IBHIS Readiness & Go-Live Phases

Although DMH has provided a Readiness Checklist on their site HERE. I have a little different view of the phases from a contract provider's perspective. For example, GO-LIVE is not an event, it is a phase that requires holding all claims, taking some readiness steps, then releasing some "test" claims, before you open your flood gates.

I am preparing a detailed readiness checklist for my clients, to use with their vendors and internal staff, so email me if you need help in that area. I am also doing some workshops on the same topic.

Here are some summary recommendations for your project planning by phase:

Provisioning & Testing Readiness

• Develop a Client Web Services (CWS) interface, with review capabilities
• Make required data collection changes in EHRS, forms / fields
• Modify EHRS set-up for procedures codes, Auths, EBP’s, drop downs, etc.
• Modify Medi-Cal &  DMH HIPAA EDI transaction sets for claims, 837, 835 etc.
• Develop COS HIPAA EDI claim transaction sets , 837, 835 etc. (this is new)
• Obtain Dun & Bradstreet Number (DUNS)
• Obtain Legal Entity Payee NPI
• Upload electronically to DMH, a signed Trading Partner Agreement
• Receive, Install & Test  Testing Digital Keys for : Claims (including COS), & CWS
• Complete Practitioner Data Verification & Updates, in EHRS &  PRM
• Select Clients for testing, based on DMH guidelines; develop test cases (extensive)
• Modify internal reports for new IBHIS SIFT extracts
• Update client records for surviving ID's (as needed)

Go-Live Readiness

Successful Application & Workflow Testing, DMH certification obtained (see testing requirements on DMH site HERE:

• PRM - Practitioner data entry into IBHIS, using PRM;
• Client Web Services  - new client data capture in EHRS; client data "gets" &  "puts" from/to IBHIS; and data posting of "gets" in EHRS; validate any data review processes EHRS allows for;
• Provider Connect - client look-up; M-Auth. request and receipt; enter M-Auth in EHRS; Day Treatment forms completion and submission;
• EDI Claims -  processing & submission (including COS); submission report validation;  EDI response retrieval &  posting to EHRS (including COS); response report validation; including transfers, voids, etc.; test new workflow including PRM, CWS, and Medi-Cal Financial data that is pulled into claims;
• Reporting and SIFT Extracts – download data, validate format and data; test modified internal reports;
• Receive, Install & Test Production Digital Keys: Claims, COS, & Web Services;
• Obtain DMH Certification for Claims & CWS;
• Users trained on all above;

Go-Live Phase

• Hold all FY14-15 Claims;
• Complete Client Data Verification & Web Services Updates, in EHRS & IBHIS;
• Complete Practitioner Data Verification & Updates, in EHRS & PRM;
• Request & Enter Day Treatment Authorizations into EHRS, using Provider Connect;
• Obtain  & Enter P-Auth Codes into EHRS;
• Submit Final Test Claims; Complete Integrated Testing of all workflows;
• Test / Validate Reports;
• Fix any Open Issues;
• GO-LIVE!

Hope this helps, email me if I left anything out.