Idaho Workflow

Overview

(As always, private pay is generally self-regulating within the confines of state law and regulatory processes. This article focuses on Medicaid requirements in the state of Idaho.) 

In the state of Idaho, Sandata is the required aggregator for EVV-eligible visits, including skilled respite. For Ankota users, that means in addition to our regular EVV services which we provide, we also deliver your visit data to Sandata upon billing to ensure your state's requirements are met. This article will help guide you through this process.

This article covers:

Set-up

Pre-Billing

Testing

Billing Management for EVV Visits

Billing

Remittance Advice Management (835s)

Imported Response Files

Corrected Visits (Sandata)

Further Details

Set-up

Ankota users in Idaho must register with Sandata to get their credentials. (Ankota will deliver eligible visit data to Sandata.) This registration will ensure Sandata will accept their data and give providers access to the Sandata log-in. 

To register with Sandata, providers must email Sandata the following information:

• Subject: Request for EVV Vendor Certification (Ankota)
• Body:
  • Provider name: YOUR COMPANY NAME
  • Provider contact name and email address: NAME, EMAIL
  • Vendor name:  Ankota LLC
  • Vendor address:  1 Franklin Street, Suite 360B, Boston, MA 02110
  • Vendor contact name & contact information:  Sharon Dodge, Director of Implementation, sharon.dodge@ankota.com, 844-4-Ankota, extension 703.

Sandata will provide credentials in return. Please send Ankota the following information:

• Any Sandata communications
• Your provider Medicaid ID and the categories or subdepartments they apply to

Internally, Ankota users are automatically set up for delivery of EVV visit data to the state as part of implementation. In addition to the usual client and caregiver information, including demographic information, authorizations, care plans, and schedules, you will want to include/update the following in your system to ensure your data exports:

• a caregiver code to enable caregiver export 
  • copy/paste text from the caregiver ID field
  • do not fill out this field for false/test caregivers, such as Ankota Support
• authorizations to enable patient export
• a full or partial SSN for the caregiver
  • you may list 0000+last 5 digits of the SSN or the full SSN, but either way data will be delivered as the required 0000+last 5 digits
• the Medicaid ID must be entered in the Medicaid ID field (even if you already entered the Medicaid ID in the client ID field)

Pre-Billing

Successful billing starts at the beginning of the client's creation. The processes below will lead to successful billing. 

• Client Management
  • Setting Authorized Service for Clients (entering authorizations)
  • Schedule Visits - Calendar-Based Scheduling (or for those who prefer the classic approach, Creating Visits from Patterns)
    • May also use My Clients/on-the-fly self-scheduling feature as needed
• Visit Management
  • Caregivers complete visits or timesheets are entered manually through the office
  • Visits are approved automatically or visits are approved by office
    • More specifically, ensure visits are closed, then review and clear the Visit Approval Dashboard
    • Apply Sandata reason codes as needed
• Prevention of Errors/Unmatched/Rejected Claims
  • Watch your warnings on the Action Center (such as missing client IDs) and address as needed
  • Watch your warnings on the Visit Approval Dashboard and address as needed
  • Apply Reason Codes as needed

Testing

No additional state testing processes are required to connect with the state aggregator, Sandata.

Billing Management for EVV Visits

Billing

In order to trigger sending data to Sandata, you will batch your data by billing normally:

• Schedule visits as usual; caregivers clock in and out as usual
• Manage visits as usual
  • Ensure visits are closed (assuming you schedule visits in advance)
  • Review/approve visits in the Visit Approval Dashboard (including selecting a Sandata reason code if applicable)
• Bill visits as usual
  • Calculate Billing
    • NOTE: if desired, select “complete” rather than “draft” on this page to skip additional billing review and send the data to Sandata
  • Review the Billing Report (Client) and complete invoices
• Once the aggregator requirement is met, you can bill as usual

The same billing process applies to non-Sandata visits.  

Remittance Advice Management (835s)

Electronic remittance advice files, also known as ERAs or 835s, can be uploaded into Ankota if you receive them.

• Process Remittance Advice (Upload 835 "receipts"  into Ankota)
• Post Manual Payments
• Review Billing Reports
  • See also: Collections Report, Exceptions Report

Imported Response Files

After you are connected with Sandata, Ankota will provide you decoded, easy-to-read response files that will tell you what errors were identified and need correction. For more information on this process, click the links below.

• Sandata Response Files (Overview)
• Accessing Sandata Response Files
• Reviewing Sandata Response Files

Corrected Visits (Sandata)

To correct visits rejected by Sandata, you will need to make corrections in Ankota and then also re-export the visit. For directions based on the type of error, see Managing Data Corrections.

Further Details

These additional resources may be of use to Idaho clients:

• The Ankota Training Overview, including videos
• Daily Adjustments
• Manual Visit Entry