Long Term Care Online Portal Security Permissions Guide. v

Transcription

1 Long Term Care Online Portal Security Permissions Guide v

2 Contents Purpose...3 General Security Information...3 Requesting Security Permissions for the LTC Online Portal...3 LTC Online Portal Tasks and Features...4 Security Profiles...6 DADS (Internal) Security Profiles...6 Tasks Allowed By Profile...7 DADS (External) Security Profiles...9 Tasks Allowed By Profile v

3 Purpose The security subsystem limits the access of the Long Term Care (LTC) Online Portal to those individuals who are granted access. Each security profile has individual access to certain aspects of the portal. This document should serve as a resource for all Department of Aging and Disability Services (DADS) staff when requesting security permissions for the LTC Online Portal. This document will highlight the general roles and tasks that are available on the LTC Online Portal to users with permissions and access. General Security Information The security subsystem limits the access of the LTC Online Portal to those individuals who are granted access. Each security profile has individual access to certain aspects of the portal. All users will have an assigned security profile based on their usage or role. Not all users will have a unique security profile, but may be included in a general profile that grants certain permissions. Requesting Security Permissions for the LTC Online Portal DADS users must request access to the LTC Online Portal. Follow the instructions outlined on the DADS website at v

4 LTC Online Portal Tasks and Features The following tasks and features are available on the LTC Online Portal. Add Note This feature allows users with the necessary security permissions to add notes to an Medical Necessity and Level of Care (MN/LOC) Assessment, Preadmission Screening and Resident Review (PASARR) Screening, Minimum Data Set (MDS) assessment, Forms 3071, 3074, 3618, and The Add Note feature may be used to provide additional MN information not captured upon original submission. Manage Community Services (CS) Workflow The CS Workflow screen will allow users with the necessary permissions to work through any documents in a status that requires manual intervention. MN/LOC Assessments that are unable to be processed in the Service Authorization System (SAS), and require Community staff review, will move to a status causing them to go into the CS Workflow. This may be due to a Claims Management System (CMS) Synch Error or another problem that will not allow SAS to process the request automatically. This Workflow applies only to MN/LOC Assessments. Correct this form If incorrect data is submitted on the MN/LOC Assessment, users with certain security permissions can submit a correction within 14 calendar days of the original submission by clicking the Correct this form button. The Correct this form feature is available for Forms 3071, 3074, 3618, and 3619 and for the Long Term Care Medicaid Information (LTCMI) section of the MDS. There are no timelines for Forms 3071, 3074, 3618, and LTCMI for MDS 3.0 currently does not have a time limit to submit corrections. PASARR Screenings are not correctable. Corrections are not allowed if a document is set to status Form Inactivated, Invalid/Complete, SAS Request Pending, or Corrected. Inactivate Form This feature allows users with the necessary security permissions to perform an inactivation on an MN/LOC Assessment, Form 3618 and 3619, or PASARR Screening. Inactivate Form can be used when a document needs to stop being processed in the workflow, or when fields cannot be corrected as needed (e.g., Medicaid Number, Individual Name). Once inactivated, the document will not be available for further processing, but it may be used as a template. Forms in SAS Request Pending, Corrected, or Inactivated status cannot be inactivated. Letter Search/View Letters This feature allows users with the appropriate security permissions to search for letters which are generated by the portal based on data from the associated document. Letters generated by the LTC Online Portal include: Client Denial, Doctor Denial, Client Overturn Denial, Doctor Overturn Denial, Client Overturn Approval, and Doctor Overturn Approval letters. Manage Third Party Resources (TPR) Workflow The TPR Workflow allows TPR staff to work on escalated Forms 3618 and 3619 submitted by PCS workers. This feature allows users to access and save searches within the LTC Online Portal. The My Searches page will display a list of predefined public searches as well as any previously saved user-defined searches. From this page, users have the ability to remove searches, open them in Power Search, or work the results in sequence. 4 v

5 Physician Search This feature allows users to search for physicians in the LTC Online Portal. This feature allows users to search across document types using various search criteria. This is an internal (Texas Medicaid & Healthcare Partnership [TMHP] and state) screen that can be utilized to search all forms, assessments, and screenings regardless of the status to which the documents have been set. Access Provider Claims Services (PCS) Workbench Accessing the PCS Workbench allows those with appropriate permissions to access forms that they can work on in the PCS Workflow. Manage PCS Coach Workflow The PCS Coach Workflow allows DADS Provider Claim Services Coach staff to work on escalated Nursing Facility (NF) documents submitted by PCS Workers. Manage PCS Workflow NF documents that are unable to be processed in SAS, and require DADS state staff review, will move to a status causing them to go into the PCS Workflow. This may be due to a CMS Synch Error, an Inactivation Request for a submission that was successfully processed in SAS or some other problem that will not allow SAS to process the request automatically. Reactivate Form This feature allows users with the necessary security permissions to reactivate forms when the form has moved to inactive status for Client Lookup, Medicaid Eligibility, or Applied Income eligibility. The Reactivate Form feature is available for Forms 3618, 3619, MN/LOC, and MDS. Note: Once a form has been inactivated using the Inactivate Form feature mentioned earlier, it cannot be reactivated. Forms in the inactive status Med ID Check Inactive, ME Check Inactive, and AI Check Inactive can be reactivated. Restart Form This feature allows users with the necessary security permissions to restart a document by clicking the Restart Form button. The Restart Form button is available for all submitted documents with the exception of Forms 3071 and Submit Forms All Nursing Facilities and all Agencies throughout the State of Texas submit documents electronically. All documents are received and stored in the LTC Online Portal. This feature allows users to submit documents based on their security permissions. Internal users with certain security permissions have the ability to submit forms on behalf of any valid vendor/contract number combination. Submit Utilization Review (UR) Assessments UR Review is used for quality assurance or can be requested by a Fair Hearing Officer. This feature allows DADS UR nurses to submit the Purpose Code 1 Utilization Review Assessments. Only a UR nurse will have the ability to submit UR Reviews and corrections to UR Reviews for MN/LOC Assessments (2.0 and 3.0). Vendor Search This feature allows users to search for vendors in the LTC Online Portal. View External Reports Long Term Care established a series of reports that the state uses to monitor program utilization, program policy adherence, audit past payments, and trends. This feature allows users with the appropriate security permissions to view external reports. Examples of external reports include: Total Forms Received, MDS Assessments by Service Group, Overturns and Fair Hearings, Total Forms Suspended Daily/Monthly, Final Status Report Daily/Monthly/Year-to-Date (YTD), and Problem Provider Reports. v

6 Security Profiles The security subsystem limits access to the LTC Online Portal to authorized individuals. Each security profile authorizes individual access to certain aspects of the portal. All users will have an assigned security profile based on their usage or role. Not all users will have a unique security profile, but may be included in a general profile that grants certain permissions. DADS (Internal) Security Profiles Security profiles intended for DADS LTC Online Portal Users include: Community Services (CS) Coordinator External Report Viewer PCS Admin PCS Coach PCS Worker TPR Worker UR Waiver nurse Note: Medically Dependent Children Program (MDCP) nurses that submit MN/LOC Assessments should refer to the DADS (External) Security Profile section of this document. 6 v

7 Tasks Allowed By Profile Security Profile Community Services Coordinator External Report Viewer PCS Admin PCS Coach PCS Worker Tasks Allowed Letter Search/View Letters Add notes to assessments View External Reports View forms Forms 3071, 3074, 3618, 3619, and 3652 Inactivate forms Forms 3618 and 3619 View assessments MDS 2.0, MDS 3.0, MN/LOC 2.0, and MN/LOC 3.0 View PASRR Screenings Inactivate PASRR Screenings Manage the CS Workflow Add notes to assessments View External Reports View forms Forms 3071, 3074, 3618, 3619, and 3652 and Customized Power Wheelchair (CPWC) forms Inactivate forms Forms 3618 and 3619 View assessments MDS 2.0, MDS 3.0, MN/LOC 2.0, and MN/LOC 3.0 View PASRR Screenings Inactivate PASRR Screenings Letter Search/View Letters Physician Search Vendor Search Add notes to MDS 2.0 and 3.0 Assessments Access PCS Workbench Manage PCS Workflow Manage PCS Coach Workflow Submit forms Forms 3618 and 3619 Restart Forms View External Reports Letter Search/View Letters Physician Search Vendor Search Access PCS Workbench Manage PCS Coach Workflow Letter Search/View Letters Access PCS Workbench Manage PCS Workflow v

8 Security Profile TPR Profile UR Waiver Nurse Tasks Allowed Add notes to assessments View External Reports View forms Forms 3071, 3074, 3618, 3619, and 3652 Inactivate forms Forms 3618 and 3619 View assessments MDS 2.0, MDS 3.0, MN/LOC 2.0, and MN/LOC 3.0 View PASARR Screenings Inactivate PASARR Screenings Manage TPR Workflow Physician Search Vendor Search Letter Search/View Letters Submit Utilization Review assessments Add notes to assessments Correct this form on previously submitted UR assessment, regardless of the user who submitted the UR assessment URs for service groups 3, 17, and 18 URs only allowed when assessment is set to status: Processed/Complete CS Processed/Complete 8 v

9 DADS (External) Security Profiles LTC Online Portal Security Permissions Guide Certain permissions may be requested if the DADS internal user (i.e., Medically Dependent Children Program [MDCP] nurse) needs to submit forms on behalf of a Vendor/Contract number. These profiles and their associated permissions are listed below. MDS Submitter MDS Miscellaneous MDSQTR Submitter MDSQTR Miscellaneous Waiver Submitter (MDCP nurse) Waiver Miscellaneous (MDCP nurse) Tasks Allowed By Profile Security Profile MDS Submitter MDS Miscellaneous MDSQTR Submitter MDSQTR Miscellaneous Waiver Submitter (MDCP Nurse) Waiver Miscellaneous (MDCP Nurse) Tasks allowed Submit MDS Comprehensive and MDS Quarterly Assessments on behalf of vendor/contract number Correct MDS Comprehensive and MDS Quarterly Assessments for linked vendor/contract numbers Reactivate MDS Comprehensive and MDS Quarterly Assessments for linked vendor/contract numbers Add notes to MDS Comprehensive and MDS Quarterly Assessments for linked vendor/ contract numbers Delete MDS Comprehensive and MDS Quarterly Assessments Verify PASARR Screening on MDS Comprehensive and MDS Quarterly Assessments Move assessments from Provider Action Required to SAS Submit MDS Comprehensive and MDS Quarterly Assessments on behalf of vendor/contract number Correct MDS Comprehensive and MDS Quarterly Assessments for linked vendor/contract numbers Reactivate MDS Comprehensive and MDS Quarterly Assessments for linked vendor/contract numbers Add notes to MDS Comprehensive and MDS Quarterly Assessments for linked vendor/ contract numbers Delete MDS Comprehensive and MDS Quarterly Assessments Verify PASARR Screening on MDS Comprehensive and MDS Quarterly Assessments Move assessments from Provider Action Required to SAS Submit MN/LOC 3.0 Assessments on behalf of vendor/contract number Move assessments from Provider Action Required to SAS Correct MN/LOC 3.0 Assessments for linked vendor/contract numbers Reactivate MN/LOC 3.0 Assessments Add notes to MN/LOC 2.0 and 3.0 Assessments for linked vendor/contract numbers Move assessments from Provider Action Required to SAS v

10 The LTC Online Portal Security Permissions Guide is produced by TMHP Training and Organizational Development Services. Contents are current as of the time of publishing and are subject to change.