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Important Provider Updates

“New” Login Requirement - Region D Recovery Auditor Provider Portal - Effective December 10 th, 2015

01/08/2016:   Provider Portal Enhancements
Effective 1/1/2016, the Region D Provider Portal has been enhanced to include a new page which tracks the status of the Discussion Period and Correspondence. In addition, the Medical Records Tracking page has been enhanced to include a copy of the Additional Documentation Request (ADR) Letter, Review Results Letter and the outcome of the review, for all claims with an ADR date that is issued on or after 1/1/2016.

To ensure Protected Health Information (PHI) is safeguarded, letters which are posted to the portal have been enhanced to redact/hide a portion of the patient HIC number and name. For example: Doe, Jane will now display as D*E, J**E. To aid providers in identifying the patient, all letters will include the RAC Case ID, patient control number and patient DOB.

12/10/2015:   HDI ADR Mailing for PRGX Providers
Effective 12/10/2015, HDI will begin complex review of claims for providers in the following PRGX Region D Provider States: Washington, Oregon, Idaho and Alaska. As a result, HDI will begin sending Additional Documentation Requests (ADRs) to providers in these states within the upcoming week(s). ALL medical records/supporting documentation, correspondence and discussion material should be submitted directly to HDI. Please click on the Contact Us link above for HDI’s contact information.

12/03/2015:   “New” Login Requirements
The Centers for Medicare and Medicaid Services (CMS) and HealthDataInsights, Inc. (HDI) are serious about safeguarding Protected Health Information (PHI). As you may be aware, the issue of cyber-security has become a serious one for all companies due to the growing threat from hackers and malware. In light of these developments, beginning December 10, 2015, HDI will implement a new “Two Factor Authentication” log in process for all users who log into the Region D Provider Portal. This new login process will require you to validate your identity with each login attempt through a security code which will be sent to the email address on file. Click on the Provider Portal User Guide Link to the right for instructions on the new login process.

12/03/2015:   Recovery Auditor Program Extension
Recovery Auditors have received approval from CMS to continue active recovery auditing activities, including sending additional documentation requests(ADRs). Recovery Auditors are also approved to review all CMS previously approved Automated and DRG Validation New Issues, Part A Post Payment “$3700 Therapy Threshold” Reviews, and a limited number of Complex and Semi-Automated Review New Issues. You may click on the New Issues link above to review the list of all Region D Approved New Issues.

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