General Billing and Form Manual. Supplier guide with billing instructions for all suppliers. The site is made available to Vermont Medicaid program providers and stakeholders for convenience. Use of Vermont`s secure websites is limited to authorized users. User activity is monitored and recorded by system personnel. Any person who uses this website expressly consents to such monitoring and recording. BE WARNED: If possible criminal activity is detected, system records and certain personal information may be made available to law enforcement agencies. Despite our best intentions to obtain complete and accurate information, discrepancies may occasionally arise and the materials on the Site may not be consistent or up-to-date with current program policies. If in doubt, please contact Supplier Services at 800-925-1706. PHI Restriction Legal Notice (Protected Health Information)Reminder: Use of this network is restricted to authorized users only. PSRs should not be shared in this module. When downloading attachments, make sure that not all files contain PHI. NOTE: Users are solely responsible for compliance with the DVHA Provider Agreement regarding the confidentiality of member information and compliance with federal and state laws governing the privacy and security of identifiable information, including phi.

The renewal also builds on Vermont`s All-Payer Accountable Care Organization (ACO) model agreement, a nationwide total cost model in which providers can take all risks under Medicaid, Medicare and commercial contracts. The ACO model was launched in 2017 with OneCare, a network of providers and hospitals. However, CMS issued a warning to the state for not meeting enrollment and spending targets in 2018 and 2019. Vermont issued a request for proposals for the COA program in April 2021. Request for Proposal contracts are for two years starting January 1, 2022 and have the option to extend them for an additional two years. The DVHA plans to sign an agreement with one or more COAs to continue to move away from health service reimbursement and transform the health system to ensure value-based care. The DVHA will continue to participate in the Crown`s standard ACO-to-payer agreement. As a riskY AGC, DVHA and its contracted suppliers will be able to align incentives through innovative value-based payment mechanisms (OBPs).

All providers may need the following minimum information to complete your application: Please note that only one point of service and one type of provider may be registered per request. All attachments must be complete, legible and up-to-date. You will be notified if your application cannot be processed because it is incomplete or the information is incorrect. The site is made available to Vermont Medicaid program providers and stakeholders for convenience. Use of Vermont`s secure websites is limited to authorized users. User activity is monitored and recorded by system personnel. Any person who uses this website expressly consents to such monitoring and recording. BE WARNED: If possible criminal activity is detected, system records and certain personal information may be made available to law enforcement agencies. Physiotherapy, occupational therapy and speech therapy. Vendor guide with billing instructions for PT, OT, and ST vendors. For the rules of the Social Services Agency, visit humanservices.vermont.gov/rules-policies Home Health Agency, Assistive Community Care and Enhanced Residential Care.

Supplier guide with billing instructions for HHA, ACC and ERC suppliers. Depending on the type of provider, additional information may also be required, for example: centres. B state-qualified health and rural health clinics. Supplier Guide with Billing Instructions for FQHC and RHC Suppliers… AHS Health Care By-law. This link will take you to the Health Care Administrative Rules (HCAR) page of the Social Services Agency to see the regulations adopted by the Social Services Agency that govern the administration of Vermont Medicaid. Applied Behavioral Analysis Supplement. Supplier`s guide with service delivery requirements and guidance. For more information, see the Psychiatric Services Supplement below. . The Social Services Agency is conducting a complete overhaul of Medicaid rules within the Social Services Agency and its departments.

The above Medicaid service rules are amended and adopted under the title Healthcare Administrative Rules (HCAR). This is a multi-year process, and during this transition period, some Medicaid rules will remain within Medicaid`s covered service rules (7100 to 7700), while other rules will be adopted in HCAR`s new collection of Medicaid rules. Dental supplementation. Supplier manual with billing instructions for the dental claim. Like most websites, HPP may also use so-called “cookie” technology. A “cookie” is a piece of data that a website may send to your browser when you link to that website. It is not a computer program and does not have the ability to read data from your computer or ask it to perform a step or function. By assigning a unique piece of data to each visitor, the site can recognize returning users, track usage patterns, and serve you better when you return to that site.

The cookie does not extract any other information about you, such as your name or address. . The Gainwell Healthcare Payer Platform (HPP) supports browsers that meet the World Wide Web Consortium (W3C) Hypertext Markup Language (HTML) specification 5. Support is based solely on HTML 5 compatibility, regardless of other factors such as browser market share. Gainwell develops HTML 5 compliant code, and compatibility is confirmed by rigorous testing. Gainwell`s HPP test team examines product development sites against Internet Explorer 11, Chrome, and Firefox. In the event that an error is identified by HPP or a customer, it is evaluated and managed through the product`s defect management process. Browser support for various commercial standard tools (COTS) such as workflow, business rules engine, or file transfer systems is based on browser functions defined by the respective software vendor. As the HTML 5 specification evolves, HPP supports minor version updates within a year of release. The current specification is HTML 5.2 and was released on 14.12.2017. HPP is committed to making its electronic and information technologies accessible to people with disabilities. We strive to meet or exceed the requirements of Section 508 of the Rehabilitation Act (29 U.S.C.

794d) as amended in 1998 and the Web Content Accessibilities Guidelines (WCAG) Version 2.1. Section 508 is a federal law that requires organizations to provide persons with disabilities with equal access to information and electronic data comparable to those without disabilities, unless doing so places an undue burden on the agency. The standards in section 508 are the technical requirements and criteria used to determine whether the Agency meets the requirements of this Act. The Web Content Accessibility Guidelines (WCAG) are part of a series of Guidelines for Web Accessibility published by the Web Accessibility Initiative (WAI) of the World Wide Web Consortium (W3C), the leading international standards organization for the Internet. This is a set of recommendations to make web content more accessible, primarily for people with disabilities, but also for all user agents, including strictly restricted devices such as mobile phones. WCAG 2.0 was released in December 2008 and became ISO ISO/IEC 40500:2012 in October 2012. WCAG 2.1 became a W3C recommendation in June 2018. PRIVACY AND SECURITY When you log in to the app for the first time, you may be asked if you are using a personal or public computer. Be careful when answering this question, as the privacy and security required to protect health data could be compromised by your choices.

The Gainwell Healthcare Payer Platform (HPP) supports browsers that meet the World Wide Web Consortium (W3C) Hypertext Markup Language (HTML) specification 5. Support is based solely on HTML 5 compatibility, regardless of other factors such as browser market share. Gainwell develops HTML 5 compliant code, and compatibility is confirmed by rigorous testing. .