Consolidated Community Reporting Initiative (CCRI ...

1 10/23/2015. Consolidated Community Reporting Initiative (CCRI). Provider Enrollment Frequently Asked Questions What is the CCRI enrollment process? To ensure continuity, the CCRI county representative will be required to assist providers in the completion of the CCRI Base Enrollment Application with applicable addenda, complete the County CCRI Attestation Form and submit the completed enrollment application(s), documentation and Attestation Form(s) in one complete package. Providers do not have access to the OMHSAS Intranet site; therefore each county mental health program is responsible for providing a CCRI enrollment application and working with their base-funded mental health providers in completing the application. Related Attachments: CCRI Provider Enrollment Tool, CCRI Provider Change/Closure Form, CCRI Provider Enrollment Application Short Form, CCRI Provider Enrollment Base Application (Long Form).

2 What requires a CCRI Provider Enrollment Base Application (Long Form) and what requires the CCRI Provider Enrollment Application Short Form? The CCRI short form is exclusive to CCRI and is used for a provider who is currently enrolled, has a valid PROMISe Provider Identification Number and is requesting to have the EPOMS. PEP added to this location for service(s) contracted and paid with county base funds. The CCRI Base Enrollment Form is used for a provider who is not otherwise enrolled in PA. Medicaid and who does not have a current PROMISe Provider Identification Number for the service(s) contracted through and paid with county base funds. Related Attachments: CCRI Provider Enrollment Tool, CCRI Provider Change/Closure Form, CCRI Provider Enrollment Application Short Form, CCRI Provider Enrollment Base Application (Long Form).

3 1. For all other questions, issues or concerns with CCRI Provider Enrollment please contact 10/23/2015. How do I find out whether provider applications were added for our county and the application as successful? Once the enrollment occurs for the CCRI provider, a letter is generated and mailed to the CCRI provider and a copy of the letter is generated to the county that submitted the CCRI. Provider Enrollment Application. The provider enrollments would then appear on the latest PRV416 file ( , the statewide file of PROMISe - enrolled CCRI providers). Related Attachments: PRV416 File What is the difference between the PRV414 and the PRV416? The PRV414 is a weekly file that contains a statewide listing of all PROMISe -enrolled providers in Pennsylvania and the adjoining states of New Jersey, Delaware, Maryland, Ohio, West Virginia, and New York.

4 This file is utilized by HealthChoices managed care organizations, as well as CCRI counties. It is sent to CCRI Counties as a resource to identify potential mental health providers with which to contract, and to research PROMISe IDs for enrolled providers. The PRV416 is a CCRI-specific monthly file that contains all active and closed provider service locations with a PROMISe EPOMS PEP. For CCRI encounter Reporting , the provider must have an open EPOMS PEP on the date of service in the PROMISe system. Related Attachments: PRV416 File, PRV 414 File Does the PRV416 file sent to us from the Department verify that a provider is enrolled correctly with an EPOMS PEP in PROMISe ? In other words, if a provider is listed on the 416. file with the correct provider type and specialty code, can we then assume that they are correctly enrolled for provider billing and county CCRI encounter data Reporting ?

5 Yes, the monthly PRV416 file is your source for CCRI provider information. The county can use the file to verify the accuracy of enrollment of the county's providers. The information contained in that file should reflect all providers enrolled into PROMISe . Related Attachments: PRV416 File Who receives notice of successful enrollment with CCRI from OMHSAS? When a provider is enrolled with the CCRI Initiative , the provider receives the original letter identifying the PROMISe provider ID and specific information relevant to the enrollment and the county receives a copy of the letter. 2. For all other questions, issues or concerns with CCRI Provider Enrollment please contact 10/23/2015. We have a few providers which we use on an occasional, as-needed basis ( , respite care).

6 Should they be enrolled for the CCRI Initiative ? We have contracts with them and pay on a per diem cost basis. Yes. In order for CCRI encounters to be accepted, the providers must be appropriately enrolled in PROMISe with an EPOMS PEP. How are Purchased Drugs handled? Does every pharmacy need to be enrolled? You do not need to enroll pharmacies. Medication payments are not to be reported in EPOMS. They will continue to be reported in the Income & Expense Report. What cost centers are used for each individual service? This question can be answered by reviewing OMHSAS Bulletin 12-02. Related Attachment: OMHSAS Bulletin 12-02. Who is responsible to submit CCRI revalidation information for continued enrollment in PROMISe ? The provider is responsible for submitting the re-validation information necessary for continued enrollment in PROMISe.

7 In addition, revalidation dates have been added to correspondence that informs providers/counties of their revalidation enrollment date. Related Attachments: OMHSAS Bulletin 14-03. If a provider is enrolled recently do they have to be CCRI revalidated again? Providers that initially enrolled with an effective date on or before March 25, 2011 will have to complete the re-enrollment process by March 24, 2016, and subsequent re-enrollments every five (5) years thereafter. Providers that initially enrolled after March 25, 2011 will not have to re-enroll until five (5) years from the date they were initially enrolled. They will also complete subsequent reenrollments every five (5) years thereafter. 3. For all other questions, issues or concerns with CCRI Provider Enrollment please contact 10/23/2015.

8 How does a provider know their CCRI revalidation date? Providers can determine their next re-enrollment deadline by logging in to the provider portal for each service location. The re-enrollment/revalidation date will be displayed in the masthead of the provider portal for each service location. The date identified is the expiration date for that specific service location based on the most recent application on file with DHS/OMHSAS. When OMHSAS mails the confirmation letter out, we also include the revalidation date specific to the service location that was enrolled. What forms does the provider need to complete for the CCRI re-validation? Providers of CCRI, enrolled through the County MH Office will need to meet the requirements set forth by the County. When the provider has met the County requirements, the County will provide the current CCRI Base Provider Enrollment Application/required documentation and will coordinate and submit the Provider Enrollment Application/documentation along with the County Attestation Form to OMHSAS at the address below, for processing.

9 OMHSAS requires original hardcopy enrollment documents/supporting documentation, which includes original provider signature/dates. DHS/OMHSAS Business Partner Support Unit 112 East Azalea Drive 2nd Floor Harrisburg PA 17110. Related Attachments: OMHSAS Bulletin 14-03, CCRI Provider Enrollment Application Short Form, CCRI Provider Enrollment Base Application (Long Form). What effective date should be used on the CCRI revalidation? The date of when the provider is completing the application for revalidation. What specific services have to be CCRI revalidated for 2015? Is there a list of the services that require revalidation? The Department must revalidate the enrollment of all providers, regardless of provider type/service at least every five (5) years. 4. For all other questions, issues or concerns with CCRI Provider Enrollment please contact 10/23/2015.

10 Is an attestation form required with the CCRI Encounter Submitters Provider Enrollment/Revalidation Application? The County is the only entity that has a Provider Enrollment Submitter ID. The County does not need an attestation to approve the County Submitter ID. Related Attachment: CCRI Encounter Submitters Provider Enrollment/Revalidation Application With the upcoming electronic enrollment process is the only county responsibility in completing the attestation form? OMHSAS will be establishing a webinar that explains how the electronic enrollment process will work and confirm the role of the County. If I have questions about Provider Enrollment for CCRI who can I contact? All questions, issues or concerns about Provider Enrollment can be sent to We will be able to provide prompt and accurate answers to questions and inquiries received.