RCPA - Rehabilitation and Community Providers Association
 
 

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Providers Must Prepare for PROMISe
December 17, 2003

Expect PROMISe Letter
Department of Public Welfare (DPW) Secretary Estelle Richman has sent a letter to every provider enrolled in Medical Assistance in Pennsylvania to alert providers of significant changes that will occur when PROMISe (Provider Reimbursement and Operations Management Information System) is implemented. PROMISe is the new claims processing system for DPW and will provide Health Insurance Portability and Accountability Act (HIPAA) compliant, state-of-the-art computer functionality, and information access. Providers should have received this letter from Secretary Richman during the week of December 8. Contact PCPA for a copy of this letter.

PROMISe Trainings Crucial
PROMISe will be implemented on March 1, 2004, therefore preparations already need to be made in order to participate in the new system. PCPA has shared this information several times, however the Department is reporting that a very low number of providers have participated in PROMISe trainings and it is believed that providers are not paying adequate attention to this issue. DPW will continue to offer trainings through the beginning of 2004 and strongly urges providers to attend. An Internet-based training is also available by going to the following web site: http://promise.dpw.state.pa.us/. If providers are not prepared to make the transition to PROMISe, payment for services will be interrupted.

Provider Handbooks Available Online
Handbooks for all providers are now available on the DPW web site at www.dpw.state.pa.us/omap/provinf/omapprovhb.asp. The handbooks have been categorized according to specialty rather than provider types, so be sure the correct handbook is accessed.

PROMISe New Claims Processing System Transition Schedule
Two of the most significant changes necessitated by the transition from the old MAMIS system to the new PROMISe system are the need to submit claims in new formats and the issuance of new provider numbers. The dates below summarize the critical dates related to the change over from the old formats to the new formats.

Paper Claims
Electronic Claims
Last Date
to Submit Claims in Old Format
First Date
to Submit Claims in New Format (PROMISe)
Last Date
to Submit Claims in Old Format
First Date
to Submit Claims in New Format (PROMISe)
February 2, 2004
February 9, 2004
February 12, 2004
March 1, 2004

All dates reflect the receipt of the claim as opposed to the date of the mailing.

Contact the Association with any questions.

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