Molina Missed Visit Info Import

The Florida Agency for Health Care Administration (AHCA) requires Molina to report Missed Visits as close to real time as possible to support the state's mandatory two-hour caregiver replacement requirement. Timely reporting helps ensure Molina can respond quickly when a scheduled visit is missed and take the necessary steps to help prevent a disruption in the member's care.

To support this requirement, HHAeXchangehas implemented a process to identify and prioritize Florida Missed Visit files for processing.

What Providers Need to Do:

The file format for submitting missed visits will remain the same as the current V5 Import Specifications, with a change in the File Naming Convention.

This interface must be used in conjunction with the Homecare EDI Import interface and applies only to Visit(s) that have been marked as Missed.

The sections below outline the required File Naming Convention, fields, file format requirements, and submission process.

 

  • In the event the system is down, or you are unable to send the file timely, please contact Molin within the three-hour notification period.
  • A schedule must be imported before a missed visit can be reported.
  • The same Schedule ID used in the original schedule import must be included in the corresponding missed visit import.
  • Failure to use the original Schedule ID will result in processing issues.

Need Help?

For assistance with the Molina EDI Missed Visit process, please submit an EDI support ticket through the Support Portal using the following selections:

  • Category: Data & Integration

  • Subcategory: 3rd Party Vendor Integration Support

File name: MissedVisit_FL_AgencyTaxID_YYYYMMDDHHMMSS.CSV

  • MissedVisit=Hardcoded

  • FL=Hardcoded

  • AgencyTaxID=Agency's Tax ID

  • YYMMDD=Date in YYYYMMDD Format

  • HHMMSS= Time stamp in HHMMSS Format

When submitting a Missed Visit import, you must use the V5 Import Specifications and populate the following required fields:

  • Agency Tax ID

  • Caregiver Code

  • Medicaid Number

  • Missed Visit (value must be "Y")

  • Missed Visit Action Taken Code

  • Missed Visit Reason Code

  • Payer ID

  • Procedure Code

  • Schedule ID

All of the fields listed above are required for a successful Missed Visit import. Records that do not contain all required fields may be rejected or fail processing. Only populate the above fields in the missed visit file import, sending information in any additional fields, may cause processing errors.

File Format Requirements

All import files must be saved in .csv format. The system can only process CSV files and is unable to process, convert, or accept any other file type.

For complete field definitions, formatting requirements, and file specifications, please refer to the V5 Import Specifications documentation.

Please refer to the Missed visit Reason code and Missed visit Action Taken codes dropdowns on the Florida EDI Code Page.