KePRO iExchange Training 2009 Points to remember: After 3 unsuccessful login attempts, the user id will be locked out and an administrator will have to reset the user’s password. Administrators are: Tammy Eames, Patty Wall, Caroline Pilson, and Greg Sykes. iExchange will time out after 20 minutes. Hit the internet Back arrow to attempt to recover data. You will be required to sign in again and restart the authorization. All required data must be entered for the authorization request to be approved.

Submitting an Authorization Request Web Address: Select – Provider login

Each box must be selected before data can be entered. The iExchange ID is always KePRO requires at least 8 different passwords before repetition. Passwords change every 30 days.

Payer is always: Virginia Medicaid P.A. Click on the gray drop-down arrow, type V, and enter.

Virginia Medicaid P.A. will show on screen. Click on Select.

Select Other

Click either location to open a new request.

Click on Member Search

Type in the individual’s Medicaid identification number and click on Submit Search.

AVOID DUPLICATE CASE ERRORS Click on View Existing Cases before Select. You will be able to see if a case for your service exists and submit using the correct date range. End date of one PA cannot match the begin date of the next PA.

After clicking on Select, this screen will reappear. Change the Submitting Provider to NPI Piedmont Community Services

For MHOP, MHCM, MHS, PSR, and TDT, select Outpatient Facility for the Treatment Setting.

“Is this an emergency?” = No Enter diagnosis codes without the period. Valid DSM IV diagnosis codes are required for all Behavioral Health Services. After entering the code, click on a white space to see if the diagnosis description populates.

Leave Unknown provider as Attending physician. For IIH, MHCM, MHS, PSR, and TDT Service Type, select 0650 Intensive In Home Services.

Enter the appropriate fax number. Ignore Media Type and FIPS fields. Select the correct procedure from the drop-down box on the left.

Service provider is always – NPI Piedmont CSB – Units and date range are as appropriate for the service being authorized. Ignore DME.

The preauthorization checklists (available 7/15/09) can be completed as a Word document, copied, and pasted in the Severity of Illness box. This will help prevent time outs and denials. Click Next step to preview the request. Ignore this box

Verify the case data is correct. Disregard the warning in red.

At this point, you may make changes or click on Submit to create the authorization request. If you do not click on Submit, a request will not be created.

If this were an actual request, “Other request confirmation” would show across top of purple box and a “Print friendly version” would be available. The Case ID # will be as shown below. You must print a copy for the client chart and a copy for your preauthorization coordinator. Log-off and close.

Remember If you do not click Submit, and you do not receive a Case ID number, your request for authorization has not been entered into the iExchange system for approval. Print auth request showing the Case ID #. If a problem arises and we do not have the Case ID number, we have no proof that the request was sent.

When additional information is requested by KePRO, login as usual until you reach this screen. Click on View updates from MCO.

Find the correct client and click on View details under “Comments were updated on:” …

Click on add to comments

In the Additional Comments box type: “Additional Information as Requested:” (add information KePRO has requested and your name and phone number). Click on Save and reprint the authorization request containing the new information for the client’s chart.

If the information KePRO requires is not submitted by the date they have requested, the authorization will be denied and an entire month’s services will be lost. Appeals may be initiated through DMAS but are not always approved.

Thank You