INTEGRATED CARE MANAGEMENT AND QUALITY IMPROVEMENT
South Carolina KEPRORequirements for
Requesting Prior
Authorizations (PA)
New 1/15/2015
TOPICS
• Retroactive Eligibility
• Service Types
• Submission
Requirements by Service
Type
• KEPRO SCDHHS Website
• Contact Information
RETROACTIVE
ELIGIBILITY
RETRO CASES
A case may be submitted as a “retro” when
retroactive eligibility occurs.
• Member not eligible for coverage at the time services were
provided.
• Member gains eligibility that is made retroactive to the date of
service.
• A “retro” case is NOT one that is submitted late for any reason.
SERVICE TYPES
• Botox
• Transplants
• Therapies (PT, OT,
ST)
• PRTF/Freestanding
Psych
• DME
• Hospice
• Home Health
• Mental Health
Counseling
• Surgical Procedures
• Inpatient
SERVICE TYPE
BOTOX
BOTOX
• Procedure Codes:
– J0585 Botox (onabotulinumtoxin A)
– J0586 Dysport (abobotulinumtoxin A)
– J0587 Myobloc (rimabotulinumtoxin B)
– J0588 Xeomin (botulinum toxin type A)
BOTOX
 J0585 Botox (onabotulinumtoxin A)
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•
•
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Strabismus
Blepharospasms
Severe primary axillary hyperhidrosis
Upper limb spasticity in adults
Cervical dystonia in adults
Chronic migraines
Spasticity related to CP in children
BOTOX
 J0585 Botox – NEW INDICATION
 Urinary incontinence due to detrusor overactivity
in neurologic conditions (spinal cord injury or MS).
 Must document inadequate response to or being
intolerant of an anticholinergic medication.
BOTOX
 J0586 Dysport (abobotulinumtoxin A)
• Cervical dystonia in adults
 J0587 Myobloc (rimabotulinumtoxin B)
• Cervical dystonia in adults
 J0588 Xeomin (botulinum toxin type A)
• Cervical dystonia in adults who failed treatment
with Botox
• Blepharospasm in adults who failed treatment with
Botox
BOTOX
Clinicals Required
– Diagnosis
– Specific muscle groups to be injected
– Amount to be injected in each muscle group
– Planned Frequency of injections
SERVICE TYPE
ORGAN
TRANSPLANTS
ORGAN TRANSPLANTS
• Transplants MUST have a current PA before the event occurs
• Types of transplants requiring a PA:
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Heart Transplant
Liver Transplant
Lung Transplant
Mismatched Bone Marrow
Multi-organ Transplants
•
•
•
•
•
•
Liver/Small Bowel
Liver/Pancreas,
Liver/Kidney,
Kidney/Pancreas
Heart/Lung
Multivisceral
– Small Bowel
– Pancreatic Transplant
ORGAN TRANSPLANTS
• No prior authorization is required for
– Corneal Transplant
– Kidney Transplant
– Matched Bone Marrow (autologous inpatient and outpatient, allogeneic related
and unrelated, and cord). Includes Stem Cell Transplants
• Pre-transplant admission for chemotherapy and/or cell harvest may
require inpatient prior authorization (follow policy of primary
insurance carrier for inpatient admission).
ORGAN TRANSPLANTS
• Organ transplants must be performed at CMS approved Transplant
Center: www.cms.hhs.gov/ApprovedtransplantCenters
• Servicing Provider: Referring Physician NPI number
• Timely submission: at least 10 days advance notice, excluding
emergent cases
• Transplant authorization:
- Transplant authorization approved for 365 days from date of PA request
- Authorization covers 75 hours prior to transplant event and up to 90 days after
transplant event.
ORGAN TRANSPLANTS
• Eligibility:
- Medicare Primary, Medicaid MCO, Private Insurance: KEPRO will review and
authorize for the transplant event only
- Transplant evaluation / workup is done outpatient, KEPRO does not review for
evaluation; follow Primary Insurance carrier policy for prior authorization
• Out-of-State Transplant:
- Transplant services must not be available in SC
- Evaluation is outpatient. KEPRO does not review / authorize
• Required Documentation:
– Transplant Prior Authorization request Form (must be completely filled out).
– Letter of Medical Necessity, signed by physician
– Fax Submissions require KEPRO Prior Authorization Fax Form – Transplant
and Surgical justification
Transplant Prior Authorization
Request Form
THERAPY SERVICES
Physical Therapy (PT)
Occupational Therapy (OT)
Speech Therapy (ST)
PT, OT , and ST
21 Years and Older - OP Hospital and Private Setting
 Prior Authorization is required.
 Provider Manual - Hospital Services and Physician provider manual for
over 21.
Under 21–OP Hospital and Private setting
 Prior authorization is required ONLY when therapies exceed
105 hours or 420 units per fiscal year.
 Information on remaining units may be found on SC Web Portal.
 Provider Manual – Physician Manual and Private Rehab Manual
EVALUATIONS
• Allowed 1 Evaluation per service per year.
• Approval given for “1” unit.
• Approval given for a 30-day time span.
INITIAL REQUESTS
• Approval period for 4 weeks.
• 1 unit of approval = 15 minutes.
• Clinical submission should include:
– Individual Plan of Care (IPOC)
– Short-term and long-term goals
– Home Exercise Program
CONCURRENT REQUESTS
• Approval period is for 8 weeks.
• 1 unit of approval = 15 minutes
• Clinical submission should include:
– Individual Plan of Care (IPOC)
– Short-term and long-term goals – have they been met?
– Home Exercise Program (HEP)
– Compliance with HEP
HELPFUL CLINICAL
INFORMATION
• Medical history – why is therapy required?
• Current functional status:
– Are assistive devices required?
– Are they willing/able to participate in therapy?
SERVICE TYPE
HOME HEALTH
HOME HEALTH
• Home Health visits are limited to a total of 50
visits per state fiscal year that begins July 1 and
ends June 30.
• Prior authorization from KEPRO is required to
exceed the 50 visit limitation.
• Home Health covered services:
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–
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Nursing Services
Home Health Aide
PT, OT, ST
HOME HEALTH
• Requests to exceed the 50 visit limitation must
include:
– KEPRO Outpatient Prior Authorization Request form
– Executive summary describing in detail the
extenuating circumstances which make additional
visits medically necessary
– Supporting medical documentation that justifies the
medical necessity
• Supporting medical documentation can include
the plan of care and clinical service notes per
Home Health service being requested
HOME HEALTH
• Home Health providers are required to track
and request additional Home Health visits prior
to the expiration of the 50 visit limitation by
utilizing the SC Medicaid Web-based Claims
Submission Tool (Web Tool)
• Authorization requests are for a 60 day plan of
care period.
HOME HEALTH
• Authorization requests for extended service beyond the
initial authorization period must be submitted to KEPRO
prior to the last authorized day in the certification period
• Providers have two business days to respond to
requests for additional information.
– If no response received to pend, the request will be forwarded
for higher level review or administratively denied
• Providers have two business days to respond to
Insufficient information requests
– If no response received to pend, the request will be closed
requiring re-submission for prior authorization
HOME HEALTH
• KEPRO will issue a PA number for approved
authorization requests. The Home Health
agency will then be able to bill for the additional
visits.
• Claim submission above the 50 visit limitation
without a KEPRO PA number will generate an
edit 837 (service requires QIO PA) and an edit
850 (home health visit frequency exceeded).
SERVICE TYPE
MENTAL HEALTH
COUNSELING
MENTAL HEALTH COUNSELING
• All services must be prior authorized unless retroactive
eligibility exists.
• All submissions must include a valid DSM-IV or CPT
diagnosis code.
– This excludes irreversible dementias, intellectual disabilities, or
developmental disorders unless they co-occur with a serious mental
disorder.
MENTAL HEALTH COUNSELING
• For Licensed Independent Practitioners (LIP) providers,
KEPRO reviews for the following codes:
– 96101 – Psychiatric Evaluation (MUST include referral source)
– 90832/90834/90837 – Individual Psychotherapy
– 90853 – Group Psychotherapy
– 90846/90847 – Family Psychotherapy
MENTAL HEALTH COUNSELING
Submission Requirements For LIP Providers
– LIP Authorization Fax Form
– Pediatric and Adult Initial Requests must also include Comprehensive
Assessment
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•
•
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•
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Demographic Information
Presenting Complaint (Behaviors, Symptoms)
Medical History
Family History
Psychological/psychiatric treatment history
Substance Use History
Mental Status Exam
Current Diagnosis
Functional Assessment
Individual/Family Strengths and Support System
Any history of abuse
MENTAL HEALTH COUNSELING
• Pediatric and Adult Concurrent Requests require submission of:
• Individual Plan of Care
• Progress Notes to include clinical information to meet
McKesson InterQual Requirements
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–
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What symptoms is the member experiencing?
How does the illness affect the member’s functioning, in school, job or
relationships?
For adolescents and adults, how many visits has the patient attended out
of the last 5 scheduled visits?
MENTAL HEALTH COUNSELING
• Submission Requirements for Physicians
– Physician’s Mental Health Form.
– Clinical documentation as to why services are required.
– For Concurrent Reviews for Adolescents and Adults, include number of
visits attended out of the last 5 scheduled visits.
MENTAL HEALTH COUNSELING
• Submission Requirements for FQHCs
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Clearly document that request is from an FQHC.
Use NPI of facility when submitting.
All services will be reviewed under CPT code T1015 with HE modifier.
Maximum of 12 units may be approved per review.
Submission must include:
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•
•
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FQHC Required Mental Health Form
Individual Plan of Care (IPOC)
Clinical Summary
For Concurrent Reviews for Adolescents and Adults, include number of
visits attended out of the last 5 scheduled visits.
SERVICE TYPE
PSYCHIATRIC RESIDENTIAL
TREATMENT FACILITY
(PRTF)
PRTF
Psychiatric Residential Treatment Facilities (PRTFs) are
facilities, other than a hospital, that provide psychiatric
Services to recipients under age 21.
PRTFs provide inpatient Psychiatric Services to recipients
who do not need acute inpatient psychiatric care, but
need a structured environment with intensive treatment
services.
PRTF
Submission Requirements
• For timely submission, providers must submit on or
before requested start of care or the request will be
approved the date it was received by KEPRO (unless
emergency)
• Respond to request for additional information within the
2 business days specified
PRTF – INITIAL REQUEST
• Initial approval period may be for a maximum of 21 days.
• Required documentation includes CALOCUS and Certificate of
Need (CON).
– Clinical should include: Current symptoms, treatment history, support
system.
• Clinical will be used to meet criteria in McKesson InterQual.
• Stays may not overlap between facilities.
PRTF – CONCURRENT
REQUEST
• Approval period may be for a maximum of 30 days.
• Submission should be by day #14 of current stay so as to not have
lapse in coverage.
• Required documentation includes IPOC, progress summary, and
documentation/attestation that required services are occurring:
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Individual Psychotherapy at least 90 minutes per week.
Group Psychotherapy sessions at least 3 times a week.
Family Psychotherapy at least once per month.
Face-to-face meeting with facility physician/psychiatrist at least once a
month.
– Psychiatric evaluation within 60 hours of admission
– Psychological evaluation within 30 days of admission.
PRTF – CONCURRENT
REQUEST
• If services are required for more than a year’s time:
– A new case will need to be set up (a case may not span more than 365
days).
– An updated CALOCUS will need to be submitted.
– Submission is required of narrative explaining why continued PRTF
services are needed.
FREE-STANDING PSYCHIATRIC
FREESTANDING
PSYCHIATRIC INPATIENT
(UNDER 21 and 65 and older)
FREE-STANDING PSYCHIATRIC
Inpatient admissions must be prior
authorized by KEPRO (unless emergent).
Services need to be medically prescribed
treatment, which is documented in an active
written treatment plan.
KEPRO will review requests for the medical
necessity of the initial admission, and will
approve for “1” day.
FREE-STANDING PSYCHIATRIC
• Required Documentation:
– Certificate of Need (CON) – or attestation to same on
Fax Form.
– Freestanding Psychiatric Inpatient Fax form.
– Additional clinical to substantiate inpatient request.
FREE-STANDING PSYCHIATRIC
Criteria
• Identify Medication compliance/adherence
• Current presenting symptoms
• Impairments on functioning
Durable Medical Equipment
DURABLE MEDICAL
EQUIPMENT (DME)
Durable Medical Equipment
• KEPRO reviews for a specific list of CPT codes, as listed in the
Procedure Codes section of the DME Manuals.
• Do not require authorization for recipients with the following
coverage types: MCHM, HOAD, HOAP, MCSC or Medicare .
• For timely submission, providers must submit on or before
requested start of care or the request will be approved the date it
was received by KEPRO
• For DME requests, KEPRO has 15 days to review requests for prior
authorization
Durable Medical Equipment
• Equipment may be approved that covered under the SC
State Plan. It must be medically necessary and
appropriate for use in the beneficiary’s home.
• Convenience and prevention items are not covered.
Durable Medical Equipment
• Submission of Medicaid Certificate of Medical Necessity
(MCMN) is required.
• There are 6 versions:
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Equipment/Supplies (DME 001)
Power/Manual wheelchair and/or Accessories (DME 003)
Orthotics/prosthetics/diabetic shoes (DME 004)
Enteral nutrition (DME 005)
Parenteral nutrition (DME 006)
Oxygen (DME 007)
• MCMN is valid for 12 months.
Durable Medical Equipment
•
Modifiers required--- NU LL UE RR
• DME Manual, Section 4, lists modifiers required for all
codes reviewed by KEPRO.
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NU – New item
LL – Capped rental item.
UE – Used item
RR – Rental.
Durable Medical Equipment
•
LL Modifiers – Capped rental item.
Items cannot be initially
purchased. Is considered purchased when it has been rented for 10 months.
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E0250 – Manual hospital bed
E0470/E0471 Respiratory assist devices
E0601 CPAP Device
E0784 Insulin pump
E0791 Parenteral infusion pump
E0940 Trapeze free stand
E2000 Gastric suction pump
K0001 Standard manual wheelchair
K0195 Elevating leg rest
Durable Medical Equipment
•
RR Modifiers– Rentals.
• Note that 6 CPT codes have a limited rental period; initial approval
may be for 4 months. If required, providers may submit for an
additional 4 months, and then 2 months. Equipment may not be
rented for over 10 months.
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•
E0372 Powered air overlay mattress
E0277 Power pressure-reducing air mattress
E0193 Powered air flotation bed
E0194 Air fluidized bed
E2402 Negative pressure wound therapy electrical pump
E0747 Osteogenesis stimulator
Durable Medical Equipment
•
Fax request to KEPRO using DME Fax Form
• Clinical will be used to meet McKesson Interqual
criteria.
• SCDHHS DME Manual lists specific criteria required for
some equipment –
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Beds
Wheelchairs
Wound VAC
MICKey buttons
Prior Authorization Checklist
SERVICE TYPE
HOSPICE
HOSPICE
Hospice Procedure codes
• T1015- GIP General Inpatient Care
• S9126- Routine home Care
• S9123- Continuous home Care
• S9125- Inpatient Respite Care
• NOTE: T2046 – Hospice Room and Board Services do not
require prior approval
HOSPICE
• General Inpatient Services
– Documentation required for a new admission into
hospice and the request is GIP:
• KePRO Fax Form
• SCDHHS Election Form (DHHS 149)
• Admission Assessment or Initial Care Plan
• Verbal Order
• Supporting Documentation
– Written Certification must be obtain prior to the submission of
the other hospice procedure codes within15 days or
– If the other codes will not be requested, written certification
must be obtained prior to submitting hospice claims
HOSPICE
• KEPRO Outpatient Fax Form
– Please make sure that all necessary information has
been filled out on the KEPRO fax form
– Include all 3 procedure codes (GIP should also be
included if that is the status of the client upon
submission)
– Requests for GIP should be submitted at the time of
inpatient admission, and if approved, will be
approved for a 30 day time span
HOSPICE
DHHS 149 Form (Medicaid Hospice Election):
– Designate an effective date for the election
period to begin
– The request must be submitted to KEPRO within
15 business days of election of benefits
– If not received within 15 business days, the
request will be approved effective the date the
request was received by KEPRO
– The days are subdivided into election periods
• Two 90-day periods each
• An unlimited number of subsequent periods of 60 days each
HOSPICE
DHHS 149 Form
HOSPICE
DHHS Form 151- Medicaid Hospice Physician Certification
and Recertification
• Written certification statements must be obtained within 2 calendar
days after hospice care has been initiated
– Signed by the Medical Director of the Hospice or the
physician member of the Hospice interdisciplinary group
– Signed by the person’s attending physician (if the
individual has an attending physician)
• If written certification is not obtained within 2 days after the initiation
of Hospice care:
– A verbal certification may be obtained within these 2
days
– A written certification must be obtained prior to
submission of a request for prior authorization
HOSPICE
DHHS Form 151- Medicaid Hospice Physician Certification and Recertification
HOSPICE
Required Clinical Documentation:
• Plan of Care
– Goals/Interventions
• Lab results, Diagnostic Tests, any clinical to
substantiate request for hospice services
HOSPICE
Other Required Documentation
• DHHS Form 153 (Revocation Form)
• DHHS 154 (Discharge Form)
• DHHS 152 (Change Request Form)
HOSPICE
• DHHS Form 153- Medicaid Hospice Revocation
• Complete DHHS form 153
• Designate an effective date to revoke Hospice
• Submit Form 153 to KEPRO within 5 business days of revocation of
benefits
• Mail a copy of the form to the nursing facility or ICF/MR
• DHHS Form 154- Medicaid Hospice Discharge
• Designate an effective date to discontinue Hospice
• Submit form to KEPRO within 5 working days of the effective date of discharge
• DHHS Form 152- Medicaid Hospice Provider Change
Request
• Complete all appropriate portions of Form 152
• Submit a copy of Form 152 to KEPRO within 5 business days
• Send a copy to the receiving Hospice Provider within 2 days
HOSPICE
DHHS Form 153- Medicaid Hospice Revocation
HOSPICE
DHHS Form 154- Medicaid Hospice Discharge
HOSPICE
DHHS Form 152- Medicaid Hospice Provider Change Request Form
SERVICE TYPE
SURGICAL JUSTIFICATIONS
SURGICAL JUSTIFICATION
• Only pertains to Outpatient Surgical procedures
– Hospital Provider manual for complete listing of Codes (Beginning section 4-63)
– Physician Provider Manual for complete listing of Codes (Beginning Section 4-18)
• Refer to KEPRO website at http://SCDHHS.KePRO.com
or SCDHHS Bulletin “Services Performed by KEPRO - Attachment A
• Servicing provider: Physician NPI number
• Fax Submissions utilize KEPRO Prior Authorization Fax Form –
Transplant and Surgical justification
SURGICAL JUSTIFICATION
• Hysterectomies
• Must include Consent for Sterilization signed 30 days prior to the
procedure.
– Exceptions are:
• If urgent/emergent surgery required (with bypassing of waiting
period), submission of doctor’s note with explanation is required.
• If retroactive eligibility was obtained, must include documentation
showing recipient was informed of future sterility prior to surgery.
• All submissions must include “Surgical Justification for
Hysterectomy.”
• Clinical information will be used to meet McKesson InterQual criteria.
Consent for Sterilization Form
Surgical Justification-Hysterectomy
SURGICAL JUSTIFICATION
• Gastric Bypass
- Two questions that must be answered
1) Is it medically necessary for the individual to have such surgery.
2) Is the surgery to correct an illness that caused the obesity or was
aggravated by obesity .
If No, to the above questions please submit additional
information regarding why procedure is needed.
SERVICE TYPE
INPATIENT ADMISSIONS
INPATIENT
• Includes: Inpatient Acute, Inpatient Psych and Inpatient Rehab and
LTAC
– NO PA required for Birth/Delivery
– No concurrent reviews (DRG)
• Review of Admission Only - NOT Length of Stay
• Servicing Provider- Must display Facility NPI number
– Allscripts Case Management Fax is sufficient as long as NPI number is
recorded
•
KEPRO Inpatient Prior Authorization Fax form (Fax submissions
only)
INPATIENT
• All non-urgent admissions must be preauthorized (submitted on or
before date of admission). This includes planned surgical
procedures and admissions for routine chemotherapy.
• Urgent/emergent admissions must be submitted within 5 business
days of the admission.
• KEPRO will complete review (including requests for additional
information) within 5 business days.
INPATIENT
- Kepro is only reviewing for the 1st 24 hours of
admission. Supporting clinical should address this
period of care.
- Documentation must be legible.
- Respond to request for additional request within the 2
business days specified.
- Clinical information will be used to meet criteria
specified in McKesson Interqual.
INPATIENT
• Medicare/Medicaid (Dually Eligible)
-
All services rendered to dually eligible Medicare/Medicaid patients
should be filed to Medicare first.
• Commercial Insurance
- All services rendered to recipients with commercial insurance should
be submitted to the primary payor first.
INPATIENT
• Managed Care Organization
- PA request for beneficiaries enrolled in a
managed care organization (MCO) must
be handled by the MCO.
INPATIENT
• Admission From an Observation Unit
• When a patient is admitted to the hospital from an
observation stay, bill the date the beneficiary was
switched to inpatient status as the first day of the
inpatient admission.
• Only if the observation stay is unrelated to the inpatient
admission, excluding the day of admission, can the
observation days be billed as outpatient services.
• Observation stays related to and within 72 hours of the
inpatient admission are considered inpatient services
and are included in the DRG payment.
INPATIENT
• Hints re: McKesson InterQual Criteria
• When additional information is requested, please address the
specific questions
• When requesting inpatient surgical procedure, be concise as to
what procedure is being performed and specify the date of service
• Specific IVFs (i.e. volume expanders) administered and the rate.
• Diet status (NPO, advancing, etc.)
• Note any failed outpatient treatment related to this admission
• IV: Drips note if continuous or the titration frequency
• Route and frequency for all medications and treatments (i.e. po
meds, nebulizers, etc.)
INPATIENT
• Hints re: McKesson InterQual Criteria
• Note any failed outpatient treatment related to this
admission.
• If nurse reviewer is unable to meet criteria with supplied
clinical information, case will be forwarded for physician
review.
MEDICAL NECESSITY DENIALS
• Medical necessity denials are denials where clinical information
that has been submitted has been reviewed by a Physician who
has determined that the request is not medically necessary (based
on the clinical submitted).
• If you disagree with denial decision, please follow instructions as
outlined in your denial letter.
• Reconsideration request- Submit to KEPRO within 60 days from
receipt of denial letter.
• Appeals request- Submit to state within 30 days of receipt of denial
letter. Appeals should be submitted after a reconsideration review
has been completed.
ADMINISTRATIVE DENIALS
• Administrative denials are denials in which the request for services
was submitted untimely or required DHHS forms were not
submitted
• Administrative denials are administered by the Clinical Nurse
Reviewer.
• Administrative denials do not allow for reconsiderations, only
appeals directly to SCDHHS
• Appeals request- Submit to state within 30 days of receipt of denial
letter.
Response Time for Decisions
from the QIO
• For all service types excluding DME and
PRTF/Freestanding Psych, KEPRO must
render a decision within 5 business days.
• KEPRO has 15 days to process DME requests
and 2 business days to process
PRTF/Freestanding Psych
Note***this is excluding time for pending for
additional information, physician review
SOUTH CAROLINA WEBSITE
FORMS
Navigate to Form Tab
to obtain Documents
such as: Fax and
Justification forms
OUTPATIENT FAX FORM
OUTPATIENT FAX FORMS cont.
INPATIENT FAX FORMS
INTEGRATED CARE MANAGEMENT AND QUALITY IMPROVEMENT
Registration for
Atrezzo Connect
Provider Portal
How To Register For
Atrezzo Connect
• Website Address:
https://scdhhs.kepro.com
• Select “ Registration For Atrezzo
Connect” (Slide 3)
• Enter your 10 digit National
Provider Identifier (NPI) number
and Legacy South Carolina
Medicaid provider ID
• Select a unique user name and
password & complete required
user information
Atrezzo Connect
Atrezzo Connect allows for:
– Secure access to Atrezzo
Connect (Provider Portal)
– Provider will be able to
access letters by
Case/Request,
Respond/Send messages
To/From KEPRO
Required Information for
Security Verification
• The provider must enter
information to verify
authenticity for security
reasons
• Registration Code:
– SCDHHS Legacy ID
Simple -5 Step Registration Process
• Start by clicking the
Atrezzo Login
button on the
SCDHHS-KEPRO
website
Login Page
• You will be brought to this login page
Step 2 – Enter NPI and Legacy ID
• Enter your
organization’s
NPI number and
Legacy Provider
ID = Provider
Registration
Code
• Click NEXT
Step 3 – Terms of Agreement
• Review Terms of
Agreement. Upon
acceptance, you will
be taken to setup for
User information.
Step 4 – Verify Address
• Click on the correct address(s) for the
new account (this associates your user
information with these locations)
• If all apply, check all of them
• Click SELECT
Step 5 – Enter Account Information
• Enter user account
information
• User Name, Password,
First/Last Name, E-mail
and Fax Number are
required fields!
• Click NEXT-This will
take you to the
Password setup and
security question Slide)
• Passwords do not
expire. Minimum 8
characters required.
Successful Completion
• Successful
Completion of
setup, takes
you to the
Home Page
View all request and Create new request
•Click Member to search using Member id or Last
name/DOB
•Click Request/Case to search using Case id,
Member info or Request info
Create Preferences, Manage User account
and New Provider Registration
Use this tab to change your password or
update your contact information
View Atrezzo User Guide and View FAQs
Account Administrator
• All information submitted for
registration under
Provider/Facility Information will
represent as the Provider Portal
Administrator (Group Admin).
• The Group Admin is responsible
for managing and creating all
Submitting User accounts for
your NPI #
– Create other Group Admins’ &
Admin Users
– Set Preferences, i.e. Diagnosis
and Procedure codes, etc
KePRO Contacts
Thank You!
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