1

Accessing the OHIP Data PortalOctober 15, 2012

The purpose of the OHIP Data Portal is to facilitate communication between the New York State Department of Health (DOH) and the Health Home Data Management Providers (DMP) regarding the status of Medicaid members eligible for Health Home services as outlined in the Health Home Patient Tracking System Specifications Document

2

DOH will release to each Managed Care Plan (MCP) assignment files containing Health Home eligible members with suggested assignments. MCPs will then review the proposed assignments and submit back to DOH, a file containing final Health Home assignment.

Health Homes will then access one assignment file through the portal that contains both Fee-for-Service and Managed Care Health Home eligible members.

3

Phase 1◦ All HHs/MCPs have access to the portal and are

currently exchanging files through the portal Phase 2

◦ All HHs/MCPs now have access to the portal ◦ Start submitting test files to portal◦ Start submitting Add records for assigned members

in converting case management programs in phase 2 counties

Phase 3◦ Does not have access yet◦ DOH is collecting contact information from HHs

regarding Portal users

4

Currently available to Health Homes and Managed Care Plans with Health Commerce System access.

Current Capabilitieso Tracking file submissiono Recipient look-up

Find member’s HH eligibility, Medicaid eligibility, HH enrollment, and last 5 claims

o Enrollment record download (“data dump”) Creates a file containing all records that a provider

has successfully submitted to the portal Upcoming Capabilities

o Assignment file downloado Member acuity score file downloado Member claim detail report

5

Follow this link to the OHIP Data Portal: http://192.168.15.109/entPageManager/entPageManager.html

and sign into the OHIP Data Portal using your HCS user ID and Password

6

Once you are in the OHIP Data Portal, click on the Health Home Tab

7

There are two sections under the Health Home Tab: ◦ A) HHTS Tracking Files: Providers upload tracking

files and download enrollment records or “data dump”

◦ B) HHTS Recipient Search: Providers use member CIN numbers to see member HH enrollment information

8

To upload a TEST file to the Portal, use the browse function to locate the appropriate TEST fixed length text file. Once you have located the correct file, select the “Test Only” box and hit the submit button

9

To upload an actual file to the Portal, use the browse function to locate the appropriate fixed length text file

Once you have located the correct file, hit the submit button

10

Please use the following naming convention to name the ACTUAL monthly files you are submitting to DOH (not the test files)

Health Home/Managed Care Plan Name_date the file was submitted

Example of Sunshine Health Home’s Tracking file submitted on July 24, 2012: Sunshine Health Home_ July 24, 2012

Please use the following naming convention to name the TEST monthly files you are submitting to DOH (not the actual files)

TEST_Health Home/Managed Care Plan Name_ date the file was submitted

Example of Sunshine Managed Care Plan’s test Tracking file submitted on July 24, 2012: TEST_Sunshine Managed Care Plan_ July 24, 2012

11

Once you have uploaded your file, you will see below the 1) File ID, 2) File Name, 3) upload date, 4) the status of the file, 5) the process date, 6) owner’s provider ID, 7) # of records that were submitted on the file, 8) the number of lines that were rejected, 9) original file submitted 10) error report, and 11) at anytime you can deleted a file that has not been processed by clicking here

12

To download the enrollment record or “data dump” scroll down to the bottom of the HHTS Tracking Files page and look for the heading: Download Enrollment Records and click on the Download button.

13

Enter the member’s CIN

14

The top section listed below will be visible for all Members enrolled in Medicaid

It shows Medicaid coverage end date, HH that member is enrolled in or that member is not enrolled, Managed Care information, if the member was pre-identified as HH eligible for DOH, and Member contact information

15

The HH Enrollment section shown below will only display if the Member is actively receiving either outreach or enrollment services per tracking file information submitted to the Portal

This section lists what MCP the member is enrolled in (if not FFS), the Health Home, the Case Management Agency (CMA), the type of enrollment, the TCM Indicator (Yes=CMA is a converting program, No=CMA is not converting program), TCM Slot type, and the segment’s begin and end dates (12/31/9999 signifies there is no end date).

16

17

The section below shows the provider names, addresses, and phone numbers associated with the last five claims or encounters submitted to Medicaid for the individual

This section will only be shown if the member is assigned to your organization