Johns Hopkins HealthCare LLC AAHAM Presentation Presented by: Presented by: Lee Phipps & Kathy Budacz 11/20/2018 6/21/13

Who We Are 11/20/2018 11/20/2018

Admissions, Urgent/Emergent Transfers Johns Hopkins LIFELINE ICD-10 Today’s Topics HealthLINK@Hopkins DHMH Reminders Admissions, Urgent/Emergent Transfers Johns Hopkins LIFELINE ICD-10 CRISP 11/20/2018 11/20/2018

HealthLINK@Hopkins Website Priority Partners, PAC, EHP & US Family Health Plan Website features include: Provider Manuals Forms Policies and Procedures Provider Search Tool HealthLINK (Log-In) 11/20/2018 11/20/2018

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Secure Interactive Web Portal HealthLINK@Hopkins Secure Interactive Web Portal Verify eligibility Submit claims and check claim status Review electronic remittance advice and download onto a PC Receive reports such as member rosters Review all outpatient Referral/Authorization requests Directly enter referrals and authorizations that do not require medical review. Send secure messages to Customer Service Contact Michelle Mayer (410) 424-4928 11/20/2018 11/20/2018

Rejection Review-Appeals Form For Priority Partners, EHP and US Family Health Plan 11/20/2018 11/20/2018

DHMH Reminders Administrative Day Rates (as of July 1, 2012) 1184 Newborn Report – for Enrollment Dental – Maryland Healthy Smiles DentaQuest Dental Program 11/20/2018 11/20/2018

Admissions Urgent / Emergent Transfers JHHC Utilization Management should be contacted and involved with any inpatient admission/transfers, as soon as possible. JHHC Care/Utilization Management may be able to assist in identifying as well as coordinating with the most appropriate facility. 410-424-4480 or 800-261-2421, or after hours at 800-307-9730. 11/20/2018 11/20/2018

Johns Hopkins LIFELINE Lifeline Critical Care Transport Team Phone: (410) 614-7777 11/20/2018 11/20/2018

Urgent / Emergent Transfers For Emergent and Urgent Physician Consultation and Patient Transfer / Transport: Hopkins Access Line (HAL) 1-800-765-5447 or (410-955-9444 (Baltimore area) or 1-410-955-8032 For example NICU 11/20/2018 11/20/2018

NICU / PICU complications Maryland Regional Neonatal Transport Program (888-540-6767) In Maryland coordinates with Johns Hopkins Hospital, University of Maryland Medical Center and Howard County General (Level III B Perinatal) Will arrange transportation 11/20/2018 11/20/2018

Admission/Review ELECTIVE – PRE-AUTHORIZED REPORT ADMISSION ON DAY OF ADMISSION 800-261-2421 OR 410-424-4480 URGENT / EMERGENT REPORT ADMISSION ON DAY OF ADMISSION OR NEXT BUSINESS DAY 11/20/2018 11/20/2018

ICD-10 JHHC is currently on target for implementation date of October 1, 2014 Testing to begin shortly 11/20/2018 11/20/2018

CRISP Johns Hopkins HealthCare has signed a contract with CRISP (Chesapeake Regional Information System for Our Patients) JHHC receives daily files from CRISP for admissions, ER, discharges and transfers. Allows JHHC to send real time CRISP data (I/P discharge date and discharge summary reports, etc.) to the members Primary Care providers. EHP and Priority Partners only. 11/20/2018 11/20/2018

COMBO 3 Complete immunizations on or before child’s 2nd birthday: 4 doses – DTaP/DT 3 doses – IPV 3 doses – Hep B (Initial dose given in Hospital) 3 doses – Hib 4 doses – PCV 1 dose – MMR 1 dose – VZV 11/20/2018 11/20/2018

Questions? PROVIDER RELATIONS 1-888-895-4998 FAX 410-424-4604 Lee Phipps – Sr. Contracting Manager (410) 762-5338 Kathy Budacz – Servicing Manager (410) 762-5360 11/20/2018 11/20/2018

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