Presentation on theme: "FY11 Provider Implementation - What to Expect"— Presentation transcript:
0EIM/ESM FY11 Provider Orientation [Supplement to the Welcome Package] Enterprise Invoice Management/Enterprise Service ManagementEIM/ESM FY11 Provider Orientation[Supplement to the Welcome Package]
1FY11 Provider Implementation - What to Expect Table of ContentsEIM/ESM OverviewProject ContextWhat is EIM/ESMBenefits of EIM/ESMFY11 Provider Implementation - What to ExpectKey Implementation RolesKey Implementation StepsHow EIM/ESM is SecuredSecurity OverviewOrganization Management FormUser Request Form (URF)Manage LocationsCentralized -vs- Decentralized BillingCustomer Service Information
2Project ContextA major EOHHS policy priority centers on strengthening the Purchase of Service system. Our policy priorities are focused on achieving three major goals:Quality. Align purchasing strategies with a vision for a quality and outcome-driven service delivery systemEfficiency. Reduce unnecessary administrative duplication for providers and purchasing agenciesBest Value. Establish efficient, rational pricing, reporting & payment practices that control program spending and maximize non-state revenueEOHHS is delivering new technology and new organizational capabilities to achieve these goals.
3Virtual Gateway Service Enterprise Service Management (ESM) What Is EIM/ESMWhat Is EIM/ESMVirtual Gateway ServiceEnterprise Invoice Management (EIM)Single point of management for invoicing and contracting activity between EOHHS agencies and POS providersProvides a fast and efficient way for providers to submit services for paymentIntegrates invoicing and payment across EOHHS agenciesProvides a central repository of information on all POS expenditures and service deliveryEnterprise Service Management (ESM)Simplifies client enrollment and referralUniform collection of demographic information and Client AssessmentProvides on-line, client-based enrollmentEnhances referral throughout continuum of care
4Benefits of EIM/ESM Key Benefits to EIM/ESM Users Several DPH, DMR and DMH providers began using EIM/ESM during FY07 with five additional agencies coming on board through FY10. When fully deployed, EIM/ESM will support approximately 10,000 users and process invoices totaling over $2 billion each year. The benefits of EIM are being realized by Agency and Provider users every day.Key Benefits to EIM/ESM UsersExpedites paymentProvides real-time payment processingOffers access to up-to-date financial dataImproves financial managementEnables detailed reportingServes as a single point of entry for providers regardless of agencyAgency Feedback Received:Removes administrative burdenMakes provider data more visibleResults in greater accuracyReduces errors, thereby reducing agency workloadProvider Feedback Received:System is straightforward and simple to useBilling process is fasterImplementation support was excellentTraining was very helpfulThe EIM/ESM team is actively working to improve technical and business issues identified in the feedback process
5FY11 Provider Implementation – What to Expect On-boarding begins 2-3 months prior to “Go-Live” and includes a series of readiness activities. A proven methodology guides the entire process. Shown is a typical timeline for deployments that target a provider beginning to use EIM/ESM at the start of the new fiscal year. Timelines may be compressed depending upon unique implementation considerations.Deployment Team Review FormsWelcomePackageDeploymentCompletesSendTrainingInvitationsAssesses provider readiness and Go Live ConfirmationSupport callsGo-Live.Provider Bills for July in EIM/ESMProviderCompletesProviderCompletes FormsProviderCompletes TrainingFormsdue from ProviderKey Communications from the Deployment Team to Providers:Welcome Package: Contains information on forms to be completedTraining Invitation: Instructions for users to complete required eLearning courses and register for instructor led training sessions (where required) or workshopsGo-Live Confirmation: Contains detailed Go Live information, including important dates and a “Day One Guide”*Reflects current estimated timeframe; subject to change
6Key Implementation Roles The provider implementation methodology requires each provider to commit resources critical to the program’s success. The key provider resource is the Point of Contact (POC) whom you’ve appointed as your organization’s representative for this project. In turn, EOHHS will assign you a dedicated VG contact, a member of the Deployment Team, to assist you throughout your implementation.EIM/ESM POC at the ProviderDeployment TeamServes as the single point of contact for EIM/ESM at the provider with whom the Deployment Team Member communicatesAchieves a basic understanding of the EIM/ESM application and its impact on the organizationDistributes all EIM/ESM related communications within their organization (EIM/ESM Users, management, or other relevant organization contacts)Commits to project deadlines and timely form submissionServes as or designates a Subject Matter Expert for EIM/ESM at the providerEnsures staff completes all required trainingServes as the primary EIM/ESM contact for the providerBecomes familiar with the provider’s business: organizational structure, users, contractsAssists in the form completion processProvides assistance via workshops, conference calls, WebEx sessions and/or appointmentsReviews formsUnderstands the nature and timing of the provider’s contracts that are going liveProvides ongoing support before, during, and after go-live (for Deployment related activities)Evaluates whether a provider is prepared for go-live
7Key Implementation Steps for the POC DescriptionWhen*What POC Needs To DoDue*1) Welcome Package (WP)ed to the POC. The WP includes instructions for downloading forms from the internet.May2010Complete all forms within the indicated timeframe. Existing EIM/ESM providers will need to validate or update their Org Form/URF.Mid-2) Traininginvitation to take computer-based EIM/ESM training on PACE, the online Learning Management System, and, if required, to register for instructor-led classes.June –JulyAll users need to fulfill training requirements. The POC will track progress.2 weeks before Go-Live4) Go-Live ConfirmationCommunicates a specific go-live date for organizations that have met form and training requirements. The Package also includes a Day One Guide and information on the release of user IDs.1 week before Go-LiveRead materials and forward the information as appropriateLate5) Go-LiveUser IDs are issued for each EIM/ESM user that has completed training requirementsAugustSome providers will begin client data entry during July.Begin to use EIM/ESM for billing and reporting.6) Post Go-LiveProvide on-boarding support for new users in the organization; notify VG of any user changes—terminations, role changes, etc.On-goingSubmit updated URF to indicate additions, deletions, or modifications to users/roles*Reflects current estimated timeframe; subject to change
8EIM/ESM is a web-based service that can be accessed from anywhere How EIM/ESM is SecuredEIM/ESM is a web-based service that can be accessed from anywhereEIM/ESM contains sensitive client dataSpecial steps have to be taken to ensure that the data stored within it is electronically secure and accessible only to those who are authorized to have such accessThis is done via a combination of Organization Management, Security Roles, and Data Access rulesGuiding Principle:EIM/ESM is secured to ensure that users can perform their job function without limitation while appropriately protecting sensitive client information
9Organization Management Form Security OverviewOrganizations in EIM/ESM can be divided into sub-organizationsFor example, a provider organization can have multiple facilities or sites where services are delivered.Security Roles control what the user can and cannot do in EIM/ESMThe system has a predefined set of roles that provides access to specific business functions of the system. A user is associated only with the roles relevant to his or her job function.For example, the “CR Reviewer” security role allows an individual to review invoices in the system but not to create or edit them. The user must be assigned a (CR, UR, AR Billing) role to be able to create and edit invoices.Data Access rules control what the user can and cannot see in EIM/ESMThe data access rules that are predefined in the EIM/ESM system consider the user’s organizational relationship to control what data records a user has access to see.For example, data access rules will ensure that a “CR Reviewer” can review invoices for his/her organization or sub-organization, but cannot view invoices for other provider organizations.Organization Management FormUser Request FormBased on these components, the Organization Management Form and User Request Form will determine the specific security design for your organization.
10Organization Management Form Organization Management in EIM/ESM refers to how an entity is structuredFor providers, it usually represents the hierarchical relationship between the parent entity (e.g. headquarters) and the various departments and sitesOrganizations not affiliated with EIM/ESM users (IT, Human Resources etc.) will not have to be captured in the Organization Management FormAn organization should be documented if it meets at least one of the following criteria:EIM/ESM will be accessed thereClients are enrolled thereClients receive services there (excluding personal homes of clients)The Organization Management Form will be completed in preparation for the first time a provider goes live with the EIM/ESM service. However, the form should be completed comprehensively, i.e., it should reflect the entire provider organization as it pertains to all Purchase of Service EOHHS contracts
11Organization Management Form (continued) To complete the Organization Management form:*Document the structure of the organization. Identify a “parent” organization and all of its sub-organizations using as many tiers as needed.A sub-organization has a direct relationship (i.e. it is owned and operated) to a parent organizationAn organization should be documented if it meets at least one of the following criteria:EIM/ESM will be accessed thereClients are enrolled thereClients receive services there (excluding personal homes of clients)Document your AffiliatesAffiliates will include organizations which may deliver services, enroll clients, or perform billing on your behalf, but are not owned and operated by the parent organizationIn this Org-structure example, ABC Provider Inc., in addition to its service delivery sites, has decided to create orgs for their programs in order to separate data access. As a result, HIV/AIDS program staff will not be able to see Mental Health program information and vice versa.*Please refer to the Welcome Package for further instructions.
13User Request Form To complete the URF(s): “Security” in EIM/ESM refers to how access to various aspects of system functionality is controlled for the users affiliated with a particular organizationTo complete the URF(s):Complete the Organization Management Form*Refer to the “Contract Go Live Schedule” to review the list of contracts scheduled to Go Live for your organization in FY11Determine which organizations on your Organization Management Form will have at least one individual accessing EIM/ESM to support the contracts going liveDocument that name of the organization as it appears on the Organization Management Form on the URF.Identify staff associated with each site as usersOnly include staff who will be directly accessing and using EIM/ESMIf a staff person works at multiple sites, they have to be included on the URF for each of those sites, or be included on the URF of a parent site.Assign roles to users on the URF that are specific to their business function.
14User Request Form (continued) In this example the provider will submit 1 URF listing all users for each ORG identified. Individuals listed for “ABC HIV/AIDS Program” will only see their relevant information. Individuals with parent-level access can see all information.URF roles, determine what a user can do in the system, i.e. what “hat” they wear. For example, only CR Authorizer will have an “Invoice Authorize” button on the screen.If no one will be accessing EIM/ESM you do not need to list that ORG on the URF.
15User Request Form-Assign Billing Staff to Locations
16EIM/ESM Manage Locations Role We have developed an optional enhancement to EIM that will aid providers with more efficient data entry when adding attendance to SDRs. It also allows users the ability to sort and/or filter SDRs by location and allow for more efficient data entry.The provider can specify whether billing will be completed centrally, i.e., at the parent level (note: this functionality is “optional” if your organization is using a centralized billing model), or in a decentralized manner at the site level (note: this functionality is “required” if your organization is using a decentralized billing model (please see chart on next slide) .Participating Organizations include orgs where the system will be accessed and information for that particular contract will be seen.Participating orgs can be listed under multiple contracts.Participating orgs can have “Billing” and/or “Enrolling” access per contract.Since the beginning of the Fiscal Year is an extremely busy time for providers, this functionality can be used anytime during the Fiscal Year, if you choose to utilize.
18What You Need To Do Next Identify EIM contracts Identify locations that need to be added/modified to your ORG structureComplete the Organization Management Form & send to Virtual Gateway DeploymentDetermine who will be responsible for this work at your Organization:Participating ORGs/Assign Locations for EnrollmentsBilling: URF > Adding/Modifying Staff AccessComplete URF forms > Send to Virtual Gateway DeploymentAnyone requesting the Manage Locations role will need to complete the all required EIM/ESM training before role will be released.
19Customer Service Information General questions regarding EIM/ESM trainingQuestions regarding completing forms, agreements, or deployment dates:General questions regarding EIM/ESM, login issues, or accessing the Virtual Gateway:Virtual Gateway Customer Service (Help Desk)TTYFax