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

2. Who We Are
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3. Admissions, Urgent/Emergent Transfers Johns Hopkins LIFELINE ICD-10
Today’s Topics
DHMH Reminders
Admissions, Urgent/Emergent Transfers
Johns Hopkins LIFELINE
ICD-10
CRISP
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4. 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)
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9. Secure Interactive Web Portal
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)
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10. Rejection Review-Appeals Form
For Priority Partners,
EHP and
US Family Health Plan
11/20/2018
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11. 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
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12. 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.
or , or after hours at
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13. Johns Hopkins LIFELINE
Lifeline Critical Care Transport Team
Phone: (410)
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14. Urgent / Emergent Transfers
For Emergent and Urgent Physician Consultation and Patient Transfer / Transport:
Hopkins Access Line (HAL) or ( (Baltimore area) or
For example NICU
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15. NICU / PICU complications
Maryland Regional Neonatal Transport Program ( )
In Maryland coordinates with Johns Hopkins Hospital, University of Maryland Medical Center and Howard County General (Level III B Perinatal)
Will arrange transportation
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16. Admission/Review ELECTIVE – PRE-AUTHORIZED
REPORT ADMISSION ON DAY OF ADMISSION OR
URGENT / EMERGENT
REPORT ADMISSION ON DAY OF ADMISSION OR NEXT BUSINESS DAY
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17. ICD-10
JHHC is currently on target for implementation date of October 1, 2014
Testing to begin shortly
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18. 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.
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19. 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
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20. Questions? PROVIDER RELATIONS 1-888-895-4998 FAX 410-424-4604
Lee Phipps – Sr. Contracting Manager (410)
Kathy Budacz – Servicing Manager (410)
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