Wisconsin: Configure FFS EVV Aggregation

Inform the aggregator of the decision to use AltEVV. Complete the missing information below and send via Email to WIAltEVV@Sandata.com.

Complete the following steps in the HHAeXchange system:

1. Go to Admin > Contract Setup > New Contract to create a contract.

   Skip this step if the contract already exists in the system.

2. Providers are identified by their 8 to 15-digit WI DMS Enumerator in the State aggregator. Enter the appropriate WI DMS Enumerator for each contract in the Agency ID (33b) field.

   

3. Select the appropriate Contract Type value from the table below:

   Contract Type Configuration
   Contract Type	Payer Program/Waiver NamePayer Program
   ANTBCBS-WIHMO	BCBS HMO
   CAREWI-WIHMO	Care Wisconsin HMO
   CAREWIFCP-WIMCO	Care Wisconsin Health Plan MCO
   CCIFC-WIMCO	Community Care, Inc. - Family Care MCO
   CCIFCP-WIMCO	Community Care Health Plan MCO.
   CCOMMHP-WIHMO	Children’s Community Health Plan HMO
   DEANHP-WIHMO	Dean Health Plan HMO
   GHCEC-WIHMO	Group Health Cooperative of Eau Claire HMO
   GHCSCW-WIHMO	Group Health Cooperative of South Central Wisconsin HMO
   GTINDEP-WIIRISFEA	GT Independence IRIS
   ICAREBC-WIHMO	Independent Care Health Plan (iCare) HMO
   ICAREFCP-WIMCO	Independent Care Health Plan (iCare) MCO
   ICARESSI-WIHMO	Independent Care Health Plan (iCare) HMO SSI
   ILIFE-WIIRISFEA	iLIFE IRIS
   INCLUSA-WIMCO	Inclusa, Inc. Family Care MCO
   LAKELAND-WIMCO	Lakeland Care, Inc. Family Care MCO
   MCFC-CW-WIMCO	My Choice Family Care-Care Wisconsin Family Care MCO
   MERCYCARE-WIHMO	Mercy Care HMO
   MHSHW-WIHMO	MHS Health Wisconsin HMO
   NHP-WIHMO	Network Health Plan HMO
   OUTREACH-WIIRISFEA	Outreach Health Services IRIS
   PREMIER-WIIRISFEA	Premier Financial Management Services IRIS
   QUARTZ-WIHMO	Quartz Health Solutions, Inc. HMO
   SECURITY-WIHMO	Security Health Plan of WI, Inc. HMO
   TRILOGY-WIHMO	Trilogy Health Insurance HMO
   UHCWI-WIHMO	UnitedHealthCare of Wisconsin, Inc. HMO
   WIFFS-FFS	FFS Delivery Channel
   WIMOLINA-WIHMO	Molina Health Care HMO

4. If a Contract Type is not found, go to Admin > Reference Table Management > Contract Type.

   Refer to the Reference Table Management topic for steps on how to add a Contract Type.

5. Go to Admin > Reference Table Management > Contract Service Code to enter a valid Service Code in the HCPCS Code field.

   Repeat this step for each contract. Refer to the Reference Table Management topic for steps on how to add a Contract Service Code.

   Refer to the WI EVV Contract Service Codes for a full list of In-Scope Service Codes.

   If an HCPCS Code is associated to an incorrect Contract Type, then the EVV visit data associated to the HCPCS Code is not sent to the aggregator. Only the confirmed visits associated to the above In-Scope Service Codes and the correct Contract Type are aggregated.

6. Go to Admin > Reference Table Management > Visit Edit Reasons to configure the valid Reason Codes.

   Refer to the Reference Table Management topic for steps on how to add a Reason Code.

   Reason Code	Description	Note Required?
   1	Caregiver Error	No
   2	Member Unavailable	No
   3	Mobile Device Issue	No
   4	Telephony Issue	No
   5	Member Refused Verification	Yes
   7	Missing in system	No
   8	Other	Yes

   A default value of Other is exported with the visit when the Reason Code differs from the table above.

7. Review all Member Profiles to ensure the Member details are entered correctly.

   Members must be identified by First Name, Last Name, and Medicaid ID. Member Medicaid IDs must be entered in the Member Profile > Medicaid ID field. Medicaid ID must be a 10 to 12-digit numeric value. Member Phone Number and Address are also required.

8. Review all Caregiver profiles to ensure that the Caregiver details are entered correctly.

   Caregivers must be identified by First Name, Last Name, and WI DMS Enumerator ID. The WI DMS Enumerator ID must be entered in the Caregiver’s Profile > Employee ID field.

   The State of Wisconsin uses the Division of Medicaid Services (DMS) Enumerator ID to identify caregivers and therefore, all caregivers must be registered with the State.

   Member and Caregiver names can consist of alpha letters, hyphens, periods, and apostrophes. All other special characters cause the record to reject.

9. Once complete, create a ticket via the Client Support Portal > State EVV Aggregation queue to set up the WI EVV Aggregation interface.

   Once confirmation is received, proceed to State Aggregation Report topic to review exported EVV data.