EAP WINTER 2015 ProviderConnections Registration for the 2015 EASNA Institute is NOW OPEN! Entitled, "Tools, Trends, and Traps: Positioning EAPs for Maximum Success", this years Institute will take place from April 22-24, 2015 at the HILTON CLEARWATER BEACH HOTEL in Clearwater, FL. For more information, please go to page 11 of this newsletter. We’ll see you in April! INSIDE THIS ISSUE 1 2015 EASNA Institute – Register Now! 2 Please Return Participant Calls within 24 hours. 2 Happy 2015 to Ceridian Providers! 3 Please don’t communicate with PNS through participants. 4-5 How to Read your Direct Deposit and Check Remittances 5 Does Ceridian EAP have your updated insurance? 6 Ceridian EAP Secure Email: Your Questions Answered 7 CAQH – Get Ready for Next Gen Provider Data Collection 8 The Importance of Submitting Case Closure Forms 9 Ceridian LifeWorks EAP Provider Q & A 10 Why are my faxed invoices being rejected? 11 More information on the 2015 EASNA Institute 12 Are you billing through the provider portal yet? 13-14 CAQH ProView™ is Launching February 2015 New Action Items to Help Prepare 14 Important Ceridian Timetables 1 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 Participant Calls/Voicemails Must Be Returned Within 24 Hours. To provide World Class Customer Service, and in accordance with your Ceridian contract, all calls or voicemails from Ceridian referrals MUST be returned within 24 hours of receipt. Thank you! Happy 2015 to our Providers and their Families! When filling out your invoices, please be mindful when completing the field for “Date of Service”. Our accounts payables systems are programmed to deny invoices submitted more than 90 calendar days past the date of service. By inputting the year as 2014, rather than 2015, you are delaying your payment until the mistake is discovered. Thank you for your attention to this matter. 2 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 How to Read Your Direct Deposit and Check Remittances Ceridian Provider Network Services has received many questions from providers regarding how to read direct deposit and check remittances. Below is graphic depicting a sample check remittance. To determine which client sessions were paid for with this payment, please refer to the Document Reference Number field in the Remittance detail. That field shows the case service/authorization number and dates of service which have been paid in this remittance. HIPAA regulations forbid Ceridian LifeWorks from sending patient names or patient health information (PHI) via email or including them in our check remittances. That is why we use case service/authorization numbers to identify our patients/participants. If you don’t keep track of these case service/authorization numbers and the associated patient/participant names, you should check your “My Referrals” list in your portal account located at www.ceridianprovidersolutions.com. If you don’t have an account, please click the “Register Now” link to create a username and password. To complete account activation, please email us with your username and tax ID (so that we may verify your identity) so that we can activate your account. 3 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 Below you will see a close up of the Remittance Detail. As you can see, under the Document Reference Number column, you see the familiar Ceridian case service/authorization number followed by the date of service (session date). So the first item in the list is payment for: Case Servnice/Authorization Number: 11626100 Date of Service (Session Date): 10/22/2014 Document Amount: Amount paid for this session is XX.00 If you don’t know which patient/participant corresponds to this case service/authorization number, check your “My Referrals” list in your Ceridian Provider Portal account. To see case service/authorization numbers that you have already closed, change the drop down menu (red arrow) to Inactive. The referrals table will then show you all cases service/authorization numbers that you have closed. You can reorder each column by clicking on the Header Title at the top of each column so that the columns are numerically or alphabetically ordered. If you have further questions, please call Provider Network Services at 800-367-3920, option 2. Thank you! Ceridian LifeWorks Provider Network Services 4 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 Attention Providers: If you need assistance, information, or documents from Ceridian EAP, please DO NOT instruct participants to contact us on your behalf. If you need to communicate with Ceridian EAP Provider Network Services, please call us at 800-367-3920, option 2 or email us at [email protected] . It is inappropriate and unprofessional to instruct a participant to contact “Ceridian Provider Network Services” on a provider’s behalf requesting that we email/fax the provider invoicing forms or inquiring about the payment status for previously invoiced sessions. Thank you! Ceridian LifeWorks Provider Network Services Is your Professional Liability Insurance up to date? Have you sent a copy to Ceridian Provider Network Services? Ceridian prides itself on the quality of the providers in its EAP Network. For that reason, we take the re-credentialing of our providers very seriously. We make every attempt to make this process as easy on our providers as possible. In fact, the only document that we request from our providers on a yearly basis is a copy of their Professional Liability Insurance policy. In order to maintain an active provider status in our system and to ensure that you continue to receive Ceridian EAP referrals, please send us a copy of your most recent policy, during the month of the policy expiration date, via email to [email protected] or via fax to 727.499.6142. You will also receive a courtesy email reminder on the month of your policy expiration. If you upload your current policy to CAQH each year, you can respond to the reminder email and we will be glad to retrieve it for you. Note: If you need insurance or would like to compare policies, TRMS is an EAPA Endorsed Insurance program. They can be reached at (855) 655-1801 or at [email protected] Thank you! 5 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 Ceridian LifeWorks EAP Secure Email: Your questions answered. Some Ceridian providers have expressed security concerns about receiving Ceridian EAP authorizations via email. Ceridian’s email gateways use Transport Layer Security (TLS). Gmail and sbcglobal also use TLS. So, if the email address you have on file with Ceridian is a Gmail or a sbcglobal email address, our Ceridian EAP authorization emails are delivered directly to your Gmail or sbcglobal inbox and the fact that it is encrypted is transparent. If TLS is not an option, then the message would be sent to Ceridian’s Secure Web Delivery (SWD) website and a notification sent to the recipient with an embedded link to retrieve their message. Worth noting: For Ceridian, TLS is always enabled and is the default preferred method of delivery. SWD is only used if the recipient’s email gateway does not support TLS. Please be assured that our corporate attorneys vetted this process in detail prior to our use. Any email you receive from Ceridian is encrypted and HIPAA compliant. More than likely, you have received a secure email from Ceridian in the past. The email was sent as secure because it contained confidential information such as patient health information (PHI). That information may be social security numbers, patient names, patient phone numbers, or sensitive medical information. If you have not already set up a secure email password for this system, you might be a bit confused. First off, this secure email password is completely unrelated to your username and password on Ceridian’s provider portal located at www.ceridianprovidersolutions.com. The two systems are completely separate. So, changing your password on the provider portal has no effect on your secure email password. If you receive a secure email from Ceridian and are unable to open it, please forward the email to [email protected]. We will have our Service Desk send you the information necessary to reset your secure email password. 6 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 Get ready for the Next Generation of Provider Data Collection? CAQH is making significant improvements to the CAQH Universal Provider Datasource® (UPD) and will launch the next generation UPD as CAQH ProViewTM in February 2015. CAQH ProView is more intuitive to use and will deliver enhanced functionality to the solution already trusted by 1.3 million healthcare providers as the premier resource for selfreporting demographic and professional information to payers, hospitals, large provider groups and health systems. Participating organizations will have access to a comprehensive repository of provider data that serves a variety of business needs. Providers will be able to easily submit information through a more intuitive, profile-based design. Key Features of CAQH ProView Scheduled for release in February 2015, CAQH ProView enhancements will include: • • • • • • • Support for additional types of provider relationships such as non-participating and delegated providers. Ability to upload supporting documents directly into CAQH ProView, eliminating the need for paper and fax and improving quality and timeliness of complete applications. Ability to complete and attest to multiple state credentialing applications in one intelligent workflow design. Self-registration in CAQH ProView before a health plan initiates the application process. Enhanced data validation features using recognized industry sources for select data (TIN, NPI, DEA), conforming addresses to the USPS standard, and comparison against the Social Security Administration's list of deceased individuals. Application programming interface (API) capabilities. Additional provider profile information, including the addition of the CMS Disclosure of Ownership questions. The Provider Network Services Team We Are Here to Help You! Ceridian LifeWorks’ Provider Network Services (PNS) team prides itself on our availability, responsiveness, personalized customer service, and clinical support. Our PNS call center team is available to take live provider calls Monday through Friday from 9AM to 5PM EST. Or you can email us at: [email protected] or through the Provider Portal at www.ceridianprovidersolutions. com. Please call the PNS Help Line at 1-800-367-3920, option 2 for assistance. For more information, go to: http://www.caqh.org/ProView-Provider-Overview.php 7 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 The Importance of Submitting Closure Forms for all Ceridian Referrals A recent audit of cases indicates that a large percentage of Ceridian providers are not submitting Case Closure Forms, but rather submitting progress notes for the final sessions. This is not the correct procedure for several reasons. A provider’s failure to submit a case closure from causes several problems. Firstly, the case does not close properly and remains in your active authorizations list. Second, the case closure form includes specific information that is used to provide reports to our customers who pay for the service. These paying customers use these reports to gauge the employee usage and effectiveness of the EAP program. If these paying customers receive incorrect reports, they may drop the service. “It is imperative that Ceridian providers submit case closure forms for all Ceridian case authorizations.” Patrick Williams Director Ceridian Provider Network Services If a client drops out of counseling or fails to attend any sessions, you can still close the case. For date of service, put the date that you are submitting the form. For number of hours, put “1”. But, make sure to check the box stating “Client dropped out of counseling” or “No Initial Client Contact”. Checking these boxes will prevent payment while still closing the case. If you have questions, please call us at 800-367-3920, option 2. We can email you our provider forms, but we encourage all providers who are not yet submitting invoices through our provider portal to do so. Submitting your invoices via the portal prevents errors and omissions. Thank you! Provider Network Services Staff 8 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 CERIDIAN LIFEWORKS EAP AFFILIATE PROVIDER QUESTION AND ANSWER Q: If a participant is authorized for 3 sessions, how many total hours does that comprise? A: Each session is authorized for 1 hour. So, if you see a participant for 2 hours during the first session and invoice Ceridian for 2 hours, 2 sessions will be deducted from the total number of authorized sessions. Q: If I see a Ceridian referral for an hour and a half, can invoice Ceridian for 1.5 hours? A: No, Ceridian does not pay for half-hour increments, so we will round the number of hours down to 1. Sessions are supposed to last between 45 minutes and one hour. Q: Am I allowed to work for Ceridian under both a group practice and under my own practice as a solo practitioner? A: Yes, you may work as a Ceridian under a group practice and under your own practice as a solo practitioner, however, you must work under two separate tax IDs and at two separate locations. You will be contracted under each tax ID separately and you must sign an agreement stating that you will not move Ceridian referrals back and forth between your group and private practice. Additionally, you will be required to invoice Ceridian under the proper tax ID. If you have a question that you would like to be answered in the next Ceridian LifeWorks EAP Provider Connections Newsletter, please send your questions to [email protected]. Q: Once the EAP sessions are completed, can I continue to see the participant under the participant’s health insurance or via private pay? A: Yes, once the EAP sessions have been completed, you may continue to see the participant. However, we ask that you have them sign a “Treatment Waiver Form” and then keep that form for your records. Please don’t send the treatment waiver form to Ceridian. We don’t need it. Q: Why do some Ceridian referrals you send me get 3 sessions while other referrals get 5 or more sessions? A: EAP stands for Employee Assistance Program. In other words, EAP benefits are provided to employees by the employer. The number of sessions authorized for a particular participant depends on the number on sessions that employer has contracted with Ceridian to provide for its employees. Q: The participant is dealing with a serious issue and needs more sessions. Can I call Ceridian to obtain more sessions for the participant? A: No, unfortunately if the participant is dealing with an issue that requires long-term treatment, the participant needs to be seen under their health insurance or via private pay. EAP is short-term solution-focused counseling intended to identify the resources that will help the participant. If the problem is long-term, it is the provider’s responsibility to help the participant make that transition for good continuity of care. 9 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 Why are my faxed invoices being denied? 1. Your invoices have the wrong case authorization number. 2. The date we received your invoice is more than 90 calendar days past the date of service on your invoice. 3. You input more than one date of service on a single invoice. 4. Your invoice is being submitted on out of date invoice forms or HCFA/1500 Forms. 5. Your invoices are illegible due to bad handwriting, an old fax machine, or fax transmission errors. 6. Your invoice did not come through completely. 7. Your tax id on your invoice does not match the tax id we have for you in our database. 8. The invoice for this particular date of service has already been paid. Faxed invoices are read by a computer system. Illegible invoices cannot be processed because the system cannot verify the information is correct with our database. All faxed invoices must, at the very least, have the correct: 1. 2. 3. 4. Case Authorization Number Date of Service (receipt date must be within 90 calendar days of the date of service) Provider’s Tax ID Number of Hours the Client was seen (typically 1 hour) If you are having trouble with faxed invoices, you should consider submitting your invoices through the Ceridian Provider Portal at: www.ceridianprovidersolutions.com To register for an account, create a username, create a password, and then follow steps to have your portal account activated. 10 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 "Tools, Trends, and Traps: Positioning EAPs for Maximum Success" Registration for the 2015 Institute Is Now OPEN! April 22-24, 2015 at the HILTON CLEARWATER BEACH HOTEL Clearwater, FL Join us April 22-24 in Clearwater Beach, Florida, where we'll be steps from the sand. This year there are more and different plenary sessions, including groups of rapid-fire, 15-minute, presentations followed by an extended Q&A discussion with participants. Members receive a $150 discount--and you'll save $50 more if you register by March 13: • • • • • • • Member, Full Conference, by March 13, $495 US Nonmember, Full Conference, by March 13, $645 US Member, Full Conference, after March 13, $545 US Nonmember, Full Conference, after March 13, $695 US Student Rate, Full Conference (must show ID at registration), $225 US Daily Rate, by March 13 (member or nonmember), $320 US Daily Rate, after March 13 (member or nonmember), $355 US Download the Advance Program and Register from Our Institute Website NOW. Register NOW for the Lowest Registration Rate Early Bird Deadline Is March 13 Click Here! Get a Hotel Room BEFORE They Are All Gone Institute Website--For the Advance Program and Registration Want to be a sponsor or exhibitor? Contact us now. We have only a few sponsorships and exhibit booths left. See what's available here. 11 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 Are you billing through the Provider Portal yet? The Ceridian Provider Portal, located online at http://www.ceridianprovidersolutions.com , was built to help you, as a provider and member of one of the top EAP networks, be as successful as possible. The portal provides you with access to a number of helpful resources such as: 1. Forms – Under “My Portal” – “Resources”, you can download a number of forms that you may need such as the Treatment Waiver Form, Intake Assessment Form, Session-Progress Notes Form, Case Closure Form, and Statement of Understanding Form to name a few. (PLEASE NOTE: YOU CANNOT SUBMIT PDF FORMS THROUGH THE “MY PORTAL” – “RESOURCES” SECTION – THESE FORMS MUST BE DOWNLOADED, COMPLETED AND THEN SENT BACK TO CERIDIAN BY EITHER FAX OR POSTAL MAIL.) 2. Referrals – Under “My Portal” – “My Referrals”, you can see a list of your active referrals. You will find the authorization number, the full name of the referral, and the date of the referral. (PLEASE NOTE: YOU ARE ABLE TO FILL OUT AND SUBMIT INTAKE ASSESSMENT, PROGRESS NOTES, AND CASE CLOSURE FORMS THROUGH THE “MY PORTAL” – “MY REFERRALS” SECTION OF THE PORTAL.) 3. Invoices – Under “My Portal” – “My Invoices”, you can see which invoices we have received from you and the date of receipt. 4. Newsletters, - Under the “My Communications” section, you can find current and past Ceridian EAP Provider Newsletters full of helpful information. The portal also allows you to submit your Intake Assessment, Progress Notes, and Closure Forms online. More importantly, the portal helps you to avoid making errors by prepopulating the important fields for you such as: case authorization number, provider name, provider group name, group tax ID number, and client name. The portal also allows you to save a copy of the completed form to your computer for your personal records. If you have any questions about registering for the portal, please call the Ceridian Provider Network Services Team at 1-800-367-3920. 12 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 CAQH ProView™ is Launching February 2015 New Action Items to Help Prepare As the CAQH ProView launch nears in February 2015, CAQH wants to ensure you are well informed and prepared. A detailed summary of all the latest launch information is available here. CAQH recommends bookmarking this link because it is an excellent resource for where to find current information about the transition and the exciting new features CAQH ProView will deliver. As a reminder, some of the transition preparations require technology updates, which are detailed in Table 1. CAQH recommends engaging your IT staff to assist. December Action Items For December, CAQH is outlining four new action items to help prepare for the launch. A complete list of action items is available on the CAQH website. Action Item #1 - Request Roster Validation Tool. CAQH has developed a roster validation tool for your organization to confirm that your new roster file format meets the CAQH ProView required changes. Please email [email protected] to request the tool. Action Item #2 - Update URL for SFTP Folder. If your organization uses FTP software or automated scripts to upload and download files from UPD, the URL for the SFTP server will be changing from ftpupd.caqh.org to sftp.proview.caqh.org. Login credentials to the SFTP server will also change to match individual user CAQH ProView usernames and passwords. Additional information about this change is available here. Action Item #3 - Capture New URL. The URL for UPD will change to https://proview.caqh.org when CAQH ProView launches in February 2015. After the system launches, please plan to update to this new link as soon as reasonably possible on any of your organization's applicable webpages or provider communications. The existing URLs for the UPD will temporarily redirect to CAQH ProView; however, it is a best practice to update to the new links to coincide with the launch. 13 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015 Action Item #4 - Help Educate Providers. CAQH will communicate the following messages to providers. Please notify your provider network about this important information to help ease their transition process. o Incomplete Providers: Providers with incomplete applications will need to complete and attest to any outstanding applications prior to the transition to CAQH ProView. Unattested data will not convert into CAQH ProView. o Email Required: CAQH ProView requires an email address for all providers as a primary method of contact. Providers should enter an email address in the UPD now. o Paper Applications Discontinued in February 2015: When CAQH ProView launches in February 2015, providers must enter and complete their information online. Paper versions of the credentialing application will no longer be accepted. o Questions: If providers have questions, CAQH has established a CAQH ProView Provider Transition Support Center. Providers can email [email protected] or call 844-259-5347. Need More Information? Refer to the CAQH ProView - Frequently Asked Questions for answers to questions about how to prepare for the launch of CAQH ProView and information about the solution's features. If you do not see an answer to your question, please email [email protected]. Thank you for your continued support as CAQH brings you a next-generation solution with time-saving features and more provider data to serve a variety of business needs. Important Ceridian EAP Provider Timetables Event Timeframe for Action Return a Ceridian Client’s Phone Call Within 24 hours Invoice for a Client Session Requested within 10 calendar days Required within 90 calendar days or Provider must submit a claim review form for payment. Complete All Authorized Sessions 6 months from authorization date (provided that first session was completed within 30 days of initial authorization.) Routine Referral Appointment within 3 to 5 days Urgent Referral Appointment within 24 hours 14 Ceridian LifeWorks EAP Provider Connections Newsletter Winter 2015
© Copyright 2024