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1. Overview of Envolve

Envolve is PA Health & Wellness’s portal for:

  • Checking client eligibility
  • Checking service authorizations
  • Creating/submitting assessment
  • Uploading documents
  • Entering notes for client/provider/MCO interactions

We use Envolve to document and show PHW the work we complete with participants. Therefore it is important to use it appropriately

First, Log in to Envolve

Eligibility Check

In order to pull up participant information, we have to search for them in the “Eligibility Check”

  • After logging in, click on “Eligibility” at the top right of the screen

This will bring you to the Eligibility Check.

  • Enter the following to pull up Participant Information:
    • Date of Service – Today’s date (usually goes in automatically)
    • Participant ID or Last Name (found in Function Portal)
    • Participant’s DOB (found in Function Portal)
  • Then, click “Check Eligibility.”

Click on the participant’s name (in blue), to access their Envolve portal information

Note: If you search with incorrect information it will tell you “Pennsylvania Health and Wellness Patient not found”

Double check that you used the correct information as all of our participants are with PHW. 

Participant Information

Participant’s Information is spread across multiple pages. We only work within a few of the tabs shown on the left of the screen

Overview Tab

General Information about the participant

There are 2 bits of important information to review in this tab

  1. Waiver Eligibility 
    • The Green box on the top of the page, with a thumbs up, indicates that the participant is currently eligible for their waiver. 
    • If the box is instead Red, with a thumbs down, the participant may not be currently eligible in their waiver. 
      • Contact your Supervisor before moving forward with any work for this participant. 
  1. Participant’s Address
    • This address must be the address that they are currently receiving services.
      • If it is not (for example if there is a different address in FP), you MUST contact your supervisor and complete a 1768 form to update PHW on the participant’s current address
  • PCP Information will not always be correct or updated. 
    • That is ok, there is nothing for us to do, except make sure we have the correct/updated information in FP. 
Authorizations Tab

Authorizations for services from PHW

**It is better to use the Authorization spreadsheet, emailed to you every day**

  • PHW creates and changes a participant’s authorizations
    • SCs/Amcord makes requests based on the participant’s needs, but they do NOT create authorizations for services. 
  • The list includes:
    • Past and current authorizations
    • Status of each authorization
      • SCs can see whether the services requested and in the participant’s service plan have been approved or denied
  • Click on the blue authorization number for more detailed information on the authorization. This can include:
    • The name of the service provider. 
    • Date the authorization was approved (“Decision Date”)
    • The number of units requested/approved
      • Units are NOT the same as hours. 

Ex. Authorization OPPL0003121 was clicked

Assessments Tab

Specific Documents that need to be completed for various participant interactions

The middle of the page will have blank assessments. Select “Fill Out Now” beside the assessment you are choosing

  • Assessments to know of include:
    1. HRA – DSNP/MMP_V4 – This is the Health Risk Assessment or Dual Eligible Special Needs Plan
      • Completed during Comprehensive Needs Assessments only, including: Annual Contact, Change Events, and NPO visit
    2. Member Contact Assessment LTSS All V5This is complete for every type of contact with the participant.
    3. LTSS Service Request_PA
      • Completed after Comprehensive Needs Assessments
      • Service Coordinator will NOT complete this in Envolve.

DO NOT utilize any of the other assessments in this section unless specifically instructed to do so by PHW or Amcord Leadership.

  • On the right side of the page is all previously submitted sessions. Click on their blue link to review the submitted assessments. 
Document Upload Tab

Where external documents can be uploaded and reviewed. 

Some of the most common documents that need to be uploaded are:

  • PHI-form
  • Prescriptions
  • POA documents
  • Advanced Directives
  • Consent Forms
  • 1768 Forms
  • POHO Documents
  • And More!


Document Naming Convention

Documents uploaded into Envolve MUST follow the following format:
Name of Document (or abbreviation)_Participant last name_Participant first initial_Participant ID#_Date of assessment

Example: 1768_Amcord_E_0123456789_04152021

  • SCs must upload documents into FP before uploading to Envolve, because FP will automatically correct the naming convention for that specific document. 
  • SC can then download the document from FP, with the now appropriate naming convention, and upload it to Envolve. 
  • After clicking on the Document Upload button, you have to do the following:
    • Select the “Document Category”
      • It should always be Long Term Services and Supports, unless specifically asked by PHW or Amcord leadership to do otherwise. 
    • Select the “Document Type”
      •  Choose the appropriate document type from the drop-down list. If you do not know which one to use, ask your supervisor. DO NOT GUESS
Notes Tab

For uploading billable session from Function Portal

  • There are several types of notes listed.  Service Coordinators use only “General Note” and “Member Death”. 
  • To create a new note click “write note” next to the appropriate type.
    • General Note – used to document contact with providers, PHW, or someone other than the participant/POA/authorized rep.
      • Once a new note is opened the Service Coordinator will enter the “note category”(admin note, inbound/outbound call), the “encounter date” (date of the event or interaction), and copy the note from function portal into the text box. 
    • Member Death – is used only when the participant passes away.
      • Once new note is opened the Service Coordinator will enter a response for every question NOT just ones marked as “required”
  • To review previous notes completed click on the blue link on the right side, most recent notes are at the bottom.
ex. blank General Note
ex. blank Member Death Note
Next 2. Member Contact Assessment Training
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