Sections:
| 1. SFTP/SSH QUESTIONS | |
| 2. INTEGRATION PROCESS QUESTIONS | |
| 3. RESPONSE ERRORS | |
| 4. DATA FIELD QUESTIONS | |
| 5. FILE VALIDATION QUESTIONS | |
| 6. CLAIMS |
Data fields listed in the state-specific CareBridge Technical Specifications - found here
Acronyms which can be found on the CareBridge Frequently Used Acronyms page - found here
----------------------------------- SFTP/SSH QUESTIONS ---------------------------------
How do I get my credentials for the SFTP site?
Send a public SSH key in OpenSSH format to evvintegration@carebridgehealth.com
What is a public SSH key?
Public SSH key authentication has the same purpose as password protection, but a higher degree of security. The vendor generates a public private key pair on their computer or server and sends the public key to CareBridge. CareBridge would store the public key and when the vendor tries to connect to the SFTP site, the private key that they generated would match to the public key we received to validate the connection.
Is there a required format for SSH key authentication with CareBridge?
Public keys sent to CareBridge must be in OpenSSH format. ssh-keygen is a utility that is included on Windows 10 systems as well as Mac/Linux systems.
The following process can be used to generate a public private key pair:
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Open Command Prompt in Windows or terminal for Mac/Linux.
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Type (or copy) the following:
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ssh-keygen -t rsa -b 4096
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Enter a file name (e.g. public-ssh-key-[organization name]).
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(Optional) Enter a password.
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(Optional) Re-enter password.
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Go to the file location where the key was saved and copy the public key.
(This will generally be a .pub file) -
Send the public key via email to evvintegration@carebridgehealth.com.
DO NOT send the private key.
Can I send a key in PuTTY format?
No – however, a key generated using PuTTYgen can be converted to OpenSSH prior to sending to CareBridge.
After I have downloaded the response file from the output folder, can it be archived?
After the response file is downloaded and saved on your server, we recommend you delete it
from the output folder. Response files located in the output folder are deleted after 30
days.
Do each of my agencies need their own username?
No, credentials are typically set up at the vendor level. A vendor would send CareBridge a
public SSH key, and would receive a username for the DEV environment and a username for PROD environment.
Whenever data is sent, each agency’s data would be sent in a separate file, and CareBridge would generate separate response files in the Vendor’s SFTP site. The Vendor would be responsible for
downloading those files and communicating response file errors to the agency.
How long does it take for response files to be generated?
While the time can very, in general, you should see a response file in about 30 minutes after
CareBridge receives a data file.
Is there a row limit for data files?
No.
-------------------- INTEGRATION PROCESS QUESTIONS ---------------------
How far in advance should we send scheduled appointments?
We recommend that you send all scheduled appointments, regardless of how far in advance
they are scheduled.
Will provider agencies have access to the CareBridge Provider Portal? Do they need to
acknowledge authorizations?
Agencies will not have access to the CareBridge Portal, and they will not need to acknowledge
authorizations. Any updates to the data will be made within the vendor EVV system and sent to
CareBridge via the vendor’s SFTP site.
Can Visits and Appointments be sent in the same file?
Yes, visits and appointments for the same Agency TIN/EIN can be sent in the same file.
------------------------------------- RESPONSE ERRORS -------------------------------------
What is a pre-billing validation error?
When CareBridge receives data from a vendor, we will compare that data with data we receive from our MCO partners to ensure EVV compliance. CareBridge will then generate a response file to you listing all the pre-billing validation errors that will need to be corrected before visits data can either be submitted to a state aggregator and/or for claims. Those corrections will need to occur in the Vendor EVV system.
Will all errors for a file/record be processed or will the response file only include the first error?
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If there are file validation errors, no row level validations will be processed.
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If a file passes file validation, all row level validations identified will be returned. A single record with multiple errors would have a row referencing each error.
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Some validations are contingent on other validations and those would only be returned if the preceding validation was successful.
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For example, if a record returns VCR2012 (Visit is not associated to an authorization), then VCR2003 (Billed units exceed max units for Authorization) would not be run until the VCR2012 error is corrected.
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When we send you a file with no errors what will we receive in response?
You will receive a response file with an identical file name as other response files. It will contain the same column headers as other response files, but there will be no file level errors or rows of data listing errors.
What should we do with a response file?
During testing, the vendor should download the response file, review the row or file level errors
indicated, and resubmit a new file. For example, if the error was VCR1017 – CheckInMethod is not valid, the visit data would need to be updated to ensure that a valid value was sent in
the CheckInMethod field (E, I, or M).
-------------------------------- DATA FIELD QUESTIONS --------------------------------
What is the difference between an appointment and a visit?
• Appointments are services to be delivered.
• Visits are services that have already been delivered.
A key difference is that when an EVV service is scheduled, appointment data should be sent and will not have check-in and check-out data and visits will have check-in and check-out data.
Subsequently, when submitted EVV visit data, the ApptID that was originally sent for the corresponding EVV schedule appointment should be re-sent for the visit.
What is the difference between TransactionID and ApptID?
- TransactionID is a field used to reference a record for troubleshooting purposes. We recommend that each record sent to CareBridge have a unique TransactionID as this number can be referenced to identify the record when troubleshooting.
- ApptID is unique to a particular visit/appointment and is used to update that same visit/ appointment with new information over time.
For example:
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An appointment is scheduled for 11/15/2020 for a particular member and this appointment information is sent to CareBridge: with ApptID 000001 and TransactionID 1001.
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Then the visit occurs on 11/15/2020, a new TransactionID would be sent, but the ApptID in
that record would still be ApptID 000001.
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After that, if there is a correction to the resulting claim generated, the same would be
referenced ApptID (ApptID 000001) when updating this information.
It is critical that the same ApptID is used to update previously sent records. This will ensure that duplicate records are not created.
What is the ClaimAction field and how should it be used?
The ClaimAction field is required for a claim to be generated by CareBridge.
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“N” is used when a visit has occurred. CareBridge generates 837 files for all visits that have
ClaimAction “N” that pass pre-billing validation and exports to Availity on a nightly basis.
- “N” is used to change a value of any field on a visit that had previously been claimed.
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“V” is used once a claim has been generated to void the claim.
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Null can be used to send data to CareBridge without generating a claim. Those visits would need to be re-sent at a later time for claim generation.
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New Jersey/Arkansas Only - “E” is used to send EVV data to CareBridge that has previously been
billed by the agency/vendor outside of CareBridge.
Note: Once a visit has been sent with ClaimAction “N”, the claim must reach a terminal status by the MCO prior to re-submitting data (“V” or "N").
How should the ApptCancelled field be used?
If an appointment has been scheduled, but does not occur, then the ApptCancelled should be populated with "C." If data was sent that needs to be removed, populating this field will have that effect.
What are Missed Visits? Are MissedReason and MissedAction required?
MissedVisitReason and MissedVisitAction are required fields if the CheckInDateTime is later than the ApptStartDateTime by more than the value listed in the state-specific CareBridge Technical Specifications.
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When applicable, these fields must be populated with valid code for a claim to be generated for the visit (see state-specific tech specs for details).
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A visit can be considered missed even if the visit occurs.
What is ApptAttestation? Is this field required?
ApptAttestation is a required field; if a member is unable to attest that the visit is completed for any reason including the vendor system’s capacity to capture the field, MA1015 - No Signature (Other) would be used.
What are Late Visits? Are LateReason and LateAction required?
LateReason and LateAction are required fields if the CheckInDateTime and the ApptStartDateTime differ by the amount indicated in the state-specific CareBridge Technical Specifications.
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When applicable, these fields must be populated with valid code for a claim to be
generated for the visit (see state-specific tech specs for details).
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A visit can be considered missed even if the visit occurs.
What are the CheckInMethod and CheckOutMethod fields?
CheckInMethod and CheckOutMethod are used to indicate whether the visit was completed using EVV, IVR, or is a manual visit. Some fields are only required for certain methods.
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EVV Visits (E) must capture latitude, longitude of the for check-in and check-out.
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IVR Visits (I) must capture the IVR Phone number.
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Manual Visits (M) must include a manual visit reason code.
| All CheckInMethods require the following fields: |
All CheckOutMethods require the following fields: |
| • CheckInDateTime • CheckInStreetAddress • CheckInCity • CheckInState • CheckInZip |
• CheckOutDateTime • CheckOutStreetAddress • CheckOutCity • CheckOutState • CheckOutZip |
If the CheckInMethod is “E” (EVV) and we send longitude and latitude, do we also need to send the address?
Yes.
What is the "Rate" field?
The Rate filed, is the billed rate associated with the visit for purposes of calculating the billed amount on the claim.
Does CareBridge provide values for fields? (e.g. ProviderID, VendorName)
The fields for which CareBridge provides input specific values are as follows, and can be found in the state-specific CareBridge Technical Specifications:
| The fields for which CareBridge provides input specific values are as follows, and can be found in the state-specific CareBridge Technical Specifications: |
|
|
• Member Attestation codes |
• Missed Visit Action Taken Codes • MCOID Codes • TimeZone • CheckInMethod • CheckOutMethod |
|
Other fields are dictated based on: |
|
|
• EVV-related data examples - lists are not all inclusive |
• Vendor/Agency determined: – VendorName – ProviderID – ProviderName – MemberID – CarePlanTasksCompleted |
------------------------- FILE VALIDATION QUESTIONS ----------------------------
I have submitted a test file to the SFTP site, why don’t I see a response file?
There are several possible reasons a response file might not be generated. The most common reasons are listed below:
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File delimitation type – Files sent to the SFTP site must be pipe-delimited “|” CSVs. If you send a comma-delimited “,” csv file, the file will fail file validation.
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File Naming Conventions – Files must match the format in the specifications:
e.g. TEST_VISITS_IA_ProviderTaxID_YYYYMMDDHHMMSS.CSV.
If the state abbreviation is missing, or the file sent to the test SFTP site has VISITS, rather than a TEST_VISITS, it will not be processed at all.
I have sent a test file to the SFTP site, why doesn’t the response file have row level errors?
• If a file fails file validation, a single row will be returned in addition to column headers with one of the following file level validation error codes:
• F1001 – Unknown file
• F1002 – Incorrect delimiter
• F1003 – Data cannot be parsed, it may be incomplete or invalid
• F1004 – File is a duplicate
• If a file was sent without any data, the response file will not return any rows of data.
• If a file was sent with data, and there are no row level errors, that means that all visits successfully passed all pre-billing validations.
What do the file level errors mean?
Examples for file level errors (this is a non-exhaustive list):
• F1001 – Files with invalid file naming conventions such as not including state initials, files sent to the test SFTP site that have “VISITS” rather than “TEST_VISITS” (or “TEST_VISITS” rather than “VISITS” in production), or files with an invalid file type (e.g. .xlsx).
• F1002 – comma delimited files.
• F1003 – Files with parsing errors such as quotes within quotes, incomplete rows, or csv files with Excel cell formatting.
• F1004 – Files where all rows are identical to a file previously received by CareBridge.
Do you have a sample response file?
The best way to get a sample response file is to connect to the testing SFTP site and send a file
with test data.
Does CareBridge need both scheduled appointments and completed visits?
Yes, we are requesting that both scheduled appointments and completed visits be sent via
integration; however, if scheduled appointments are not sent in advance of completed visits, it
will not stop claims or visit data from being processed.
What do I send for ApptStartDateTime and ApptEndDateTime if I am not sending scheduled appointments?
If appointments are not scheduled in advance within your system, vendors can send the ApptStartDateTime and ApptEndDateTime to match the CheckInDateTime and CheckOutDateTime.
------------------------------------------------ CLAIMS ------------------------------------------------
Is CareBridge releasing the claim on the same day that we receive the information?
There is a ClaimAction field listed in each state-specific CareBridge Technical Specifications that should be used to indicate that visits should be submitted for claims. If the flag is indicated, those visits will be submitted same day for claims.
Is a manual intervention from the provider necessary to review and release claims?
No.
What is the turn around time that the provider could see the status of a claim?
There is no specific turn-around time, but it should not change from current turn-around time.
How are billed units calculated?
The check-in and check-out times determine the visit units. The billed amount is calculated based on visit units and rate.
How do corrected claims get handled?
Once a claim reaches a terminal status a claim can be corrected by sending "C" in the ClaimAction field along with the corrected data making sure the ApptID is the same (ClaimAction "N" can also be used to indicate a corrected claim). CareBridge will review the visit information and reconcile this against the previously claims visit data. CareBridge will only generate a corrected/adjusted claim if there is a change to the claim billing attributes (e.g., unit increase/decrease, rate increase/decrease, additional visits for same date of service, etc.).
How does the claim adjudication information get to the vendor?
The agency and/or vendor would be able to access claim adjudication information via Availity.