Commonwealth of MassachusettsExecutive Office of Health and Human Services

Enterprise Invoice Management/Enterprise Service Management

EIM/ESM FY11 Provider Orientation[Supplement to the Welcome Package]

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Table of Contents

• EIM/ESM Overview– Project Context

– What is EIM/ESM

– Benefits of EIM/ESM

• FY11 Provider Implementation - What to Expect– Key Implementation Roles

– Key Implementation Steps

• How EIM/ESM is Secured– Security Overview

– Organization Management Form

– User Request Form (URF)

– Manage Locations

– Centralized -vs- Decentralized Billing

• Customer Service Information

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Project Context

Efficiency. Reduce unnecessary administrative duplication for providers and purchasing agencies

Best Value. Establish efficient, rational pricing, reporting & payment practices that control program spending and maximize non-state revenue

Quality. Align purchasing strategies with a vision for a quality and outcome-driven service delivery system

A major EOHHS policy priority centers on strengthening the Purchase of Service system. Our policy priorities are focused on achieving three major goals:

EOHHS is delivering new technology and new organizational capabilities to achieve these goals.

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What Is EIM/ESM

Enterprise Invoice Management (EIM)

Single point of management for invoicing and contracting activity between EOHHS agencies and POS providers

Provides a fast and efficient way for providers to submit services for payment

Integrates invoicing and payment across EOHHS agencies

Provides a central repository of information on all POS expenditures and service delivery

Virtual Gateway Service

Enterprise Service Management (ESM)

Simplifies client enrollment and referral

Uniform collection of demographic information and Client Assessment

Provides on-line, client-based enrollment

Enhances referral throughout continuum of care

What Is EIM/ESM

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Benefits of EIM/ESM

Key Benefits to EIM/ESM Users

Expedites payment

Provides real-time payment processing

Offers access to up-to-date financial data

Improves financial management

Enables detailed reporting

Serves as a single point of entry for providers regardless of agency

Key Benefits to EIM/ESM Users

Expedites payment

Provides real-time payment processing

Offers access to up-to-date financial data

Improves financial management

Enables detailed reporting

Serves as a single point of entry for providers regardless of agency

Agency Feedback Received:

• Removes administrative burden

• Makes provider data more visible

• Results in greater accuracy

• Reduces errors, thereby reducing agency workload

Provider Feedback Received:

• System is straightforward and simple to use

• Billing process is faster

• Implementation support was excellent

• Training was very helpful

• The EIM/ESM team is actively working to improve technical and business issues identified in the feedback process

Several DPH, DMR and DMH providers began using EIM/ESM during FY07 with five additional agencies coming on board through FY10. When fully deployed, EIM/ESM will support approximately 10,000 users and process invoices totaling over $2 billion each year. The benefits of EIM are being realized by Agency and Provider users every day.

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Apr-10 May-10 Jun-10 Jul-10 Aug-10

Email Welcome Package

FY11 Provider Implementation – What to Expect

Forms due from Provider

Send Training

Invitations

ProviderCompletes Forms

Deployment Team Review Forms

Key Communications from the Deployment Team to Providers:• Welcome Package: Contains information on forms to be completed• Training Invitation: Instructions for users to complete required eLearning courses

and register for instructor led training sessions (where required) or workshops• Go-Live Confirmation: Contains detailed Go Live information, including important

dates and a “Day One Guide”

Key Communications from the Deployment Team to Providers:• Welcome Package: Contains information on forms to be completed• Training Invitation: Instructions for users to complete required eLearning courses

and register for instructor led training sessions (where required) or workshops• Go-Live Confirmation: Contains detailed Go Live information, including important

dates and a “Day One Guide”

ProviderCompletes Training

Deployment Completes

Provider Completes

Support calls

On-boarding begins 2-3 months prior to “Go-Live” and includes a series of readiness activities. A proven methodology guides the entire process. Shown is a typical timeline for deployments that target a provider beginning to use EIM/ESM at the start of the new fiscal year. Timelines may be compressed depending upon unique implementation considerations.

*Reflects current estimated timeframe; subject to change

Go-Live.Provider Bills

for July in EIM/ESM

Assesses provider readiness and email Go Live Confirmation

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• Serves as the primary EIM/ESM contact for the provider

• Becomes familiar with the provider’s business: organizational structure, users, contracts

• Assists in the form completion process– Provides assistance via workshops,

conference calls, WebEx sessions and/or appointments

– Reviews forms• Understands the nature and timing of the provider’s

contracts that are going live• Provides ongoing support before, during, and after

go-live (for Deployment related activities)• Evaluates whether a provider is prepared for go-live

Key Implementation Roles

• Serves as the single point of contact for EIM/ESM at the provider with whom the Deployment Team Member communicates

• Achieves a basic understanding of the EIM/ESM application and its impact on the organization

• Distributes all EIM/ESM related communications within their organization (EIM/ESM Users, management, or other relevant organization contacts)

• Commits to project deadlines and timely form submission

• Serves as or designates a Subject Matter Expert for EIM/ESM at the provider

• Ensures staff completes all required training

Deployment TeamDeployment TeamEIM/ESM POC at the ProviderEIM/ESM POC at the Provider

The provider implementation methodology requires each provider to commit resources critical to the program’s success. The key provider resource is the Point of Contact (POC) whom you’ve appointed as your organization’s representative for this project. In turn, EOHHS will assign you a dedicated VG contact, a member of the Deployment Team, to assist you throughout your implementation.

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Key Implementation Steps for the POC

Description When* What POC Needs To Do Due*

1) Welcome Package (WP)

Emailed to the POC. The WP includes instructions for downloading forms from the internet.

May2010

Complete all forms within the indicated timeframe. Existing EIM/ESM providers will need to validate or update their Org Form/URF.

Mid-May

2) Training

Email invitation to take computer-based EIM/ESM training on PACE, the online Learning Management System, and, if required, to register for instructor-led classes.

June –July

All users need to fulfill training requirements. The POC will track progress.

2 weeks before Go-

Live

4) Go-Live Confirmation

Communicates a specific go-live date for organizations that have met form and training requirements. The Package also includes a Day One Guide and information on the release of user IDs.

1 week before Go-

Live

Read materials and forward the information as appropriate

Late July

5) Go-Live

User IDs are issued for each EIM/ESM user that has completed training requirements August

Some providers will begin client data entry during July.

Begin to use EIM/ESM for billing and reporting.

August

6) Post Go-Live

Provide on-boarding support for new users in the organization; notify VG of any user changes—terminations, role changes, etc.

On-goingSubmit updated URF to indicate additions, deletions, or modifications to users/roles

On-going

*Reflects current estimated timeframe; subject to change

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How EIM/ESM is Secured

• EIM/ESM is a web-based service that can be accessed from anywhere

– EIM/ESM contains sensitive client data– Special steps have to be taken to ensure that the data stored within it is

electronically secure and accessible only to those who are authorized to have such access

– This is done via a combination of Organization Management, Security Roles, and Data Access rules

Guiding Principle:

EIM/ESM is secured to ensure that users can perform their job function without limitation while appropriately protecting sensitive client information

Guiding Principle:

EIM/ESM is secured to ensure that users can perform their job function without limitation while appropriately protecting sensitive client information

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Security Overview

• Organizations in EIM/ESM can be divided into sub-organizations – For example, a provider organization can have multiple facilities or sites where

services are delivered.

• Security Roles control what the user can and cannot do in EIM/ESM – The system has a predefined set of roles that provides access to specific business

functions of the system. A user is associated only with the roles relevant to his or her job function.

– For example, the “CR Reviewer” security role allows an individual to review invoices in the system but not to create or edit them. The user must be assigned a (CR, UR, AR Billing) role to be able to create and edit invoices.

• Data Access rules control what the user can and cannot see in EIM/ESM – The data access rules that are predefined in the EIM/ESM system consider the

user’s organizational relationship to control what data records a user has access to see.

– For example, data access rules will ensure that a “CR Reviewer” can review invoices for his/her organization or sub-organization, but cannot view invoices for other provider organizations.

Organization Management

Form

Organization Management

Form

User Request Form

User Request Form

Based on these components, the Organization Management Form and User Request Form will determine the specific security design for your organization.

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Organization Management Form

Organization Management in EIM/ESM refers to how an entity is structured

• For providers, it usually represents the hierarchical relationship between the parent entity (e.g. headquarters) and the various departments and sites

• Organizations not affiliated with EIM/ESM users (IT, Human Resources etc.) will not have to be captured in the Organization Management Form

• An organization should be documented if it meets at least one of the following criteria:

– EIM/ESM will be accessed there

– Clients are enrolled there

– Clients receive services there (excluding personal homes of clients)

The Organization Management Form will be completed in preparation for the first time a provider goes live with the EIM/ESM service. However, the form should be completed comprehensively, i.e., it should reflect the entire provider organization as it pertains to all Purchase of Service EOHHS contracts

The Organization Management Form will be completed in preparation for the first time a provider goes live with the EIM/ESM service. However, the form should be completed comprehensively, i.e., it should reflect the entire provider organization as it pertains to all Purchase of Service EOHHS contracts

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Organization Management Form (continued)

To complete the Organization Management form:*1. Document the structure of the organization. Identify a “parent” organization and all of its sub-

organizations using as many tiers as needed.• A sub-organization has a direct relationship (i.e. it is owned and operated) to a parent organization

• An organization should be documented if it meets at least one of the following criteria:• EIM/ESM will be accessed there

• Clients are enrolled there

• Clients receive services there (excluding personal homes of clients)

2. Document your Affiliates• Affiliates will include organizations which may deliver services, enroll clients, or perform billing on your

behalf, but are not owned and operated by the parent organization

In this Org-structure example, ABC Provider Inc., in addition to its service delivery sites, has decided to create orgs for their programs in order to separate data access. As a result, HIV/AIDS program staff will not be able to see Mental Health program information and vice versa.

*Please refer to the Welcome Package for further instructions.

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User Request Form

To complete the URF(s):

1. Complete the Organization Management Form*

2. Refer to the “Contract Go Live Schedule” to review the list of contracts scheduled to Go Live for your organization in FY11

3. Determine which organizations on your Organization Management Form will have at least one individual accessing EIM/ESM to support the contracts going live • Document that name of the organization as it appears on the Organization

Management Form on the URF.

4. Identify staff associated with each site as users• Only include staff who will be directly accessing and using EIM/ESM

• If a staff person works at multiple sites, they have to be included on the URF for each of those sites, or be included on the URF of a parent site.

5. Assign roles to users on the URF that are specific to their business function.

“Security” in EIM/ESM refers to how access to various aspects of system functionality is controlled for the users affiliated with a particular organization“Security” in EIM/ESM refers to how access to various aspects of system functionality is controlled for the users affiliated with a particular organization

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User Request Form (continued)

ABC Park St. House

ABC Natick MH

Center

ABC Provider, Inc.

ABCHIV/AIDSProgram

ABCMental Health

Program

ABCLynn Health

Center

ABC Allston Clinic

In this example the provider will submit 1 URF listing all users for each ORG identified. Individuals listed for “ABC HIV/AIDS Program” will only see their relevant information. Individuals with parent-level access can see all information.

If no one will be accessing EIM/ESM you do not need to list that ORG on the URF.

URF roles, determine what a user can do in the system, i.e. what “hat” they wear. For example, only CR Authorizer will have an “Invoice Authorize” button on the screen.

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EIM/ESM Manage Locations Role

We have developed an optional enhancement to EIM that will aid providers with more efficient data entry when adding attendance to SDRs. 

– It also allows users the ability to sort and/or filter SDRs by location and allow for more efficient data entry.

– The provider can specify whether billing will be completed centrally, i.e., at the parent level (note: this functionality is “optional” if your organization is using a centralized billing model), or in a decentralized manner at the site level (note: this functionality is “required” if your organization is using a decentralized billing model (please see chart on next slide) .

– Participating Organizations include orgs where the system will be accessed and information for that particular contract will be seen.

– Participating orgs can be listed under multiple contracts.

– Participating orgs can have “Billing” and/or “Enrolling” access per contract.

Since the beginning of the Fiscal Year is an extremely busy time for providers, this functionality can be used anytime during the Fiscal Year, if you choose to utilize.

Since the beginning of the Fiscal Year is an extremely busy time for providers, this functionality can be used anytime during the Fiscal Year, if you choose to utilize.

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Beach St Oak St

Billing Staff Joe Billing Staff Ann

Client JonesClient West

Client WoodsClient Smith

Provider XYZ

Billing Supervisor

Decentralized

Billing Staff Joe ’ s SDR View

Billing Staff Ann’ s SDR View

Billing Supervisor’ s SDR View

Client Jones Beach StClient West Beach St

Client Woods Oak StClient Smith Oak St

Client Jones Beach StClient West Beach StClient Woods Oak StClient Smith Oak St

Organizations

Billing Staff

Enrollments

SDR

KEY

Provider ABC

Birch St Pine St

Client PackardClient Willett

Client CookeClient Souza

Billing Supervisor

Centralized

Client Packard Birch StClient Willett Birch StClient Cooke Pine StClient Souza Pine St

Billing Supervisor’ s SDR View

EIM/ESM Centralized vs Decentralized Billing

Centralized vs Decentralized Billing

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What You Need To Do Next

• Identify EIM contracts

• Identify locations that need to be added/modified to your ORG structure– Complete the Organization Management Form & send to Virtual Gateway

Deployment (virtualgatewaydeployment@state.ma.us)

• Determine who will be responsible for this work at your Organization:– Participating ORGs/Assign Locations for Enrollments– Billing: URF > Adding/Modifying Staff Access – Complete URF forms > Send to Virtual Gateway Deployment (

virtualgatewaydeployment@state.ma.us)– Anyone requesting the Manage Locations role will need to complete the all

required EIM/ESM training before role will be released.

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Customer Service Information

• General questions regarding EIM/ESM training– VirtualGatewayTraining@state.ma.us

• Questions regarding completing forms, agreements, or deployment dates:– VirtualGatewayDeployment@state.ma.us

• General questions regarding EIM/ESM, login issues, or accessing the Virtual Gateway:

Virtual Gateway Customer Service (Help Desk)– 1-800-421-0938– TTY 1-617-988-3301– Fax 1-617-988-3119