Highmark Whole Care Providers billing Personal Care Services

Please see notice below regarding two important changes for Highmark Whole Care Providers billing Personal Care Services:

Topic #1: The claims clearinghouse that Highmark Whole Care providers are currently using to bill services (Change Health Clearinghouse) will no longer be available for billing after May 15, 2023. Providers must bill all personal care services via Netsmart Mobile Caregiver+.

Topic #2: Highmark Whole Care is working with the state of PA to ensure that all EVV visit/encounter history that is currently stored inside of Netsmart Mobile Caregiver+ is released from Netsmart to the state aggregator. To ensure that this occurs, all providers are required to perform the following functions inside of the Netsmart Mobile Caregiver+ provider portal by June 1, 2023.

1. Log into your Netsmart Mobile Caregiver+ provider portal.

2. Go to the “worklist” tab

3. Remediate all unmatched visits to ensure they match. The goal is for there to be no unmatched visits inside of your worklist.

4. If you release claims from Netsmart Mobile Caregiver+ and receive a rejection, remediate the rejection reason and resubmit your visit.

5. If you have any archived visits, move those visits to the worklist. Then, clear any error messages so only matched visits are in your worklist.

Additional Notes:

Netsmart will be automatically releasing all matched visits in your provider worklist to the state aggregator between May 10-15.

Providers must correct all unmatched visits in the Netsmart Mobile Caregiver+ worklist by May 15 in order to avoid claims being denied for duplicate.

Netsmart has User Guides available to help providers with the task of remediating unmatched visits and rejected visits. Training Resources are available at:

https://mobilecaregiverplus.com/training-resources/user-guides/

For additional assistance contact Netsmart Customer Support at 833-483-5587