The ISL Encounter Reporting screen is used to review services, prepare for reporting, and export the report to submit to DHCS. To report ISL encounters, there are 6 general steps to follow:
- Enter ISL encounters
- Prep for submission
- Submit to DHCS
- Document DHCS’s response
- Make corrections as needed
- Resubmit (repeat)
Each of these are described in more detail below.
Enter ISL Encounters
ISL encounters are entered as services into SmartCare. These can be done via direct entry, batch service entry, or the batch service upload process. ISL encounters often use procedure codes that start with “ISL”, but may also occur for billable (CPT/HCPCS) services that are unable to be claimed to Medi-Cal in certain situations per DHCS guidance, including when the client does not have Medi-Cal coverage or the service was delivered in a lockout setting. Some may require a note to be attached while others do not. Some are tracked as minutes, while others are tracked as “units”, often as dollar amounts.
Prepare for Report Submission
Quick Steps:
- Navigate to the ISL Encounter Reporting screen.
- Use the filters as needed to narrow down the records shown.
- Click “Refresh Unsubmitted Encounters” to pull the most recent information from the service data.
- Address the errors by editing the services
The ISL Encounter Reporting screen will provide you information about what errors are expected in response to submitting the data to DHCS. To address these, edit the service in question, then return to the ISL Encounter Reporting screen and “Refresh Unsubmitted Encounters” to pull in your recent changes. This will re-check for errors. Continue to work the errors until you’re ready to submit to DHCS.
You may want to “Export for Review”, which will export the data to a human-readable Excel file.
Submit ISL Report to DHCS
Quick Steps:
- Navigate to the ISL Encounter Reporting screen.
- Use the filters as needed to narrow down the records shown.
- Click “Export for Submission”.
- Save the resulting file and upload it to the DHCS ISL Portal.
Note that the default file name will likely be “Export Data”, so you’ll want to rename this file. Follow the DHCS ISL upload instructions to upload your file.
Upload DHCS’s Response
Note: The Import Response functionality is currently in development. Please use the manual method until further guidance is provided.
Quick Steps:
- Download the response file.
- Navigate to the ISL Encounter Reporting screen
- Click “Import Response” and select the response file you downloaded.
You can also manually mark records as accepted or rejected using the “Manually Accept” and “Manually Reject” buttons.
To undo these manual markings, use “remove acceptance” and “remove rejection” respectively.
Make Corrections
After you’ve determined which records have been accepted and rejected from DHCS, you’ll want to make edits.
Please note that CalMHSA has found inconsistencies between DHCS’s rejections and their guidance. If a record was rejected but you feel that it should have been accepted, submit a bug ticket to the DHCS ISL Portal.
Quick Steps:
- Determine which services were rejected and make edits to those services and/or client demographics to address the rejection reasons.
- Navigate back to the ISL Encounter Reporting screen and select the rejected services you’ve updated and select “Resubmit Reject”.
If there were accepted encounters that you need to modify, edit the service and then use “Mark as Replacement”. This will allow you to resubmit these encounters.
If there were accepted encounters that should not have been reported, select them and click “Mark as Void”.
If you had previously voided an encounter and need to re-add it to a batch, select the record and click “Re-Pickup”.
Resubmit
As corrections are made and new services are entered, resubmit using the steps above.