HCSIS Compare

The HCSIS Compare process will review the consumer information in Provider Management to HCSIS. The report will compare facility/location, service codes, units, effective dates, and rates. The report will show each item that doesn't match. Differences should be reviewed and corrected before the billing is submitted.

We recommend this process be completed weekly to stay on top of authorization changes and reduce the number of denied claims.

Download HCSIS Service Auth Files

REQUIRED STEP:  You must download the files from HCSIS and save to your computer.

  1. Log into HCSIS.
  2. Navigate to the service authorization screen (Tools menu > Notices > Service Authorization Notice)
  3. In the filter section, download the file FOR EACH COUNTY you work with.
  4. Save the file as a .csv to your computer.
  5. If you work with multiple counties, you can combine all the county csv files into one csv file. If you do not combine into one file, then you will need to run the HCSIS Compare process multiple times/review multiple reports.

HCSIS Compare Process

NAVIGATION:  ANALYSIS menu > HCSIS Compare

  1. In the SELECT FILE field, click the paperclip and navigate to the saved file on your computer.
  2. Select the .csv file that you downloaded from HCSIS.
  3. Enter the begin and end date, typically the standard fiscal year - 7/1 through 6/30.
  4. If there is a county column in your service authorization file, check the box ‘County column inserted to csv’.
  5. Place a check mark in the NOTIFY box and click the PROCESS button.  
  6. Once the file has been uploaded to the system, you will receive a prompt that the process is complete.  Click OK.
  7. A report will be displayed to show any variances from HCSIS and the system. It is important to carefully review and fix these items.

Review HCSIS Compare Report

After the HCSIS Compare process completes, a report will generate showing you any differences between HCSIS and Provider Management. The report will be broken into these sections: 

  1. Error Finding Match 
    1. Consumer was not found in HORIZON - add new consumer 
    2. Service Plan is in HORIZON not HCSIS - delete service authorization if it is not valid
    3. The facility fee line was not found in HORIZON - update the Facility Master Fee for Service tab to include the service code
    4. The service plan was not found in HORIZON - update the individual's service authorization
  2. Record Found
    1. All service details match in HCSIS and Provider Management
  3. Record Found - consumer line is highlighted in yellow.  Something is different between HCSIS and Provider Management for the individual highlighted. Review and correct the difference.
    1. RATE - if the Horizon column is different than the Promise column, update the rate in the Facility Master
    2. UNITS - if the Horizon column is different than the Promise column, update the individual's service authorization
    3. START DATE - compare the dates to the individual's service plan effective date; update the service authorization to match Promise
    4. END DATE - compare the dates to the individual's service authorization end date; update the service authorization to match Promise
  4. After you review the errors and correct, run the HCSIS Compare process again (step 2). 
  5. Keep repeating until the reports shows all consumers as Record Found and nothing is highlighted in yellow.

VIDEO:  HCSIS Compare

8/2024

NEED MORE HELP?  Submit a ticket to the Help Desk or call (814) 535-7810 or (800) 889-3388