Provider Connections - Ceridian Provider Solutions

EAP
WINTER 2015
ProviderConnections
Registration for the 2015 EASNA
Institute is NOW OPEN!
Entitled, "Tools, Trends, and Traps:
Positioning EAPs for Maximum Success",
this years Institute will take place from
April 22-24, 2015 at the
HILTON CLEARWATER BEACH HOTEL in
Clearwater, FL.
For more information, please go to
page 11 of this newsletter.
We’ll see you in April!
INSIDE THIS ISSUE
1
2015 EASNA Institute – Register Now!
2
Please Return Participant Calls within 24 hours.
2
Happy 2015 to Ceridian Providers!
3
Please don’t communicate with PNS through participants.
4-5
How to Read your Direct Deposit and Check Remittances
5
Does Ceridian EAP have your updated insurance?
6
Ceridian EAP Secure Email: Your Questions Answered
7
CAQH – Get Ready for Next Gen Provider Data Collection
8
The Importance of Submitting Case Closure Forms
9
Ceridian LifeWorks EAP Provider Q & A
10
Why are my faxed invoices being rejected?
11
More information on the 2015 EASNA Institute
12
Are you billing through the provider portal yet?
13-14
CAQH ProView™ is Launching February 2015
New Action Items to Help Prepare
14
Important Ceridian Timetables
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
Participant Calls/Voicemails Must Be
Returned Within 24 Hours.
To provide World Class Customer Service, and in accordance with your Ceridian
contract, all calls or voicemails from Ceridian referrals MUST be returned within 24
hours of receipt.
Thank you!
Happy 2015 to our Providers and their Families!
When filling out your invoices, please be mindful when completing the field for “Date of
Service”. Our accounts payables systems are programmed to deny invoices submitted more
than 90 calendar days past the date of service. By inputting the year as 2014, rather than
2015, you are delaying your payment until the mistake is discovered.
Thank you for your attention to this matter.
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
How to Read Your Direct Deposit and Check Remittances
Ceridian Provider Network Services has received many questions from providers regarding how to read
direct deposit and check remittances. Below is graphic depicting a sample check remittance. To determine
which client sessions were paid for with this payment, please refer to the Document Reference Number field
in the Remittance detail. That field shows the case service/authorization number and dates of service which
have been paid in this remittance. HIPAA regulations forbid Ceridian LifeWorks from sending patient names
or patient health information (PHI) via email or including them in our check remittances. That is why we use
case service/authorization numbers to identify our patients/participants. If you don’t keep track of these
case service/authorization numbers and the associated patient/participant names, you should check your
“My Referrals” list in your portal account located at www.ceridianprovidersolutions.com. If you don’t have
an account, please click the “Register Now” link to create a username and password. To complete account
activation, please email us with your username and tax ID (so that we may verify your identity) so that we
can activate your account.
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
Below you will see a close up of the Remittance Detail.
As you can see, under the Document Reference Number column, you see the familiar Ceridian case
service/authorization number followed by the date of service (session date). So the first item in the list is
payment for:
Case Servnice/Authorization Number: 11626100
Date of Service (Session Date): 10/22/2014
Document Amount: Amount paid for this session is XX.00
If you don’t know which patient/participant corresponds to this case service/authorization number, check
your “My Referrals” list in your Ceridian Provider Portal account.
To see case service/authorization numbers that you have already closed, change the drop down menu (red
arrow) to Inactive. The referrals table will then show you all cases service/authorization numbers that you
have closed. You can reorder each column by clicking on the Header Title at the top of each column so that
the columns are numerically or alphabetically ordered.
If you have further questions, please call Provider Network Services at 800-367-3920, option 2.
Thank you!
Ceridian LifeWorks
Provider Network Services
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
Attention Providers:
If you need assistance, information, or documents from Ceridian EAP,
please DO NOT instruct participants to contact us on your behalf.
If you need to communicate with Ceridian EAP Provider Network Services, please call us at 800-367-3920,
option 2 or email us at pnsinquiries@ceridian.com .
It is inappropriate and unprofessional to instruct a participant to contact “Ceridian Provider Network
Services” on a provider’s behalf requesting that we email/fax the provider invoicing forms or inquiring
about the payment status for previously invoiced sessions.
Thank you!
Ceridian LifeWorks
Provider Network Services
Is your Professional Liability Insurance up to date?
Have you sent a copy to Ceridian Provider Network Services?
Ceridian prides itself on the quality of the providers in its EAP Network.
For that reason, we take the re-credentialing of our providers very
seriously. We make every attempt to make this process as easy on our
providers as possible. In fact, the only document that we request from
our providers on a yearly basis is a copy of their Professional Liability
Insurance policy. In order to maintain an active provider status in our
system and to ensure that you continue to receive Ceridian EAP
referrals, please send us a copy of your most recent policy,
during the month of the policy expiration date, via email to
cassie.smith@ceridian.com or via fax to 727.499.6142.
You will also receive a courtesy email reminder on the month of your policy expiration. If you upload your
current policy to CAQH each year, you can respond to the reminder email and we will be glad to retrieve it
for you.
Note: If you need insurance or would like to compare policies, TRMS is an EAPA Endorsed Insurance program. They can be
reached at (855) 655-1801 or at eapainfo@trustrms.com
Thank you!
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
Ceridian LifeWorks EAP Secure Email:
Your questions answered.
Some Ceridian providers have expressed security
concerns about receiving Ceridian EAP
authorizations via email.
Ceridian’s email gateways use Transport Layer
Security (TLS). Gmail and sbcglobal also use TLS.
So, if the email address you have on file with
Ceridian is a Gmail or a sbcglobal email address,
our Ceridian EAP authorization emails are delivered
directly to your Gmail or sbcglobal inbox and the
fact that it is encrypted is transparent.
If TLS is not an option, then the message would be sent to Ceridian’s Secure Web Delivery (SWD) website
and a notification sent to the recipient with an embedded link to retrieve their message.
Worth noting: For Ceridian, TLS is always enabled and is the default preferred method of delivery. SWD is
only used if the recipient’s email gateway does not support TLS.
Please be assured that our corporate attorneys vetted this process in detail prior to our use. Any email you
receive from Ceridian is encrypted and HIPAA compliant.
More than likely, you have received a secure email from Ceridian in the past.
The email was sent as secure because it contained confidential information such as patient health
information (PHI). That information may be social security numbers, patient names, patient phone
numbers, or sensitive medical information.
If you have not already set up a secure email password for this system, you might be a bit confused.
First off, this secure email password is completely unrelated to your username and password on Ceridian’s
provider portal located at www.ceridianprovidersolutions.com.
The two systems are completely separate. So, changing your password on the provider portal has no effect
on your secure email password.
If you receive a secure email from Ceridian and are unable to open it, please forward the email to
pnsinquiries@ceridian.com.
We will have our Service Desk send you the information necessary to reset your secure email password.
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
Get ready for the Next Generation
of Provider Data Collection?
CAQH is making significant improvements to the CAQH
Universal Provider Datasource® (UPD) and will launch the next
generation UPD as CAQH ProViewTM in February 2015.
CAQH ProView is more intuitive to use and will deliver
enhanced functionality to the solution already trusted by 1.3
million healthcare providers as the premier resource for selfreporting demographic and professional information to payers,
hospitals, large provider groups and health systems.
Participating organizations will have access to a comprehensive
repository of provider data that serves a variety of business
needs. Providers will be able to easily submit information
through a more intuitive, profile-based design.
Key Features of CAQH ProView
Scheduled for release in February 2015, CAQH ProView
enhancements will include:
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Support for additional types of provider relationships such as
non-participating and delegated providers.
Ability to upload supporting documents directly into CAQH
ProView, eliminating the need for paper and fax and improving
quality and timeliness of complete applications.
Ability to complete and attest to multiple state credentialing
applications in one intelligent workflow design.
Self-registration in CAQH ProView before a health plan initiates
the application process.
Enhanced data validation features using recognized industry
sources for select data (TIN, NPI, DEA), conforming addresses
to the USPS standard, and comparison against the Social
Security Administration's list of deceased individuals.
Application programming interface (API) capabilities.
Additional provider profile information, including the addition
of the CMS Disclosure of Ownership questions.
The Provider
Network Services
Team
We Are Here to Help You!
Ceridian LifeWorks’ Provider
Network Services (PNS) team
prides itself on our availability,
responsiveness, personalized
customer service, and clinical
support. Our PNS call center
team is available to take live
provider calls Monday through
Friday from 9AM to 5PM EST.
Or you can email us at:
PNSInquiries@ceridian.com or
through the Provider Portal at
www.ceridianprovidersolutions.
com.
Please call the PNS Help Line at
1-800-367-3920, option 2 for
assistance.
For more information, go to:
http://www.caqh.org/ProView-Provider-Overview.php
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
The Importance of Submitting Closure Forms for all Ceridian Referrals
A recent audit of cases indicates that a large
percentage of Ceridian providers are not
submitting Case Closure Forms, but rather
submitting progress notes for the final sessions.
This is not the correct procedure for several
reasons. A provider’s failure to submit a case
closure from causes several problems. Firstly, the
case does not close properly and remains in your
active authorizations list.
Second, the case closure form includes specific
information that is used to provide reports to our
customers who pay for the service. These paying
customers use these reports to gauge the
employee usage and effectiveness of the EAP
program. If these paying customers receive
incorrect reports, they may drop the service.
“It is imperative that Ceridian providers submit case
closure forms for all Ceridian case authorizations.”
Patrick Williams
Director
Ceridian Provider Network Services
If a client drops out of counseling or fails to attend any sessions, you can still close the case. For date of
service, put the date that you are submitting the form. For number of hours, put “1”. But, make sure to check
the box stating “Client dropped out of counseling” or “No Initial Client Contact”. Checking these boxes will
prevent payment while still closing the case.
If you have questions, please call us at 800-367-3920, option 2. We can email you our provider forms, but we
encourage all providers who are not yet submitting invoices through our provider portal to do so.
Submitting your invoices via the portal prevents errors and omissions.
Thank you!
Provider Network Services Staff
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
CERIDIAN LIFEWORKS EAP AFFILIATE PROVIDER
QUESTION AND ANSWER
Q: If a participant is authorized for 3
sessions, how many total hours does that
comprise?
A: Each session is authorized for 1 hour. So, if you
see a participant for 2 hours during the first session
and invoice Ceridian for 2 hours, 2 sessions will be
deducted from the total number of authorized
sessions.
Q: If I see a Ceridian referral for an hour
and a half, can invoice Ceridian for 1.5
hours?
A: No, Ceridian does not pay for half-hour
increments, so we will round the number of hours
down to 1. Sessions are supposed to last between 45
minutes and one hour.
Q: Am I allowed to work for Ceridian under
both a group practice and under my own
practice as a solo practitioner?
A: Yes, you may work as a Ceridian under a group
practice and under your own practice as a solo
practitioner, however, you must work under two
separate tax IDs and at two separate locations. You
will be contracted under each tax ID separately and
you must sign an agreement stating that you will not
move Ceridian referrals back and forth between
your group and private practice. Additionally, you
will be required to invoice Ceridian under the proper
tax ID.
If you have a question that you would like to be answered in the
next Ceridian LifeWorks EAP Provider Connections Newsletter,
please send your questions to pnsinquiries@ceridian.com.
Q: Once the EAP sessions are completed,
can I continue to see the participant under
the participant’s health insurance or via
private pay?
A: Yes, once the EAP sessions have been
completed, you may continue to see the participant.
However, we ask that you have them sign a
“Treatment Waiver Form” and then keep that form
for your records. Please don’t send the treatment
waiver form to Ceridian. We don’t need it.
Q: Why do some Ceridian referrals you send
me get 3 sessions while other referrals get 5
or more sessions?
A: EAP stands for Employee Assistance Program.
In other words, EAP benefits are provided to
employees by the employer. The number of
sessions authorized for a particular participant
depends on the number on sessions that employer
has contracted with Ceridian to provide for its
employees.
Q: The participant is dealing with a serious
issue and needs more sessions. Can I call
Ceridian to obtain more sessions for the
participant?
A: No, unfortunately if the participant is dealing
with an issue that requires long-term treatment, the
participant needs to be seen under their health
insurance or via private pay. EAP is short-term
solution-focused counseling intended to identify the
resources that will help the participant. If the
problem is long-term, it is the provider’s
responsibility to help the participant make that
transition for good continuity of care.
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
Why are my faxed
invoices being denied?
1. Your invoices have the wrong case authorization number.
2. The date we received your invoice is more than 90 calendar days past the date of service on your
invoice.
3. You input more than one date of service on a single invoice.
4. Your invoice is being submitted on out of date invoice forms or HCFA/1500 Forms.
5. Your invoices are illegible due to bad handwriting, an old fax machine, or fax transmission errors.
6. Your invoice did not come through completely.
7. Your tax id on your invoice does not match the tax id we have for you in our database.
8. The invoice for this particular date of service has already been paid.
Faxed invoices are read by a computer system. Illegible invoices cannot be processed because the system
cannot verify the information is correct with our database.
All faxed invoices must, at the very least, have the correct:
1.
2.
3.
4.
Case Authorization Number
Date of Service (receipt date must be within 90 calendar days of the date of service)
Provider’s Tax ID
Number of Hours the Client was seen (typically 1 hour)
If you are having trouble with faxed invoices, you should consider submitting your invoices through the
Ceridian Provider Portal at:
www.ceridianprovidersolutions.com
To register for an account, create a username, create a password, and then follow steps to have your portal
account activated.
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
"Tools, Trends, and Traps:
Positioning EAPs for Maximum Success"
Registration for the 2015 Institute Is Now OPEN!
April 22-24, 2015 at the HILTON CLEARWATER BEACH HOTEL
Clearwater, FL
Join us April 22-24 in Clearwater Beach, Florida, where we'll be steps from the sand. This year there
are more and different plenary sessions, including groups of rapid-fire, 15-minute, presentations
followed by an extended Q&A discussion with participants.
Members receive a $150 discount--and you'll save $50 more if you register by March 13:
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Member, Full Conference, by March 13, $495 US
Nonmember, Full Conference, by March 13, $645 US
Member, Full Conference, after March 13, $545 US
Nonmember, Full Conference, after March 13, $695 US
Student Rate, Full Conference (must show ID at registration), $225 US
Daily Rate, by March 13 (member or nonmember), $320 US
Daily Rate, after March 13 (member or nonmember), $355 US
Download the Advance Program and Register from Our Institute Website NOW.
Register NOW for the Lowest Registration Rate
Early Bird Deadline Is March 13
Click Here! Get a Hotel Room BEFORE They Are All Gone
Institute Website--For the Advance Program and Registration
Want to be a sponsor or exhibitor? Contact us now.
We have only a few sponsorships and exhibit booths left. See what's available here.
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
Are you billing through the Provider Portal yet?
The Ceridian Provider Portal, located online at http://www.ceridianprovidersolutions.com , was built to help you, as a
provider and member of one of the top EAP networks, be as successful as possible. The portal provides you with access to
a number of helpful resources such as:
1.
Forms – Under “My Portal” – “Resources”, you can download a number of forms that you may need such as the
Treatment Waiver Form, Intake Assessment Form, Session-Progress Notes Form, Case Closure Form, and
Statement of Understanding Form to name a few. (PLEASE NOTE: YOU CANNOT SUBMIT PDF FORMS
THROUGH THE “MY PORTAL” – “RESOURCES” SECTION – THESE FORMS MUST BE DOWNLOADED,
COMPLETED AND THEN SENT BACK TO CERIDIAN BY EITHER FAX OR POSTAL MAIL.)
2. Referrals – Under “My Portal” – “My Referrals”, you can see a list of your active referrals. You will find the
authorization number, the full name of the referral, and the date of the referral. (PLEASE NOTE: YOU ARE ABLE
TO FILL OUT AND SUBMIT INTAKE ASSESSMENT, PROGRESS NOTES, AND CASE CLOSURE FORMS
THROUGH THE “MY PORTAL” – “MY REFERRALS” SECTION OF THE PORTAL.)
3. Invoices – Under “My Portal” – “My Invoices”, you can see which invoices we have received from you and the date
of receipt.
4. Newsletters, - Under the “My Communications” section, you can find current and past Ceridian EAP Provider
Newsletters full of helpful information.
The portal also allows you to submit your Intake Assessment, Progress Notes, and Closure Forms online. More importantly,
the portal helps you to avoid making errors by prepopulating the important fields for you such as: case authorization
number, provider name, provider group name, group tax ID number, and client name. The portal also allows you to save a
copy of the completed form to your computer for your personal records. If you have any questions about registering for the
portal, please call the Ceridian Provider Network Services Team at 1-800-367-3920.
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
CAQH ProView™ is Launching February 2015
New Action Items to Help Prepare
As the CAQH ProView launch nears in February 2015, CAQH wants to ensure you are well informed
and prepared. A detailed summary of all the latest launch information is available here. CAQH
recommends bookmarking this link because it is an excellent resource for where to find current
information about the transition and the exciting new features CAQH ProView will deliver.
As a reminder, some of the transition preparations require technology updates, which are detailed in
Table 1. CAQH recommends engaging your IT staff to assist.
December Action Items
For December, CAQH is outlining four new action items to help prepare for the launch. A complete list of
action items is available on the CAQH website.
Action Item #1 - Request Roster Validation Tool.
CAQH has developed a roster validation tool for your organization to confirm that your new roster file
format meets the CAQH ProView required changes. Please email upd@caqh.org to request the tool.
Action Item #2 - Update URL for SFTP Folder.
If your organization uses FTP software or automated scripts to upload and download files from UPD, the
URL for the SFTP server will be changing from ftpupd.caqh.org to sftp.proview.caqh.org. Login
credentials to the SFTP server will also change to match individual user CAQH ProView usernames and
passwords. Additional information about this change is available here.
Action Item #3 - Capture New URL.
The URL for UPD will change to https://proview.caqh.org when CAQH ProView launches in February
2015. After the system launches, please plan to update to this new link as soon as reasonably possible
on any of your organization's applicable webpages or provider communications. The existing URLs for
the UPD will temporarily redirect to CAQH ProView; however, it is a best practice to update to the new
links to coincide with the launch.
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015
Action Item #4 - Help Educate Providers.
CAQH will communicate the following messages to providers. Please notify your provider network about
this important information to help ease their transition process.
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Incomplete Providers: Providers with incomplete applications will need to complete and attest
to any outstanding applications prior to the transition to CAQH ProView. Unattested data will
not convert into CAQH ProView.
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Email Required: CAQH ProView requires an email address for all providers as a primary
method of contact. Providers should enter an email address in the UPD now.
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Paper Applications Discontinued in February 2015: When CAQH ProView launches in
February 2015, providers must enter and complete their information online. Paper versions of
the credentialing application will no longer be accepted.
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Questions: If providers have questions, CAQH has established a CAQH ProView Provider
Transition Support Center. Providers can email proview@caqh.org or call 844-259-5347.
Need More Information?
Refer to the CAQH ProView - Frequently Asked Questions for answers to questions about how to prepare
for the launch of CAQH ProView and information about the solution's features. If you do not see an
answer to your question, please email upd@caqh.org.
Thank you for your continued support as CAQH brings you a next-generation solution with time-saving
features and more provider data to serve a variety of business needs.
Important Ceridian EAP Provider Timetables
Event
Timeframe for Action
Return a Ceridian Client’s
Phone Call
Within 24 hours
Invoice for a Client Session
Requested within 10 calendar days
Required within 90 calendar days or Provider must submit a claim review
form for payment.
Complete All Authorized Sessions
6 months from authorization date
(provided that first session was completed within 30 days of initial
authorization.)
Routine Referral
Appointment within 3 to 5 days
Urgent Referral
Appointment within 24 hours
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Ceridian LifeWorks EAP Provider Connections Newsletter
Winter 2015