UPR Overview

This guide covers the Universal Patient Record (UPR) Linked Contract functionality and how it affects the Patient record in the HHAeXchange system. The purpose of this functionality is to improve the Patient Management experience by resolving or removing certain limitations associated with historical HHAeXchange Linked Payer Contract processes in the system. Historical HHAeXchange Linked Payer Contracts were primarily governed by Payers via their own HHAeXchange system to send Placements and Authorizations to Providers.

Key benefits of UPR Linked Contract functionality include:

• Elimination of duplicate records. The system allows one Patient record to host both Internal (Provider-controlled) and Linked (Payer-controlled) contracts.

• Greater Provider control of the Patient record. Historically, the majority of Patient details could only be updated by the Payer; Providers can edit more fields within the Patient record associated with UPR Linked Contracts.

• Standardization of functionality and workflows across all Patient records, regardless of the contract type.

The HHAeXchange system:

• Ensures claim integrity across all contracts in the system with built-in safeguards to prevent users from sending incorrect claims or falling out of compliance.

• Maintains the core benefits and functionality associated with the historical HHAeXchange Linked Payer Contract processes; such as Authorizations sent to Providers directly from Payers via HHAeXchange, Communications functions for sharing information and messages with Payers, and the ability to submit claims with the proper validations in place that help increase payments and reduce denials.