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MHCP - MN–ITS Direct Data Entry (DDE) User Guide

Authorization Request (278) – Home Care Services

Completing MN–ITS Direct Data Entry

Use the Home Health Care Authorization Request (278) to request authorization for the following home care services:

  • • Skilled Nurse Visits (SNV)
  • • Home Health Aide (HHA) Visits
  • • Private Duty Nursing (PDN) Visits

  • Contact the case manager if the recipient is on a waiver or the Alternative Care (AC) programs.


    Complete Authorization Tab

    Complete Services Tab

    Authorization Response

    Authorization Request Outcome

    Login to MN–ITS

  • 1. Login to MN–ITS (Refer to the login process, if necessary)
  • 2. From the left menu:
  • a) Select MN–ITS
  • b) Select Authorization Request (278)

  • Complete Authorization Tab

    Follow the instructions in the table below to complete the authorization tab for home health care services.


    Field Instruction

    MN–ITS Field

    Authorization Category

     

    Select Home Health Care as the Service Type Code

    Graphic of the Service Type Code field in the MN–ITS 278 Authorizatoin screen and an arrow selecting "home health care" as the type.

    Requester

     

    Verify the Organization or Last Name is correct.

    If incorrect, type in the information.

    NOTE: Organization or Last Name auto-populates based on the NPI/UMPI you use when you login to MN–ITS.

    Graphic of the Requestor section with the request ID, organization or last name, address fields populated with an MHCP Provider's information. The first name and communication number fields are also displayed yet do not contain information.

    (Consolidated providers only)

    Select the Look Up action button to open a pop-up window that displays your service locations.

    NOTE: Non-consolidated providers will not see this option and should continue to Organization or Last Name.

    Graphic of the Request ID (NPI/UMPI) field populated with the NPI "1234567890" and an action button with the word "look up".

    (Consolidated providers only)

    Select Show Taxonomy in the pop-up window.

    Graphic showing an arrow selecting "show taxonomy", in the Taxonomy Select Location pop up, from the MN–ITS authorization screen.

    (Consolidated providers only)

    1. Select the drop down arrow

    2. Select the taxonomy for the location providing home care services on this request

    3. Select submit

    Graphic showing an arrow first selecting "nursing care active" as the taxonomy code and then selecting "submit".

    Enter the Communication Number or email information to contact the person who completed the assessment.

    The communication number must in the following formats:

    • Telephone – XXX-XXX-XXXX

    • Fax – XXX-XXX-XXXX

    • E-mail – person@email.com

    Graphic of the communication number field.

    Select the drop down arrow to display and select the communication Type:

    • Telephone

    • Fax

    • E-mail

    Graphic of the communication number, type field and an arrow selecting "telephone" as a choice from a drop down menu.

    Select “A” to add and store the communication information.

    Repeat the two steps above to add up to 3 communication types.

    Graphic of the type field with an arrow selecting the "A" action button.

    Enter the last name of the nurse who completed the assessment in the Contact Last Name field.

    Graphic of the Contact Last Name field.

    Enter the first name of the nurse who completed the assessment in the Contact First Name field.

    Graphic of the Contact First Name field.

    IHS/Tribal providers only: Enter your three-digit tribal identifier in the Supplement ID field.

    Graphic of the Supplemental ID field with the words "home care tribe ID" in parenthesis.

    Subscriber

     

    Enter the 8-digit MHCP id number from the recipient’s MHCP ID card in the Subscriber ID field.

    Graphic of the Subscriber ID field.

    Enter the Birthdate of the recipient in the MMDDCCYY format with or without dashes and slashes. (ex.01012001, 01/01/2001 or 01-01-2001)

    Graphic of the Birthdate field with the example "mm/dd/ccyy" in parenthesis.

    Enter the Last Name of the recipient.

    Graphic of the subscriber Last Name field.

    Enter the First Name of the recipient.

    Graphic of the subscriber First Name field.

    Patient Event

     

    The Certification Type Code defaults to I

    Graphic of the Certification Type field populated with the word "initial".

    Enter the Diagnosis Code(s) and select “A” to add the code into the additional field.

    Remove a diagnosis code: select and highlight the code from the additional field then select “D” to delete.

    Graphic of the Diagnosis Code field with action buttons "A" and "D" and an additional empty field.

    Enter the date of the nurse conducted the home care assessment in the Event Date field.

    Use the MMDDCCYY format.

    Graphic of the Event Date field with both the words "home care assessment date" and an example showing "mm/dd/ccyy" as the date format in parenthesis.

    Enter the treatment plan/additional information about the request.

    NOTE:

    Enter the following information for each type of request:

    45-day temporary – describe the proposed treatment plan and observations.

    All other requests – add text to clarify the request (ie. Limited exception request, reconsideration, etc.)

    Graphic of the message text field with the words "home care additional information" in parenthesis.

    Complete the Services Tab

    Follow the instructions in the table below to complete the Services tab for home health care services.


     

    Select the Services tab at the top of the screen.

    Graphic of two file folder tabs; one with the words "Authorization" in one tab and "Services" in the other and an arrow selecting the Services tab.

    Enter the end date if you know the last date of service for this request. Use mm/dd/ccyy format.

    The Medical Review Agent will determine the end date upon review.

    Graphic of the End Date field with an example showing "mm/dd/cc/yy" as the date format in parenthesis.

    Enter the appropriate Procedure Code that requires authorization.

    Graphic of the Procedure Code field.

    Enter modifier in the Modifiers field when necessary.

    Select A to add the modifier to the next field.

    To delete, select the entry then select D.

    Graphic of modifier field with an "A" and "D" action button and additional field for storing modifiers.

    Enter the number of units you are requesting.

    Graphic of the Quantity field.

    Enter the total dollar amount you are billing for the line. Multiply your usual and customary charge by the number of units in the quantity field to get the total dollar amount.

    Graphic of the Line Amount field with an example of "1234753.57" in parenthesis.

    Select the frequency of the home care visit in the Time Period Qualifier field.

    Use the following frequencies:

    PDN - Daily

    SNV and HHA - Daily, Weekly, Monthly or Yearly.

    Graphic displays the Time Period Qualifier field with the words "Home Care Frequency" in parenthesis and a drop down menu displaying the following options: hourly, daily, weekly, monthly, yearly, visit and episode.

    Enter the NPI of the Physician who ordered the service in the Provider NPI field.

    The last and first name fields will auto-populate with the physician’s information.

    Graphic showing a section with a heading "Service Provider Information" and three fields each with one of the following titles: "Provider NPI", "Organization/Last Name" and "First Name".

    Select the Save button to save the line item.

    To add additional lines, select the New button to clear the fields on the screen, and then add the additional line(s).

    To delete a line, select the line item then select the Delete button

    Graphic showing the action buttons each containing one of the words: "save" "new" and "delete".

    Saved line information is visible next to the blue dot on top of page.

    Repeat above steps until all line items are entered.

    Graphic showing a picture of how information will display after the service line information is entered and saved. The graphic shows a colored dot followed by both, the words: "Begin Date:" and "Procedure Code:"

    Select the Submit action button and receive your response.

    Graphic of an action button containing the word "submit".


    Authorization Response

    Use the information below to help understand the response after you submit your request.

    AUTHORIATION (278) RESPONSE

    Print and maintain a copy of the Authorization response.

    Graphic showing the authorization response you receive after you submit the request.

    The number assigned to the request displays at the top of the response.

    Graphic of the response with the confirmation number surrounded by a rectangle.

    The response contains information to fax the response with additional documentation when necessary. All long term requests require supporting documentation – see the Homecare Section of the MHCP Provider Manual for documentation requirements.

    For long term requests, write the11-digit number assigned on each page of your documentation and fax a copy of the response with your documentation to 651- 431-7447.

    Graphic of the response with the fax information surrounded by a rectangle.


    Authorization Request Outcome

    A medical review agent reviews the home care authorization requests for medical necessity. After your Authorization Request is approved or denied, retrieve the Authorization determination letter from the MN–ITS Mailbox Miscellaneous Received, SAL file type folder.

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    © 2017 Minnesota Department of Human Services Updated: 12/11/12 7:20 AM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 12/11/12 7:20 AM