Q.

When is the replacement MMIS go-live date? Is it September 1, 2008?

A.

The MMIS will be implemented by mid-December 2008, a three-month extension of the previous implementation goal of September 2008. Until December, please continue to do business as usual.
 
The specific go-live date is still in the planning process. If you eSubscribe to the MMIS Provider Resources Web site, you can find out the specific date once it’s confirmed.

Q.

What is an MMIS?

A.

The Medicaid Management Information System (MMIS) is the mechanized claims processing and information retrieval system that all states are required to have according to section 1903(a)(3) of the Social Security Act and defined in regulation at 42 CFR 433.111. All states operate an MMIS to support Medicaid business functions and maintain information in such areas as provider enrollment; client eligibility, including third party liability; benefit package maintenance; managed care enrollment; claims processing; and prior authorization.

Q.

What providers will use the replacement MMIS at implementation?

A.

All providers who bill Oregon Medicaid for payment using the CMS-1500, UB-04, ADA 2006, DMAP 505, DMAP 1036 paper claims or using Electronic Date Interchange (EDI) will use the replacement system.

Q.

Why are we replacing the current MMIS?

A.

The DHS MMIS contains 30-year-old technology that is extremely out-of-date, and in need of replacement. The system cannot handle the state’s current needs of processing payments to approximately 31,000 health care providers and tracking the medical eligibility of about 600,000 Oregonians.

Our current system was designed to handle about 260,000 claims per month; it is now processing over 2 million claims monthly. Because the system is so overworked, it has become difficult to maintain and is incapable of being expanded to meet future needs.

Q.

What makes the replacement MMIS better than the current MMIS?

A.

Providers get many benefits from the replacement MMIS (listed here).

The replacement MMIS is based on a CMS-certified model that is currently operating in several other states. It uses current technology that will allow DHS staff to easily access, update, and analyze data. It will also allow DHS to update the MMIS to keep pace with changes in claims volume, program/policy, technology, and more.  

Q.

Who is helping DHS replace the MMIS?

A.

DHS is using the services from Electronic Data Systems (EDS). It was determined that the most cost-effective solution for Oregon’s Medicaid operation would be to have the system put in place by a company that has a proven track record in successfully designing and implementing Medicaid Management Information Systems in other states.

Q.

I have questions about how the replacement MMIS will work for me. Who can I talk to about my concerns?

A.

If you have any specific questions you’d like to ask, you can always e-mail us at mmis.questions@state.or.us. We will review your question and answer it on this page, or refer it to your appropriate DHS division contact for follow-up.

Q.

Am I already using the MMIS?

A.

If you submit claims to DMAP today, your claims are being processed through the MMIS today.

Q.

When a new question is answered on the FAQ, does an e-mail go out to providers that the FAQs have been updated?

A.

Yes. Because DHS is adding more information throughout the site as the MMIS replacement project progresses, you might not get a single e-mail that only contains information about the updated FAQ. The e-mail will probably contain information about other updates to the Web site as well.

Q.

What are the ways that providers can bill with the replacement MMIS?

A.

They can bill using the Provider Web Portal, paper claim submission, or by using Electronic Data Interchange (EDI). The Provider Web Portal supports individual claim submissions (one submission at a time); EDI is the electronic exchange of claimd data from the billing provider to other health care payers, including DHS, in a HIPAA-compliant batch format. You can learn more about EDI on the DHS EDI Web site.

Q.

Will the new system be faster?

A.

Like today, the replacement MMIS will adjudicate claims according to a fixed weekly payment cycle.  But in the replacement MMIS, providers will be able to submit claims directly into the MMIS via the Provider Web Portal. Like EDI claims, Web Portal claims bypass the steps required for paper claims processing, which allows for faster entry of claims into the MMIS.

Another timesaver is that you will no longer need to wait for your paper Remittance Advice to arrive in order to find out the status of your submitted claims. If you submit a claim via the Provider Web Portal, you will see at the time you submit the claim whether it will pay, deny, or suspend.

You will be able to check the Provider Web Portal for any claim you have submitted (Web, EDI, or paper), and find out its adjudication status before your RA arrives. If needed, you will also be able to make adjustments to suspended or denied claims you review online.

Q.

We aren’t able to do electronic billing in the current system. Will we be able to do this in the new system?

A.

There will be three ways a provider will be able to submit claims. By paper, electronically, or through the MMIS Provider Web Portal

If you have questions about Electronic Data Interchange, contact DHS EDI Support Services at dhs.edisupport@state.or.us. For information about how to register and test to become an EDI Trading Partner so that you can submit EDI claims to DHS, go to the EDI Registration and Testing page.

Q.

We aren’t able to do electronic billing in the current system. Will we be able to do this in the new system?

A.

Yes. If you only bill a few claims a month, submitting claims on the Web may be for you. The statewide trainings walk through the process of submitting claims using the Provider Web Portal.

Q.

We currently submit claims through a clearinghouse/billing service/vendor. Will be we able to continue using them in the new system?

A.

DHS will test all current EDI Trading Partners to make sure their EDI transactions (including claims) process correctly in the new system.

If your EDI submitter is able to set up the transactions as outlined in the new MMIS Companion Guides, connects successfully with the new MMIS EDI server, and tests successfully with DHS, you should be able to continue using your current submitter.

Q.

We are a skilled nursing facility. We do not currently bill DHS using the UB-04 or CMS-1500. Does the September 2008 deadline apply to us?

A.

In September, all nursing facilities will be required to use the standard institutional claim format (UB-04 paper form or 837I transaction) to receive Medicaid payment.

If you have never billed on the UB-04 and want to register for training, e-mail mmis.questions@state.or.us, and we will forward your e-mail to SPD’s MMIS training coordinator.

If you would like to register to bill DHS using the 837I transaction, e-mail dhs.edisupport@state.or.us for more information.

Q.

What happens if a provider needs to adjust a claim that is older than one year? Will we be able to adjust that claim on the Web?

A.

Yes. The new system does not enforce timely filing limitations on claim adjustments. Providers can adjust any claim in the MMIS, regardless of the submission date.

However, the timely filing of submitting claims is still enforced.

Q.

As a Contract RN, I currently fax claims in for processing. Will I be required to continue that practice?

A.

Once the Provider Web Portal becomes available for claims processing, Community Health Support Program RN providers (formerly Contract RNs) can submit claims online instead of by fax.

Q.

In the new system, will we still need to bill prior-authorized (PA) procedures and non-PA procedures on separate claims?

A.

No. You can bill PA and non-PA procedures on a single claim. This will be true of EDI, Web, and paper claims in the new system.

Q.

How many diagnosis codes can be entered for each claim type?

A.

• Dental claims: 6 codes
• Pharmacy: 9 codes
• Professional: 8 codes
• Institutional: 26 codes

Q.

During provider training, I learned that there are new fax numbers for submitting correspondence to DHS. Which of these numbers should I use for submitting supporting documentation for claims?

A.

Q.

When will NCPDP 5.1 Point of Sale pharmacy claims transfer from First Health to EDS?

A.

• Your DHS provider number and NPI
• The name and contact information for your VAN

Q.

Is the deadline for EDI testing still August 31, 2008?

A.

With the new implementation schedule, DHS EDI Support Services will adjust the testing timelines as needed. Once a new timeline is confirmed, DHS will send e-mail notifications through the EDI Bulletins, EDI System Alerts, and MMIS Provider Resources eSubscribe mailing lists.

Q.

Will there be a change to how we receive 835s in the new system?

A.

The process for receiving 835s is the same, but the SFTP server will change. All EDI submitters need to test their connection with this new server to ensure they are able to complete business-to-business testing with the new server before the replacement MMIS goes live.
 
DHS EDI Support also published the new MMIS Companion Guide for the 835, so that you can make sure your transactions meet the new DHS standards. For more information about EDI testing for the new system, go to the MMIS EDI Web page.

Q.

My password to the new SFTP server doesn’t work. What do I do?

A.

In July, the password protocol changed. Contact DHS EDI Support (888-690-9888) for your new password.

Q.

We use a clearinghouse. Will the new system be able to send our transactions through the clearinghouse?

A.

Yes. If your clearinghouse has successfully tested with the new SFTP server and the updated transactions.

Q.

I use an Electronic Eligibility Verification Services (EEVS) vendor. Now that the MMIS implementation date is in December, will the EEVS contracts be extended until December?

A.

No. DMAP’s decision to end the EEVS contracts is not related to changes to the MMIS. The EEVS contracts are still ending August 31, 2008.
 
You need to contact your EEVS vendor to see if the new MMIS implementation schedule has changed their decisions about ending or continuing service.

Q.

My EEVS vendor said they would end service August 29. Will they provide service after that, now that the MMIS implementation schedule has changed?

A.

You will need to contact the vendor to find out if the new schedule has changed their decision to end service. If you need to find out about your options for verifying eligibility between now and December, go to the OHP Eligibility Verification Web page.

Q.

Will the 270/271 (EDI Eligibility Inquiry and Response) stay the same until December?

A.

Yes. Until December, the current 270/271 transactions will continue as they are today.

Q.

How will transportation providers verify eligibility for after-hours transports?

A.

Transportation brokerages will continue to receive their daily eligibility download in the new system. The dispatcher could check eligibility before the driver provides the service. If brokerages share their login information for the Automated Voice Response, the driver could verify eligibility by telephone.

Q.

In the new system, will we be able to verify eligibility in a batch format, or will we have to look up each client individually?

A.

If you verify eligibility today using Electronic Data Interchange (270/271 transactions), you will still be able to do so in the new system.
 
However, the 271 will not provide as much information in the new system. You may need to individually check for information such as enrollment, TPR, benefit package, and copayment information using the Provider Web Portal and/or Automated Voice Response. The Provider Web Portal does not have batch capability.

Q.

Will we have the capability to verify next-day eligibility, or just the current date and before?

A.

Eligibility information will still be the current date or before (no future dates).

Q.

Our EEVS vendor let us know that we won’t be able to get eligibility information from them after August 29. How will we verify eligibility between August 29 and when the new system goes live?

A.

DMAP’s Eligibility Verification Web page lists the current options available for providers until go-live: The 270/271 EDI transaction, AIS telephone system, and AIS Plus Web system.

Q.

Now that the MMIS is being implemented in December, will the current 8.5 x 11” monthly Medical ID cards still be mailed for September, October, November, and December?

A.

Yes. DHS will continue to mail the monthly Medical ID. The last monthly Medical ID clients will receive will be for the month of December.

Q.

Are the new wallet-sized ID cards still coming out in September 2008?

A.

No. DHS will begin mailing the new ID cards at implementation in December.

Q.

Is the Medical Care ID changing?

A.

Yes. The monthly letter-sized Medical Care ID will be replaced with a one-time wallet-sized Medical Care ID card for each client eligible for DHS medical assistance. DHS will only replace a client's card upon request, or if the client's name changes.

The new Medical Care ID will only show the client's name, Medicaid ID number, and the card's date of issue.

Q.

How does this change affect me?

A.

The Medical Care ID itself will no longer be considered proof of eligibility. Providers will need to verify client eligibility, obtain third-party resources and enrollment information using one of the methods described at this link.

Q.

Will the new Medical Care ID be a magnetic stripe card ("swipe card")?

A.

No. Like the cards of some private health insurance carriers, the new ID will be paper.

Q.

Can I see a sample of what the new Medical ID card will look like?

A.

A sample is available here. (PDF)

Q.

Since the copayment information will no longer be on the Medical ID, will it be on the coverage letter that clients receive?

A.

Yes. However, the coverage letter is for the client’s information only. If providers want to find out whether a client needs to pay a copayment, they will need to find this information using the Provider Web Portal. The Benefit and HSC List Inquiry on the Provider Web Portal will tell you if the client pays a copayment, but not the copayment amount.

• For clients on the OHP Plus and OHP with Limited Drug benefit packages, copayments are between $0 and $3 for drugs not paid for by their medical plan. Many drugs no longer require a copayment. For more information, see the announcement to prescribers and pharmacies at this link.
• Clients on the OHP Plus and OHP with Limited Drug benefit packages also pay $3 for outpatient services, such as office visits to see a doctor or other health care provider.
• Clients on the OHP Standard benefit package are not charged copayments.

Q.

When will newborns receive their Medical ID?

A.

3 to 5 business days after DHS enters the newborn into the system, the newborn’s household will receive an updated coverage letter that includes the newborn, and a new Medical Care ID for the child.
 
To make sure DHS knows to enter the newborn into the system, providers should complete the Newborn Notification Form (DMAP 2410).

Q.

When clients move into managed care, leave managed care, or change managed care plans, how will DHS let the clients know their new status?

A.

When a DHS client experiences changes in managed care enrollment, benefit package, or other changes that affect how the client receives DHS services, DHS will send an updated coverage letter that shows the current benefit, enrollment, and other coverage information for the entire household. This letter is for the client’s information only and is not a guarantee of eligibility.

A.

DHS plans to mail the PIN letters approximately two weeks before the replacement MMIS goes live. If you eSubscribe to the MMIS Provider Resources Web site, you will receive e-mail notification from DHS when the letters get sent out.

Q.

What is the PIN letter for?

A.

There are actually two PIN letters: One for Automated Voice Response, and one for the Provider Web Portal. You need to keep both these letters so that you can successfully log into these systems when the replacement MMIS goes live.

Q.

I am the security administrator for a medical group that bills for several different providers. Will all these providers get their own PIN letter?

A.

If a single provider entity (such as a group) has multiple service locations, the group will receive one Web portal PIN letter sent to the “base provider” determined by DHS.

• This single ID and PIN will be used to set up Web Portal access for all of the other service locations.
• The base provider will be determined by the earliest effective date; if several service locations have the same effective date, then the base provider will be determined by the lowest provider ID number.

Q.

Can you tell me where the PIN letter for my office will be mailed to?

A.

The PIN letters will go to the mailing address on file for each provider. If you have multiple locations or providers to bill for and want to know which location your PIN letters will go to, contact DMAP Provider Enrollment (800-422-5047).
 
If you need to update your mailing address so that you can receive your PIN letters at the right address, make sure to complete and submit the Provider Information Update (DMAP 3035) form to DMAP Provider Enrollment.

Q.

What happens if I lose or misplace my PIN letters?

A.

You will need to contact DMAP Provider Services (800-336-6016) with your DHS provider number so that they can send a new PIN letter to you by U.S. mail. It will take 3-5 business days to arrive. Make sure to keep your PIN letters safe so that you are able to verify eligibility when the replacement MMIS goes live!

Q.

We are a transportation provider. We currently get authorizations from the DHS branch office on the 405T form. Will we now get authorizations through the Provider Web Portal?

A.

No. The Prior Authorization functions of the Provider Web Portal are only to request prior authorizations for certain health care and dental services.

Q.

If I submit a prior authorization request through the Web portal, how will I be notified if the request is approved — By letter, or on the Web?

A.

DHS will send a letter, but you will also be able to check the status of your PA request on the Web portal to see if DHS has approved it.

Q.

Will the PA process for Community Health Support Program (Contract RNs) remain the same, and why?

A.

Yes. This is an SPD policy decision.

Q.

Will the PA process for Community Health Support Program (Contract RNs) remain the same, and why?

A.

Yes. This is an SPD policy decision.

Q.

How will provider enrollment change?

A.

In the replacement MMIS, providers will be able to submit most of their basic enrollment over the Web (learn more at this link). Required attachments will be mailed or faxed to a secure, central location for scanning and entry into the MMIS.

The system also supports interfaces with Oregon’s Board of Medical Examiners, Board of Nursing, and Board of Pharmacy that will allow DHS staff to more quickly validate any licensing credentials required for provider enrollment.

Q.

As an enrolled provider, will I need to change how I submit information updates to DHS provider enrollment staff?

A.

Many providers will be able to update contact information, address information, office hours and more via the Provider Web Portal (learn more at this link).

Q.

When will DHS implement the replacement system?

A.

The replacement MMIS is set to "go live" later this year. The features described on the How you will benefit page, including the Provider Web Portal, will not be available until this date. For information on what you can do now to prepare for implementation, go to the What you can do now page of this site.

Q.

What do I need to do to get ready to use the new system?

A.

Review the changes listed on the What you can do now page. This page lists the various changes that will come with the replacement MMIS and what you can do now to prepare.

Q.

How is DHS helping providers get ready for the replacement MMIS?

A.

DHS has formed the Provider Implementation Workgroup to make sure appropriate communications and training allow providers to learn what they need to do to get ready for the replacement MMIS. You can learn more about the mission and goals of this workgroup on the About Us page of this site.

Q.

Will my existing direct deposit information be converted to the replacement MMIS?

A.

Yes. DHS and EDS are reviewing all provider information stored in the current system and establishing how to convert this information into the replacement system.

Q.

What are the system requirements to use the replacement MMIS?

A.

To use the Provider Web Portal, you will need a compatible browser and an internet connection. If you have support staff who do not have internet access and you want them to perform certain functions of the Web portal, make sure you get them appropriate access.

Q.

What will providers be able to do using the Web portal?

A.

There are many benefits to using the Provider Web Portal, and you can read about them at this link. One significant benefit is that providers will be able to submit claims, prior authorization requests, and eligibility inquiries, then get immediate response about the status of those requests, including current information about third-party resources (TPR) and managed care enrollment in client eligibility verifications – all online.

Q.

Is the Web portal secure? How will providers get access to the Web portal?

A.

Yes, it is secure. The Provider Web Portal provides all the benefits listed at this link, and is available only to enrolled providers that DHS has authorized to use the portal. Users must have a secure username and password to access the portal.

Prior to the implementation date, DHS will send authorized providers an initial logon ID and PIN via U.S. ground mail. Providers will then need to login and select a unique username and password in order to start using the Provider Web Portal.

Q.

Can providers see a demonstration of the Web portal?

A.

Providers who attend one of the Oregon MMIS Implementation training sessions in 2008 will be able to see a demonstration of the Provider Web Portal, and also take home information about how to use the Web portal once the replacement MMIS goes live. Go to the MMIS training information page to learn more about plans for provider training.

Q.

How far back will providers be able to access historical claims on the Web portal?

A.

All claims on file in the MMIS will be available to providers. Initially, this will include six years of converted historical claims (plus all lifetime procedure claims), and will eventually grow to include 10 years of historical claims.

Q.

We already use Web-based eligibility verification through DHS. Is the Provider Web Portal different?

A.

The current Web-based service is through First Health’s Automated Information System (AIS), which will no longer be available once the new system goes live.

The new Provider Web Portal replaces the Web AIS and provides many additional tools, including online claims and prior authorization requests, online Prioritized List inquiries, and the ability to update your office’s demographic information, such as office hours, address(es) and whether you are accepting new patients.

The telephone-based AIS is also going away. It will be replaced by the Automated Voice Response (more information is available).

Q.

We are a billing agency that bills for many providers. Can we get one Web Portal ID set up for us to access all of our providers’ information?

A.

Providers will receive a DHS ID and PIN letter to allow them access to the secured Web Portal. Once the acting administrator of that office assigns you as a clerk, you will be defined as a supporting staff member that will need system access to work on behalf of the provider. A clerk can be assigned to more than one provider.

Q.

Does the Web Portal replace my current eligibility verification system?

A.

The Provider Web Portal only replaces Web-based AIS, currently provided free from DHS through a contract with First Health. Both Web and telephone AIS services will end when the new system goes live.

If you do not use AIS to verify eligibility, then you need to contact your vendor to find out if they will continue to provide eligibility verification services in the new system.

Q.

What if the Third-Party Liability (TPL) panel shows different resource information than what we have? Who would we notify?

A.

As in the current system, you would report the resource to DHS using the Medical Resources form (DHS 0415H).

Q.

Why does the Eligibility panel show the Medicare effective date, but not the client’s Medicare ID?

A.

The initial system design of the replacement MMIS did not include the number.

Q.

The current Medical ID shows that the client has Medicare coverage, but does not show if there is a Medicare supplemental, such as Secured Horizons or Trillium. Will the Provider Web Portal show who the client’s primary Medicare carrier is?

A.

If the information is available to DHS, the client’s Medicare carrier information will display in the Third Party Liability (TPL) panel of the Eligibility inquiry response.

Q.

The current Medical ID shows that the client has Medicare coverage, but does not show if there is a Medicare supplemental, such as Secured Horizons or Trillium. Will the Provider Web Portal show who the client’s primary Medicare carrier is?

A.

If the information is available to DHS, the client’s Medicare carrier information will display in the Third Party Liability (TPL) panel of the Eligibility inquiry response.

Q.

Does the Medicare Paid Amount field on Web portal claims allow negative dollar amounts?

A.

No. The paid amount must be greater than or equal to zero.

Q.

Can we log into the Provider Web Portal to test how it works?

A.

No. You will have to wait for the PIN letter that gives you the initial login information for accessing the Provider Web Portal. The letter won’t be sent until approximately two weeks before the MMIS goes live. For more about the PIN letter, see the PIN letter FAQs.

Q.

I am the site administrator for a medical group that currently uses First Health’s AIS Plus Web service to verify eligibility. Since AIS Plus is going away, will I need to manually register all the staff that have AIS Plus access, for Provider Web Portal access?

A.

Yes, you will need to manually assign access to the Provider Web Portal for each staff member you want to access the Web portal. If you are in a group with multiple service locations, you will need to assign staff to the main group Web portal account, and to any associated service location accounts.
 
To do this, you will need to make sure you get the PIN letter that DHS will send two weeks before go-live. For more information about PIN letters, see the PIN letter FAQs.

Q.

What is the Web address for the Provider Web Portal?

A.

It will be www.or-medicaid.gov. Links to this site will also be available on the DHS Web site.

Q.

Do providers have to do any testing in order to use the Web portal?

A.

No testing is required to use the Web portal. Providers only need a computer with an Internet connection that supports Internet Explorer 6 or 7, or Mozilla Firefox 2. They will also need the PIN letter that gives the initial login information to access their Web portal accounts and delegate access.

Q.

Will the Provider Web Portal allow us to search for more than a one-month eligibility time span?

A.

The Web portal allows you to view up to 13 months of historical eligibility data (through the date of inquiry). As in the current system, you can’t request eligibility verification for future dates.

Q.

We are a billing service and bill for many different providers that are not associated with each other at all. How can I get access to the Web portal for each of these providers?

A.

You will need to contact each of your customers and ask them to give you access to their Web portal accounts.
 
One of your customers will have to create a Web portal account for you so that you are in the Web portal system. Once that account is created, you can communicate the information for your account to your other customers so that they can search for you and add you as a clerk on their own Web portal accounts.

Q.

What kind of training will be available?

A.

DHS and EDS are working together to plan classroom trainings throughout the state in 2008. These trainings will help prepare providers for the transition to the replacement MMIS. The Oregon MMIS Implementation training will include an overview of the replacement MMIS benefits and changes; information on billing via the Web, and more (see this link for more information).

Q.

Will there be training in rural areas?

A.

So far, DHS and EDS have identified 30 different sites for classroom training; many of these are in rural areas. Training will begin approximately 8-12 weeks prior to implementation.

Q.

Who will train new providers on the MMIS process?

A.

Once the replacement MMIS goes live, DHS will be responsible for educating providers on how to use the new system. This will be through updating provider billing resources/materials and continued guidance from your current DHS contacts. More details will be available as we approach the implementation date.

Q.

We submit claims electronically. Should we go to this training?

A.

Yes, we encourage all providers to attend training. The training provides information about many changes that are coming with the replacement MMIS, including information about the new tools available to you with the Provider Web Portal, which offers benefits to both electronic and paper billers.

Staff from DHS and from the MMIS contractor, EDS, will be available at all trainings to answer questions about the new system. More information about the training is available.

Q.

Where can I learn about how we will submit claims for prescriptions in the new system?

A.

DHS has specific sessions set aside specifically for pharmacy providers. They provide information about changes to Point of Sale, prior authorization, and more. The next sessions are Sunday, July 27, in Eugene, and Sunday, August 17, in Portland. More information is available (see “POS, PBM and MMIS Training for Pharmacy Providers”).

Q.

We don’t bill; our clearinghouse does. Do we need to go to this training?

A.

If you don’t bill, but want to learn about changes to verifying eligibility, changes to the Medical ID, and tools that your office can use through the Provider Web Portal, this training will be helpful.

Most of the training will be of interest to billers and those who would coordinate Provider Web Portal logins for their staff. Providers who currently bill DHS, should register at least one billing staff person so they can take the training material back to the office to share with others. If a billing service or clearinghouse bills for you, encourage them to attend.

Q.

I won’t be able to attend the MMIS training in my area. Can I go to another city?

A.

You can go to any of the statewide trainings that fit your schedule. You are not required to go to the training that is nearest you.

If you are unable to attend any of the statewide training sessions, you can also look at the training material on the Web. DHS will also post a self-paced, Web-based training course on the DHS Learning Center in August.

Q.

I can’t attend any of the statewide trainings. Can I get trained online?

A.

DHS now has an MMIS provider eCourse available through the DHS Learning Center (search for course C00818). The eCourse provides an overview of changes for fee-for-service providers, managed care organizations, and step-by-step instructions on how to use various functions on the Provider Web Portal. You will need Internet Explorer 6 (not 7) and the Adobe Flash Player to view this course.
 
You can also look at the statewide training material in PDF at this link.

Q.

I got a CD of the training material at one of the statewide trainings. I can’t open it on my computer. What do I do?

A.

The training material is in Microsoft Word 2000. If you have problems opening it, you can view the material in PDF on the MMIS Provider Resources Web site.

Q.

I bill on paper, but would like to find out more about billing electronically. Should I attend this training?

A.

If you want to find out more about electronic billing, you can go to the EDI Web site and read the Introduction to Electronic Billing Practices. The MMIS training covers changes as a result of the new MMIS, and the new tools available via the Provider Web Portal, which will be valuable to all providers.

Q.

I missed the session in my city. Will there be another training in my area?

A.

DHS plans to provide additional training in larger cities around Oregon later this year. In August, the MMIS provider eCourse was posted to the DHS Learning Center (see course C00818). You can also view PDFs of the training material at this link.
 
Make sure to eSubscribe to find out the latest changes and when we will be adding new training dates!

Q.

I only do eligibility verification or prior authorization; I don’t do billing. Which session would be best for me to attend?

A.

If those are the only parts of the training you are interested in, feel free to register for any of the available Institutional, Professional, or Combined sessions. You can leave before the billing part starts.

Q.

We are a nursing home, currently using TADS. Which training do we go to?

A.

If you currently bill on the UB-04 to Medicare, you can go to any of the Institutional or Combined classes. If you have never billed using the UB-04, e-mail mmis.questions@state.or.us so that you can get registered for a class that meets your needs.
nbsp;
If you currently bill Medicare electronically, then you should contact DHS EDI Support Services so that you are ready to bill electronically with DHS when the new system goes live.

Q.

How will the replacement MMIS help Medicaid clients?

A.

The replacement MMIS will provide up-to-date information about physicians and other medical providers in an online directory that Medicaid clients, as well as their advocates, home-care providers and family members can access. You can find out more information at this this link.

Q.

Will I still have my 6-digit "DMAP" provider number?

A.

Yes. All currently enrolled providers with a 6-digit “DMAP” provider number will retain this number in the replacement system. However, use of this number will not be the same due to the implementation of NPI for covered providers.

Q.

Will payment be by electronic transfer only?

A.

Only if the provider requests this method of payment. DHS will provide two options of payment: Paper check or Electronic Funds Transfer (EFT, or direct deposit). Click here for more information about EFT.

Q.

How will we get Remittance Advices (RAs) in the replacement MMIS?

A.

You will still have the same options for receiving RAs: The paper RA and the electronic 835 transaction.

Q.

I currently must have a business account for EFT. Will this still be necessary in the new system?

A.

In the replacement MMIS, you will be able to have your EFT go to a personal or business checking or savings account.

Q.

Will Community Health Support Program RN providers (formerly Contract RNs) be able to use EFT?

A.

Yes.

Q.

Are current providers required to complete a new enrollment form?

A.

No. Current providers don’t need to complete provider enrollment forms, and current EDI trading partners don’t need to complete new Trading Partner Agreements for Electronic Data Interchange.
 
However, all providers need to make sure that their current mailing address is on record with DHS so that their PIN letters for Provider Web Portal and Automated Voice Response go to the right place. For more information, see the PIN letter FAQs.

Q.

I have called DMAP Provider Services, but haven’t received any response. What do I do?

A.

The DMAP Provider Services Unit Call Center staff are training for the new Medicaid Management Information System (MMIS) so that they are prepared to help you use it at implementation.
 
Although DHS staggered the training sessions and will take other steps to minimize the impact on providers, during this time of training there may be fewer representatives to answer the telephones. We apologize if you experience a longer wait time when you call the Provider Services 800 number.
 
If you are not able to reach someone at the call center by phone, you can send an e-mail to dmap.providerservices@state.or.us. Please allow 1-2 business days for follow-up of e-mail inquiries.

Q.

I have called DHS EDI Support Services, but haven’t received any response. What do I do?

A.

DHS EDI Support Services is getting ready for the replacement MMIS, and experiencing some reduction in response times. They will continue to return calls and e-mails as quickly as possible, but ask for your patience as DHS moves forward to make the replacement MMIS a success.
 
If you are not able to reach someone in EDI Support Services by phone, you can send an e-mail to dhs.edisupport@state.or.us. Please allow 1-2 business days for follow-up of phone and e-mail inquiries.