Developmental Programs Provider Billing and Payment

In order for Office of Developmental Programs (ODP) direct service providers to receive payment for Waiver-Funded services rendered, they are required to submit their claim transactions through PROMISeTM (Provider Reimbursement and Operations Management Information System in electronic format). PROMISeTM is Pennsylvania’s dedicated claims processing system. PROMISe™ interfaces with the Home and Community Services Information System (HCSIS) to process Home and Community Based Service (HCBS) claim invoices for ODP.

The term "claims processing" is generally used to describe the series of activities and processes that occur systematically, based on claim criteria, to facilitate the accurate adjudication of claim data received by PROMISe™. Claim payments are dependent on the provider’s ability to submit a claim successfully in order to ensure payments occur in a timely manner. In order for a provider to submit a claim successfully and be approved for payment, it is important that the provider understands the ODP billing process and rules surrounding it. The Provider Billing and Payment section contains billing, payment, and claim’s resolution resources specific to ODP. These resources support independent self-resolution activities by the provider. ODP strongly encourages direct service providers to attempt self-resolution of their claim errors.

ODP specific billing, payment, and claim resolution provider resources are stored in the Provider Information Center (PIC). Please click on the following link to access the PIC: http://pic.odpconsulting.net/. Once you reach the PIC homepage, registered users should click on the link titled Provider Billing and Payment. You will be redirected to another page with the same link name. Please click this link next. At this time, you will be asked to login. Enter your Username and Password, which are case sensitive. After logging in successfully, you will enter the Provider Billing and Payment site, which lists the provider billing resources currently available.

New users to the PIC will need to complete a brief registration before the information stored in the PIC can be accessed. From the PIC homepage, scroll down until you see the section on the right called "Registration". Next, click on the web page link titled "New User Registration". Please record your Username and Password to login to the PIC in the future. The password will not be included in the confirmation email that will be sent when the request is processed (please allow up to 2 business days for the request to be processed). Once the registration is complete, you can access and update your account information, including changing/personalizing your password, by clicking the Update Profile link on the website. Once you receive the confirmation e-mail indicating you are a registered user, please follow the steps outlined in the previous paragraph to navigate to the resources stored in the PIC under the Provider Billing and Payment link.

Please visit the PIC often to obtain the latest version of provider billing resources and to view new resources currently under development. For assistance regarding claim issues, please contact the ODP Claims Resolution Section:

Toll Free Number: (866) 386-8880
Business Hours: Monday through Thursday 8:30 am to 12:00 pm and 1:00 pm to 3:30 pm
E-mail Address: ra-odpclaimsres@pa.gov

Remittance Advice Alerts/PROMISe Banner Page for information regarding processing of billing and payment issues.