(The following process is used for payer Anthem Healthkeeperz, where Barnestorm is used as your alternate EVV vendor.)
CREATE/SEND EVV FILES TO ANTHEM/NETSMART:
1. Go to Billing > HIPAA Transactions > Netsmart/Anthem
2. If this is your first time going to this screen, you may need to type in your Netsmart SFTP Credentials. Click the Edit Netsmart EFT Credentials tab to enter your credentials. You will also come to this screen to update your information. Note: Barnestorm does not keep this information. For any issues with your Netsmart User ID or password, please contact Netsmart directly.
3. On the left, use the From/Thru fields to put in the date range of the EVV visits to be sent.
4. Click Select EVV Visits
5. Review the listing for any errors. Examples of errors include invalid HCPCS/Revenue code, invalid DOB, invalid ID: the ID number must be the patient's Medicaid number. If there are any errors, go to the referral or assessment to correct the item/error indicated.
NOTE: Only visits in locked&charged status will appear in the import listing.
6. Once the listing is correct, click the Prepare the Import File button.
Note: The Prepare the Import File button will not appear, if there are any errors indicated for the date range you have selected. You will need to resolve those errors first; or adjust the date range to exclude the visits with errors, in order to proceed.
7. You will receive the following popup. Click Yes to send the import file.
8. You will see a brief popup showing the file is sending and the successful indicator.
9. From here you will need to monitor status of each visit in the Caregiver+ Claims Portal. From there, you will follow procedure to "release" each visit/claim to payer for processing. (See attached manuals for guidance: Mobile Caregiver+.)
Check For Rejected Visits:
Click the Check for Rejected Visits button to view any rejected visits. Review the visit for any missing values. A common reason for rejection is using the Anthem ID # and not the Medicaid ID number in the referral. Make any corrections, then proceed back to the import screen.
Recreating Import File For Rejected Visits:
1. Go to Billing > HIPAA Transactions > Netsmart/Anthem
2. Put in your EVV date range
3. Check the 'Only Previously Sent EVV' box
4. Since the visits were rejected, you do not need to increase the ID Suffix, the number should be 0.
5. Click Select EVV Visits, then proceed at Step 6 above
Resending Visits Where the Claim has Denied:
1. Go to Billing > HIPAA Transactions > Netsmart/Anthem
2. Put in your EVV visit date range
3. Check the 'Only Previously Sent EVV' box
4. The 'ID Suffix' box will appear. Here you will change the number to add to the end of the visit id, you should only need to change that when you have to resend the same visit multiple times. You will start with #1. The number will need to be increased each time you resend the same visit.
5. Click Select EVV Visits, then proceed at Step 6 above
BILLING THE CLAIM VIA THE CAREGIVER+ CLAIMS PORTAL:
Once the EVV has been submitted, using steps above, you will follow the Caregiver+ procedure to view EVV and release the claims for processing via the Caregiver+ Claims Portal.
Click here for the Caregiver+ Claims Console Quick Reference Guide to review EVV to release for billing.