes. CMS is considering the possibility of an extension for ICD-10 compliance, but no decision has been made. It is also possible that no extension will be granted. There has been no formal announcement beyond this. Until we are notified of an official change, the Department will continue to proceed with meeting any and all requirements for compliance and strongly encourages its providers and trading partners to do likewise.
Q -- Why is there only one Hewlett-Packard Enterprise Services (HPES) hospital provider representative for the entire state of Georgia? I think one hospital representative with district managers for each district would be more efficient.
A -- DCH has recognized the need for additional hospital representatives and HP has now added three consulting representatives to more effectively and expeditiously address the many and varied issues that our hospital provider community faces.
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DCH Goes Digital
Financial Management and Healthcare Facility Regulation (HFR) were instrumental in the early adoption of digitized information management at the agency. Now areas such as the Office of Inspector General, State Health Benefit Plan, HFR's Office of Health Planning Certificate of Need (CON) unit, and Legal Services can scan and store files digitally.The Georgia Department of Community Health (DCH) is becoming fully digital by converting older paper files into an electronic document management system. It will enable DCH employees to scan, save and view paper files in an electronic format.
"It makes good business sense to digitize our files," said Matt Jarrard, DCH's health planning director. "Already we can see our return on investment in the amount of staff time saved by being able to search an electronic document management system."
Now, DCH employees can search for files quickly and easily from their desks. Almost like initiating a Google Search, staff can enter a key search word; then files containing that word appear on screen. Archiving is much easier and faster with a document management system, and paper files and file rooms have been greatly reduced in size. Not only does the document management system serve DCH's digital needs, it also helps DCH to remain transparent and accessible to its constituents.
"The public can use the CON file-viewing area without waiting for staff to pull paper files," Jarrard said. "Overall, digital files save time, are a more efficient use of resources and are much easier to search."
--Article by Karen Rothschild, DCH Deputy Director of Communications
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Geomapping Serves Providers, Consumers with Simplicity, Ease of Use
Then imagine having a loved one who needs an assisted living residence. You want to move this person close to you, but you don't know where to begin. You'd like to be able to go online, quickly find out what is available in your area, what levels of care are offered, view inspection reports and determine if there are facilities near public transportation.Imagine being a hospital administrator, going to your computer and researching your entire marketing area to see the spectrum of health care services, facilities, utilization demographics and financial profiles by using a simple tool.
The Licensure and Certificate of Need (CON) sections of the Georgia Department of Community Health's (DCH) Healthcare Facility Regulation Division (HFR) have been working since August 2011 to combine their data systems and place them on Google Maps. This month you'll be able to geomap licensed health care facilities in Georgia to research business and personal questions or concerns about facilities regulated by DCH.
"Geomapping will open the door for obtaining information about Georgia health care facilities in ways that will make sense to the researcher," said Matt Jarrard, DCH's health planning director. "Google Maps will simplify the mystery of selecting a suitable facility for a family member or targeting new patients in the area with a few mouse clicks. We're very excited about geomapping going live, and we'll continue to improve it as we move forward."
Once the system is operable in April, we'd be interested in hearing your feedback about it. Let us know at DCH-i@dch.ga.gov.
--Article by Iris McIlvaine, DCH Public Relations Manager
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Integrated Eligibility Portal Simplifies Program Application Process
A new web-based eligibility system for application to multiple social services is under development with goals to streamline the eligibility process for consumers, eliminate redundant data entry for case workers, and reduce duplicate client information shared by multiple social services.An aggressive undertaking to simplify enrollment in Medicaid and other state programs is underway in Georgia.
The Georgia Department of Community Health (DCH) is the lead agency on the project and is working with the Department of Human Services, the Department of Public Health and the Georgia Technology Authority. The new Integrated Eligibility System (IES) will allow consumers to apply online and obtain eligibility for programs like Medicaid, TANF, SNAP (formerly Food Stamps) and WIC through a single web portal.
"Benefits include automated caseworker functions, enhanced customer service, improved program efficiency and better service delivery between health and human services agencies," said Jon Anderson, deputy chief of Member Services and Eligibility Policy, DCH's Medicaid Division. "The new system will connect programs that the state was previously unable to link without extensive assistance from staff. The state also plans to electronically validate employment history, income verification and citizenship to simplify the enrollment and reenrollment process for families."
Agencies involved have been meeting for more than a year to prepare for the new system. Numerous options and solutions must be considered as the process moves forward. The program may take one of several formats -- a commercial off-the-shelf version modified to support Georgia requirements, an adaptation of another state or states' system, or possibly a hybrid solution.
"Once the agencies involved determine their requirements, requests for proposals will be issued for vendors to propose, design and implement the initiative," Anderson said. "The Patient Protection and Affordable Care Act (PPACA) requires that the IES must implement new Medicaid rules and a mechanism to provide eligibility determination based on Medicaid applications submitted through a web portal by January 1, 2014."
The first eligibility determination phase is limited to Medicaid's expanded population's coverage based on Modified Adjusted Gross Income (MAGI). Plans call for a complete solution for all other Medicaid populations and other programs that will be implemented by December 31, 2015.
Express Lane Eligibility
As a precursor to the new Integrated Eligibility System, Georgia is already using Express Lane Eligibility to enroll members in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Georgia was the first state in the nation to implement the program and is one of only five states currently using the system.
"Because individuals are frequently referred back and forth between WIC and Medicaid and/or PeachCare for Kids, this was a logical approach for our agencies," Anderson said. "Pre-existing rules, including income verification, draw the two programs together."
Georgia was commended in the recent report from the US Department of Health and Human Services for its innovative programs of enrollment and retention of members in the Children's Health Insurance Program (CHIP). As a result, the state received nearly $5 million as a CHIPRA bonus in December.
--Article by Jeffrey L. Holt, DCH Webmaster
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5010: A Success Story
Having a good relationship with the practice management team and vendors, plus volunteering to participate in test runs, helped with readiness by the deadline."Don't fear 5010," said Janice F. Beneby, billing manager with W.D. Lucky, M.D., Inc., a wound care practice serving Georgians. "We read e-mails, pop-ups, bulletins, journals and dashboard flashes as they were published and, after doing a little of our own research, we were able to be 5010 compliant by the January 1, 2012, deadline."
Beneby said that the key to the conversion was having three pieces of information:
The plus-4 ZIP code (https://www.usps.com) for ALL referring providers and entities for which the organization provides services Accurate National Provider Identifier (NPI) numbers (https://nppes.cms.hhs.gov), which will eventually replace providers' Tax/Employer Identification numbers (TIN, EIN) The facility's National Provider Identifier (NPI) number (https://nppes.cms.hhs.gov)
"Once we gathered this information, we spent days entering it into our data files," Beneby said. "We tracked the 5010 bulletins, 'Where You Should Be Now,' posted by our practice management team on a weekly basis, and that's all there was to it. By January 1, we were ready. We're already taking steps to be ready for the ICD-10 conversion in October 2013."
For more information about the 5010 and ICD-10 conversions, visit www.dch.georgia.gov/ICD10.
--Article by Pamela A. Keene, DCH Media and Public Relations Manager
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MMIS Certification -- What It Means to Providers
The Georgia Department of Community Health (DCH) and our fiscal agent Hewlett-Packard Enterprise Services (HPES) received official notice of certification of the system earlier this month.Georgia's upgraded Medicaid Management Information System (MMIS), the backbone for information and claims processing for the state's 1.7 million Medicaid and PeachCare for Kids enrollees, is now certified by the Centers for Medicare & Medicaid Services (CMS).
In CMS' certification letter, several DCH and HPES staffers were praised for their thorough and responsive support rendered throughout the certification process.
"This was an amazing accomplishment that drew praise from all quarters, particularly federal officers who reviewed and approved the product," said DCH Commissioner David A. Cook. "With a project this large, we know that many people here within DCH and with our partner HPES are to be commended for their hard work and dedication. DCH and HPES will continue to monitor provider and trading partner feedback for necessary and ongoing system improvements as we move forward."
After more than one year of preparation, data conversion, training and testing, the system went live on November 1, 2010, to 40,000 providers of services to the state's Medicaid and PeachCare for Kids members. The new system eases administrative burdens, streamlines paperwork and processes and saves both time and money for providers and the state.
Here are the benefits of the MMIS for Georgia's providers:
Weekly claims payments -- claims processed on a weekly financial cycle. Claims status -- check claims status any time (in process, paid, suspended and denied), regardless of format. Member eligibility status -- immediate online verification of member eligibility before providing the service, reducing fraud and saving money. More web-based services -- automated provider enrollment, service authorization and more. Online, on-demand training -- training to suit your schedule, reducing time away from the office. Electronic record of payments -- Internet accessibility of Remittance Vouchers and Remittance Advice, eliminating paper documents, saving time and money. Provider enrollment online -- reduces time through a secure web portal application process. Information and a Newsletter -- Contact information for HP Field Representatives is located on the MMIS website, www.mmis.georgia.gov, under the Provider Information tab, Provider Notices tab within the quarterly Provider Focus newsletter. Provider Focus lists all of the HP Field Representatives and the counties they serve.
Do you know mmis.georgia.gov? Look for important banner messages, lists of upcoming events, provider manuals, updated forms, online training activities, pharmacy notices, the best way to enroll and more. Visit www.mmis.georgia.gov for more information.
Let us hear from you If you see a Medicaid policy, process or procedure that needs improvement, please contact the Provider Call Center at 1-800-766-4456. Or e-mail us at DCH-i@dch.ga.gov.
--Article by Iris McIlvaine, DCH Public Relations Manager
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Speaking Up!
Deputy Commissioner Blake Fulenwider will address this organization in April: Tuesday and Wednesday, April 24-25 -- iHT2 Health IT Conference -- http://ihealthtran.com/atlantahome.html
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Recent Board Actions
At its Thursday, March 8, meeting, the Board of Community Health took the following actions: Unanimously approved a Resolution entitled "SHBP Teachers Plan Employer Contributions: Rate Correction" and Unanimously approved for final adoption the PeachCare For Kids Provider Rate Increase Public Notice.

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Meetings and Public Comment Opportunities
Next Board of Community Health Meeting -- Thursday, April 12 -- 10:30 a.m. -- 2 Peachtree Street, 5th Floor Board Room, Atlanta.
Get News You Can Use Join our mailing list for DCH-i at DCH-i@dch.ga.gov.

Editor-in-Chief Pamela A. Keene
Graphic Design Karen Rothschild
Webmaster Jeffrey L. Holt
Production Iris McIlvaine
Circulation Denise Smith
Peggy Woodruff Interim Director of Communications
About the Georgia Department of Community Health
The Department of Community Health (DCH) conducts the business of health care for Georgia. Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and underserved populations.
DCH is responsible for Medicaid and PeachCare for Kids, the State Health Benefit Plan, Healthcare Facility Regulation and Health Information Technology in Georgia.
We are dedicated to A Healthy Georgia.
2 Peachtree

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