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GeneralWill AMH be able to give service providers any data back?
AMH will be setting up a web based reporting system for our counties and providers to access, run reports and view data. It won't be fully operational until 2016, but providers can request reports now. See http://www.oregon.gov/oha/amh/mots/Pages/Data-Requests.aspx for more information.
GeneralIf we don't have to do termination "forms", how do you know outcome information?
Within the Data Submission Guide is a data point titled “Client Treatment Status”. This information will provide us the status of the client and through status updates and non-Medicaid service data AMH will be able to generate information regarding outcomes.
Non-Medicaid ServicesWhat particular non-Medicaid service data will need to be submitted?
A limited amount of data for non-Medicaid services is required. This information will assist us in capturing data that we currently cannot report to the legislature and federal government and to track outcomes on the clients. More information regarding non-Medicaid services is available within the document; “Policy on Non-Medicaid Service Data Submission to AMH” located at: http://www.oregon.gov/oha/amh/mots/internalresources/Policy%20on%20Non-Medicaid%20Service%20Data%20Submission%20to%20AMH.pdf.
Non-Medicaid ServicesNon-Medicaid service data: What are the expectations for submission? Quarterly or when a service  is rendered?
AMH would like to see non-Medicaid Service data, services that are not funded by Medicaid, submitted shortly after the service is rendered. The data must be submitted every 30 days and is due by the 15th of each month for the non-Medicaid services provided during the previous month.
Non-Medicaid ServicesAs far as encounter data, will we continue to submit our Medicaid encounter data as we do now and  then submit the same data to another place?
No. Your Medicaid claims will continue to be submitted to the same place. Do not submit Medicaid services to MOTS, as we can pull it from the MMIS system. The non-Medicaid service data that MOTS will collect is for those services you provide that are not paid with Medicaid funds or through Medicaid billings, but are paid for with public funds.
Non-Medicaid ServicesWho do you consider to be a non-Medicaid client and required to submit non-Medicaid service data  to AMH?
Actually, it's really non-Medicaid funded services. So, you might have a client that is OHP eligible, but some services that are provided aren't covered. These are the non-Medicaid service data we would like to collect. More information on the non-Medicaid service data can be found at http://www.oregon.gov/oha/amh/mots/internalresources/Policy%20on%20Non-Medicaid%20Service%20Data%20Submission%20to%20AMH.pdf
GeneralWill the status data submission be quarterly? Meaning we would only send the data 4 times a  year? So it would be possible that a client was admitted, had a status change(s) and discharged in the  same period?
AMH is asking for data at admission (enrollment), and updates to that data to be sent to AMH at least on a quarterly basis. And yes, a client could be opened and complete treatment in a very short period of time. Status data can be submitted more frequently than every 90 days in order to show improvement over time.
GeneralSuppose somebody is being treated by a provider in county A because they live there, but they work  in county B and want to take a class in county B for convenience. How does this get submitted?
If services are being paid for with public funds, the entity (CMHP or provider) that is responsible for making sure those services are provided must make sure those services, where ever they may occur, are reported. Use of the County of Responsibility field will help AMH better understand who’s paying for those services.
GeneralAre we required to submit data if Medicaid is not primary, but secondary payor?
Status data is required for all clients whose services are paid for with public funds, including Medicaid. If a service is provided, and it is paid for with public funds other than Medicaid, please submit non-Medicaid service information as well.
Non-Medicaid ServicesHow do you define non-Medicaid Services?
Non-Medicaid services are any publicly funded services that aren’t funded in any way by Medicaid. So this would include grants, contracts with AMH, write offs, etc. The only thing that’s not included is if a client is fully self-pay or has private insurance. For those, you do not need to submit that data (status or non-Medicaid service data), unless they are a required reported service such as methadone or DUII. Please see the policy on Non-Medicaid Services at: http://www.oregon.gov/oha/amh/mots/internalresources/Policy%20on%20Non-Medicaid%20Service%20Data%20Submission%20to%20AMH.pdf for help on deciding which services should be entered into MOTS Client Entry.
GeneralDo foster care services need to report status data?
Adult Foster Home (AFH) clients do not need to be reported in MOTS at this time, as no MH or A&D treatment is given within the home. Clients in Residential Treatment Facilities (RTF), Residential Treatment Homes (RTH), and Secure Residential Treatment Facilities (SRTF) DO need to be reported in MOTS.
GeneralHow do we know if a client is a PSRB client? Is it just the referral code?
This will be picked up from the Legal status data element.
GeneralHow does MOTS track multiple admissions? For example, if a client comes in through outpatient,  then has a crisis, then an involuntary commitment, all within the 90 day period, how would AMH know?
New admits, crisis and involuntary commitments events must be submitted within 7 days of event. This information is not considered a status update, but rather an event. This is defined more clearly in the MOTS Reference Manual located at http://www.oregon.gov/oha/amh/mots/internalresources/MOTS%20Reference%20Manual.pdf.
OWITS/EHRWill CMHPs be able to see dashboard reports with clients they serve or clients they pay for or both?
As a CMHP, if you are paying for services you will be able to see the service details, because the county of responsibility data field will allow this. You will also be able to see the services you provide as a CMHP. Dashboard reports will be available in spring 2016.
Non-Medicaid ServicesIn the Service data, are entities supposed to submit the full usual and customary charge? Or the  UCC minus the client’s adjusted fee schedule?
Submit the full amount that would be charged to someone paying out-of-pocket.
OWITS/EHRCan a provider submit data under multiple provider IDs?
Each provider will register within the MOTS system with up to two Oregon Medicaid Provider IDs. These IDs are the number you will use to submit your data and by which your data will be tracked.
OWITS/EHRWe have 2 Medicaid numbers (one MH and one AOD) and then other provider numbers for different  services (child MH, adult MH, AOD, DUII, ICTS). Do these go away?
We are now only requiring one Oregon Medicaid Provider number, however an entity can submit up to two. Provider numbers for different services will no longer be necessary or used. We will track service using different data elements and information on how we will track these services is available within the MOTS Reference Manual located at http://www.oregon.gov/oha/amh/mots/internalresources/MOTS%20Reference%20Manual.pdf.
Client EntryIs there a limit to the amount of staff that has access to the Client Entry online application?
No, there is no limit. It will be up to your organization on how many staff will have access. Each organization will have an Agency System Administrator to determine this and set up access for the staff. Each staff with access will be assigned a secure access ID, etc. with roles and responsibilities assigned to them to determine how much access they will have to the system.
GeneralHow will MOTS Client Entry work with existing EHRs?
MOTS Client Entry is one data submission method. If you already have an EHR and can generate a file to send to us from that EHR that contains all necessary data, you do not need to use MOTS Client Entry. When you register in MOTS, tell us that you will be using EDI.
Client EntryHow is it all going to come together between clinical and clerical in entering the MOTS client entry  data?
Some agencies are going to have their clerical staff enter the administrative information, then Save as Draft, and have their clinical staff enter the clinical info afterwards and then submit. If you are going to have just one person enter all the information into MOTS Client Entry from the counselors, you might use the MOTS Client Entry Cheat Sheet which is available on the COMPASS website. It’s available in PDF or Word format, so that you can modify it as needed. Some agencies have chosen to let the counselors enter the data into MOTS Client Entry. Which method you decide to use in your agency depends on your current and future business processes.
GeneralI don't understand why it is being left up to the agency to determine how we set ourselves up (re:  agency/facilities). It seems that this choice will ensure inconsistency.
We are asking for each Agency to have a System Administrator who will set up the Agency and its facilities, as well as enter the users for each. AMH wants to give providers the ability to add users, remove users, assign users to certain facilities, add new facilities, etc. This gives the providers more control over how their data is entered.
General Can we start with manual entry (Client Entry) and move to EDI submission later?
Yes, you can use MOTS Client Entry for now, until your EDI submission process (sending electronic data from your own EHR) is ready. When you are ready to change your submission method, you will need to contact your system administrator and have them make the request in MOTS Admin.
Non-Medicaid ServicesWhy are there no business rules to prevent discrepancies between non-Medicaid services provided  and the assigned diagnosis codes. Ex: A Methadone maintenance service can be submitted for a client w/o  opiate diagnosis.
As we continue to use the new MOTS Client Entry system, we want to hear from providers using the system. We want to hear your ideas on how to make it better. Please send your suggestions to mots.support@state.or.us. While we want the system to be easy to use and have as few restrictions as possible, we will be adding more business rules over time to deal with inconsistencies or discrepancies. Thank you for your help.
EDIOur agency is concerned about the financial burden it may cost to upgrade our existing EHR to meet  the new data element requirements and transmission.
AMH understands that this change to the data and the way data is collected will take some effort by the provider and CMHP. COMPASS staff is willing to meet and discuss any concerns regarding these efforts. Remember, there are three different ways to submit data, including a low cost Electronic Health Record. AMH wants to work with providers to ensure they choose the best method and that the method has limited impact on the business. Incentive payments are also available to CMHPs that meet the reporting requirements.
EDIIs the EDI (batch) submission similar in structure to the HIPAA 5010 formats such as 837, 835, 270,  271, etc.?
Both the status and non-Medicaid service files need to be delimited flat files. Information on the file extracts are available within the AMH File Transfer Specifications for Electronic Health Records document located on the MOTS web page at: http://www.oregon.gov/oha/amh/mots/internalresources/EDI_Batch_File_Specifications_and_Certification.pdf
EDIDo you have requirements for the text like client name, etc. For instance I understand that All Caps  was required at some point.
The Data Dictionary provides you with the specification and rules for submitting data. The document can be found on the MOTS web page at: http://www.oregon.gov/oha/amh/mots/internalresources/Data_Dictionary_and_Business_Rules.pdf
EDIAre openings to be reported separately from status updates?
Yes. New enrollments (openings) must be submitted within 7 days of the first active treatment episode. You would then be required to submit a status update on this client at least every 90 days.
EDIOn the status updates, what EHR data changes constitute the need for an update? When we do  report changes, will we just report the values that changed, or do we resubmit the whole file and your  system will tease out the changed values?
Just re-submit the whole file and we can tease out what has been changed. Files can be reported at the end of each quarter or as often as your organization would like.
EDICan we use the Client Entry web data submission method until we can get the EDI up and running?
Yes, you may use the Client Entry web tool until you get your electronic health record system implemented and the EDI submission process is successful.
EDIDo existing clients need to be re-opened in the new system?
No, when a client returns for services, you would just reactivate them within your systems, using the data field of “Client Treatment Status” as active. Hopefully, all the past demographic information on the client is still within your record system and the provider would just update any of the data fields that have changed and submit a status update.
EDIRelated to a person's specific case number that we are supposed to use when they return, can the field  be moved to have 7 (or 8) digits? We are trying really hard to not duplicate numbers, with changes to  EHR, this is very hard.
The Client ID field is alphanumeric and can accommodate up to 15 characters in length. When a client returns, the same client ID should be used for the individual.
EDIShouldn't you have MH only, Addictions only, and MH and A&D options?
For Mental Health only clients, complete the client profile and Behavioral Health detail. For Addiction only clients, complete the client profile, Behavioral Health and Addictions Detail. For Dual Diagnosis clients, we will use all three.
EDIAre Crisis and Involuntary records additional to the behavioral health status record which may be  already existent for some clients who are engaged in BH outpatient treatment and require either or both  of these services?
If an existing client is seen for a MH Crisis or Involuntary Service, a MH Crisis record or Involuntary Service record will need to be submitted. Both records are considered as separate events from regular treatment.
EDIIf a client is seen for MH Crisis or Involuntary services, are you expecting providers to include 2+ status records in a file?
No, only one status record would be submitted within a file for a client. However, if a client is seen for a MH Crisis and/or Involuntary Service, then a provider must submit a MCD and/or INS segment for these events also.
EDIWill subcontractors set up EDI interface directly or do they submit to Mental Health Provider/CCO?
Subcontractors of the CMHPs/CCO’s are required to interface directly with MOTS.
ICD-10 and DSM-VRegarding Diagnosis - Are you planning to require or allow DSM V?
DSM IV & DSM V will not be used; however, the ICD-10 codes listed within the DSM V may be used. AMH moved from ICD-9 to ICD-10 in October 2015, the same time as MMIS.
EDICan an agency submit data more often than 90 days and will AMH capture information each time?
EDIIf a client has a crisis and is an existing client, can they be treated like regular treatment and the  provider would not have to submit a crisis record?
We need to capture separately and outside of regular treatment the crisis event. AMH receives and distributes funds for crisis services and needs to track by county where crisis events are occurring to help us better plan for service coverage. We recommend that you update your system to do this.
ICD-10 and DSM-VDSM-V is doing away with the 5 Axis which includes the GAF score, what impacts will this have on MOTS?
The GAF score is now optional.
OWITS/EHRCan OWITS be accessed from any computer with internet access?
OWITS can be accessed from any computer connected to high speed internet with a modern web browser, such as Internet Explorer version 10 or higher, Mozilla Firefox, Google Chrome, Safari, and others.
OWITS/EHRAre you aware of any problems running OWITS on the Windows 7 operating system? What  about Windows 8?
There are no known issues with Windows 7 or Windows 8. OWITS is compatible with most modern browsers and operating systems, including smartphones with web browsers.
OWITS/EHRIs the access secure even when using a computer outside of the office?
Yes, OWITS is accessed through a secure and encrypted portal. The security is at the same level as that of your bank and is actually stronger than the minimum required encryption standard for the federal government's "top secret" files. For OWITS you will have to use a user name, password and a PIN to access the secure website. Even though the system is secure, we still recommend that providers adhere to HIPAA standards regarding accessing patient data outside the office.
OWITS/EHRHow does a user get access to their clients’ information in OWITS?
OWITS uses role based access to limit and allow access to the data you will need for your job. A system administrator will work with you to be sure you have the access you need.
OWITS/EHROur agency has several facilities, but staff should only be able to view information in their  facility. Is it possible to limit access to one facility?
Yes, staff can be limited to data in one facility.
OWITS/EHRCan a system administrator log you out?
Yes, if necessary the system administrator can log you out. This is necessary if you close the browser before logging out and then try to log in again from another computer or after resetting a Wi-Fi connection because OWITS sees the user as still logged in and will not allow you to log in again.
FEi (Focused eHealth Innovations) is the contractor for the OWITS System. FEi is a leading IT company specializing in Federal and Local Government data system solutions. For the past decade they have maintained a leading position in providing programming and consulting services in their primary areas of expertise—Behavioral Health Data Systems, and Clinical Trials Software Solutions for institutional systems of care. For more information, visit the company web site at http://www.feisystems.com/.
OWITS/EHRHow does OWITS benefit providers?
Mental health treatment and substance abuse counseling providers who choose to use OWITS will benefit because OWITS: - Is free until July 1, 2016. - Contains a behavioral electronic health record (EHR). - Is proven current technology. - Offers the ability to collaborate with other providers for client services (using an electronic referral) or with other states for system improvements. - Includes HIPAA compliant security and privacy notifications. - Is flexible and modifiable. - Is interoperable with other systems. - Will allow providers to avoid duplicate MOTS data entry. - Data can be used to improve outcomes. - Offers improved efficiency in tracking patients and services. - Is capable of budget tracking. - Improves data integrity. - Can improve billing processes. - Provides secure access to personal health records. - Is web–based. - Offers one-source reporting. - Contains a voucher system for the ATR4 grant. - Meets current federal minimum user guidelines.
OWITS/EHRWhat are the primary OWITS modules?
OWITS offers all of the essential modules for collecting client demographics and administering clinical services. Here is a snapshot of the more frequently used modules, however many more are available within OWITS. - Client Profile - Intake - Screenings and Assessments - Admission - Program Enrollment - Progress and Encounter Notes - Discharge - Consent (ROI) and Referral - Treatment Plan - Progress Notes - Group Notes - Drug Test Results
OWITS/EHRWhat if providers want a new module or a system change?
Providers are encouraged to make requests and suggestions regarding adding new modules or making useful changes to OWITS. Change requests should be submitted to the state via email (owits.support@state.or.us) or the OWITS Forum (http://owits.boards.net). The state will implement some changes. If it is determined that the change would not be widely beneficial or is not cost-effective but would otherwise not cause any problems, then providers have the opportunity to volunteer to pay for the change themselves, individually or collaboratively. Providers also have the opportunity to work through the OWITS Users Group (OWUG) to discuss proposed changes.
OWITS/EHRIs there a warning or flag to show that users are in a non-production site, so they don’t  inadvertently key in protected health information (PHI) in the test/training site?
The training environment displays “Training” in the upper left corner (the production environment does not). Production and training sites require a different user name. Due diligence will have to be used at all times to ensure users are in the appropriate site and do not key PHI in the test/training site.
OWITS/EHRDoes the system track deletions from the electronic health record? Is there the ability to  review audits or history of those changes?
Yes, deletions, changes, additions, and views to all of the modules are tracked, in addition to what user made the changes.
OWITS/EHRCan certifications and licenses be tracked by the facility?
Yes, certifications and licenses can be tracked at the Agency level within OWITS.
OWITS/EHRCan you search for clients through the scheduler?
Yes, you can search for clients through the scheduler.
OWITS/EHRIs there longitudinal checking of chart reviews to remind staff when reviews are due?
Yes, there is the ability to have staff reminded that a specific review must be done, using either in-system alerts or email susbscriptions to custom SSRS reports.
OWITS/EHRCan you add issues to the list of reasons a person is seeking services?
Yes, you can add to the list of issues that a person is seeking services.
OWITS/EHRAre all five axes included for diagnosis?
They were for clients admitted prior to 10/1/2015. OWITS now includes the three DSM-V diagnostic categories and the ICD-10 diagnosis codes and descriptions.
OWITS/EHRIn the Progress Note, is time included for the service provided?
Yes, there is the option of adding the time. This data element is required for some services, optional for others.
OWITS/EHRCan the drop-down menus be changed for specific program or provider only or will all users see  the same drop-down options?
Changes made to drop-down menus are seen by all users. However, many changes can be made that do not adversely affect (and may benefit) other users.
OWITS/EHRCan clinicians write progress notes if the treatment plan has not yet been signed off?
Yes, progress notes can be created prior to the treatment plan being signed off. It is even possible to record notes before the client engages in treatment or after the client has left treatment.
OWITS/EHRIs there a flag in the system if a client is noted as an IV drug user and/or pregnant?
Yes, there are queries already set up to pull and report this information, and custom reports can be written as needed.
OWITS/EHRIs the consent in the EHR a consent-to-treat form?
No, there is no consent-to-treat form in the EHR. It does, however, allow users to note if and when a consent-to-treat form was signed.
OWITS/EHRWhat about billing?
OWITS contains a billing module that works for Medicaid, self-pay, and private insurance, using the CMS1500 form and/or 837/835 file transfers.
OWITS/EHRHow much will OWITS cost after July 1, 2016?
Exact amounts have not yet been determined, but based on current usage, it is estimated to cost $1250 per agency per month.
OWITS/EHRWhat if I want to switch from OWITS to MOTS Client Entry or to another EHR?
AMH staff will work with your agency to facilitate any such transition. It may be possible to electronically export data from OWITS and import it into another EHR.
OWITS/EHRIs OWITS limited to use only by publicly funded treatment providers?
It was limited at its initial implementation, but that limitation has recently been removed. OWITS is available for any mental health or substance abuse treatment provider in Oregon as long as that provider is willing and able to pay its share of the support and maintenance costs that will be required after July 1, 2016.
OWITS/EHRIf there is an assessment missing from the EHR can it be added?
Yes, assessments can be added; however, there may be an additional cost to do this.
OWITS/EHRCan providers scan current paper records into OWITS?
OWITS can accept up to two documents (of any file type), up to 10mb each, per client. They are securely stored and available for download. This capacity may be expanded in the future.
Client EntryShould we complete the Involuntary Service form for PSRB clients?
Involuntary Services are not for PSRB clients. It is only used for civil commitments.
Non-Medicaid ServicesWhere can I find a description of procedure codes to be sure I'm coding non-Medicaid Services correctly?
Current Procedural Terminology (CPT) Codes - You can find options for buying or accessing these codes online. Healthcare Common Procedure Coding System (HCPCS) - You can find options for buying or accessing these codes online.
GeneralShould I use the Provider Enrollment forms on the MOTS web site or the forms on the MAP Provider Enrollment web site to apply for a Medicaid Provider Number?
If you will only use the Medicaid Provider number to submit data to MOTS, use the forms available on the MOTS web site to apply for a non-Payable Medicaid Provider number and return them to MOTS. In the future, if you decide to bill Medicaid/OHP, you will need to contact MAP Provider Enrollment at 1-800-422-5047 or provider.enrollment@state.or.us for instructions on changing your non-Payable number to a Payable Medicaid Provider number. If you know ahead of time that you will be billing Medicaid/OHP, please use the forms on the MAP Provider Enrollment web site and send them directly to MAP. Their web site is http://www.oregon.gov/oha/healthplan/Pages/providerenroll.aspx
GeneralDoes Respite count as a Crisis in MOTS? / How do I enter Respite and Respite services in MOTS?
No, Respite is not considered Crisis for MOTS purposes. The Crisis should be submitted as a Crisis Event and clients receiving Respite will be submitted as 'Active' clients with an Admission Date (Client Profile and Behavioral Health Detail records). Respite services need to be billed to Medicaid or submitted as non-Medicaid services to MOTS, whichever is appropriate.