PA - HHAeXchange

Certain Managed Care Organizations (MCOs) in PA have chosen to use HHAeXchange as their data aggregator. Rosemark has a CSV file that can be uploaded to import visit data from Rosemark to HHAeXchange. If you are interested in activating this feature or have further questions please email Customer Care at support@shoshana.com.

Why do PA Agencies need an integration?

The goal of the integration is for Rosemark agencies to continue managing ALL of their data in Rosemark and have that data be transmitted to the state of PA (through HHAeXchange) to maintain compliance with the 21st Century Cures Act. In order for the integration to be successful, each agency must set up their particular data in Rosemark a certain way so that it conforms to expected standards set by the state. These rules must be followed by ALL agencies regardless of what software they use to run their agency.

 

Agency Configuration

In order to sync your agency details correctly with HHAeXchange we will need your Medicaid provider ID. This is supplied to you by the state when you are approved to provide Medicaid services. First go to the main Rosemark File Menu > Configuration > Medicaid. Fill out your Medicaid Provider ID, and set your ICD code number to 10. Move on to identifying Medicaid service types.

 

Identifying Medicaid service types

Each Medicaid program you are registered under and each procedure code you provide services for (and bill for) will need to be set up in Rosemark.

Go to File > Configuration > Service Types and Rates.

Here you'll need to set up service types codes that show three pieces of information:

1. MCO Abbreviation

Example: Keystone, PAHW, UPMC

2 . Grouped Procedure Code

Example: Homemaker, Personal Care Assistant, Respite

3.  Procedure Code 

 Example: T1019, S5150, T1019: U1, S5130

Here is an example of a complete service type that is ready to sync to HHAeXchange:

                                             Keystone - Respite - T1005

 

In the description field of the service type put in the procedure code as well as the modifier(s), if appropriate. Keep in mind that each procedure code you bill under needs to have its own matching service type in Rosemark. For instance, if you bill under T1019 and T1019:TF then you should have 2 service types in Rosemark. Once you have set up the appropriate service types, move on to Client and Caregiver data entry. To see a list of currently available procedure codes for HHAeXchange PA please review this document. 

 

Client Data

Each Medicaid client profile in Rosemark must contain the following data:

• First and Last Name (Info Tab)
• Medicaid Number (Inquiry Tab)
• Birth Date (Condition Tab)
• Primary ICD 10 Diagnosis Code (must be the first thing in the Diagnosis field on the Condition Tab)
• Payer ID (View Service Tab - Auth # Field)

 

 

Caregiver Data

Each Medicaid caregiver profile in Rosemark must contain the following data:

• First name and last name (Info Tab)
• Social Security Number (HR Tab)
• Caregiver ID # (Communication Tab)

Once you have completed the Initial Set up instructions as listed in this guide, please email support@shoshana.com to schedule a call with our Customer Success team to review your data and complete the integration.