Transition to New Fiscal Agent Contrator
In October of 2022, Alaska's Department of Health, Division of Health Care Services announced that it signed a contract with Health Management Systems, Inc. (HMS), a Gainwell Technologies company, to provide Fiscal Agent Services (FAS) to support the Alaska Medicaid Program. These services include:
- Provider and member call center support
- Provider enrollment
- Service authorization: data entry and determination
- Claims processing and resolution
- Training and publications
- Mailroom and data entry
- Finance and accounting assistance
- Electronic data interchange support
- Business analyst and subject matter expert systems support
- Systems development and quality assurance support
The transition from Conduent to HMS is currently anticipated to cutover on April 1, 2023. You should experience no difference in how you contact he Alaska Medicaid Fiscal Agent other than a change in logo and email addresses. P.O. boxes, phone and fax numbers will not change. For more details, please see the Provider FAQs
Providers may refer patients with questions to the Recipient FAQs.
Effective August 15, 2022, claims for Personal Care and Community First Choice Personal Care services will be processed as follows:
- Claims will be reviewed against Electronic Visit Verification (EVV) data submitted to the state EVV aggregator.
- If there is not EVV data in the aggregator to support the claim submitted at the time of adjudication, the claim will be denied.
- New exception codes have been created related to EVV data and will appear on provider remittance advices going forward.
As part of the 21st Century Cures Act, Alaska implemented Electronic Visit Verification (EVV) on January 1, 2021, for Personal Care and Community First Choice Personal Care services. This required providers to electronically collect required data at the time-of-service delivery and not submit a claim for payment under 7 ACC 125.010 – 7 AAC 125.199 without also submitting the EVV data to support the claim.
For additional information, please see Alaska Medicaid Billing Guidance: Personal Care and Community First Choice Personal Care Services Require Electronic Visit Verification on the Provider Updates page.
Questions? Please contact EVV Project Team, Department of Health at 907-269-3666 or by DSM at firstname.lastname@example.org.