03-23-05 october 2006 web interchange - basic presentation presented by the eds provider field...
TRANSCRIPT
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03-23-05October 2006
Web interChange - Basic PresentationWeb interChange - Basic Presentation
Presented by the EDS Provider Field Consultants
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page 2Web interChange - Basic Presentation October 2006
AgendaAgenda
• What is Web interChange?
• How to Enroll in Web interChange
• Overview
• Verifying Member Eligibility
• Check Write
• Web interChange Claims Submission– Institutional
– Coordination of Benefits
– Professional
– Dental
• Claim Inquiry
• Questions
Welcome and Announcements
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page 3Web interChange - Basic Presentation October 2006
What is Web interChange?What is Web interChange?
• Web interChange is an interactive Web application that allows providers to:
- Submit claims.
- Submit voids or adjustments.
- Review processed claims.
- Verify members eligibility.
- Inquire about previously received payments.
- Submit prior authorizations (if applicable).
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page 4Web interChange - Basic Presentation October 2006
• Access Web interChange from the Indiana Health Coverage Programs (IHCP) Web site at: https://interchange.indianamedicaid.com
• Download Web interChange enrollment forms.• Complete and mail or fax forms to:
EDS Indiana Title XIX
Electronic Solutions Helpdesk
950 N. Meridian Street
Suite 1150
Indianapolis, Indiana 46204-4288
Fax number: (317)488-5185
• Send original enrollment forms by mail, even if sending them by fax.
• Web interChange is free.
How to EnrollHow to Enroll
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page 5Web interChange - Basic Presentation October 2006
• Each provider must assign an Administrator to oversee the daily functions of your individual practice or group.
• In addition to the enrollment form, providers must send a note of acknowledgement on company letterhead indicating the owner approves the person completing the request form as an Administrator for the organization.
• By signing, the owner acknowledges that he or she has read and understood the document and agreed to the terms and conditions as they describe the role that the administrator will perform.
Enrollment RequirementsEnrollment RequirementsAdministrator
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page 6Web interChange - Basic Presentation October 2006
OverviewOverviewWeb interChange Logon Screen
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page 7Web interChange - Basic Presentation October 2006
OverviewOverviewWeb interChange Home Page
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page 8Web interChange - Basic Presentation October 2006
Verifying Member EligibilityVerifying Member EligibilityEligibility Inquiry Window
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page 9Web interChange - Basic Presentation October 2006
Verifying Member EligibilityVerifying Member Eligibility
The following enhanced member-related features are available through Web interChange:
• County caseworker, county information, and case identification numbers
• Detailed TPL information
• Online TPL update requests
Note: These features are not available through the Automated Voice Response (AVR) or the OMNI swipe machine.
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page 10Web interChange - Basic Presentation October 2006
Check WriteCheck WriteCheck Inquiry Window
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page 11Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing
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page 12Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Header Information
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page 13Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Additional Billing Codes
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page 14Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Diagnosis Information
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page 15Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Procedure Information
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page 16Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Condition Code Information
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page 17Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Occurrence Code Information
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page 18Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Occurrence Span Information
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page 19Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Value Code Information
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page 20Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionAttachment Information
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page 21Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Attachment Information
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page 22Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Note Information
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page 23Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Note Information
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page 24Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionBenefit Information
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page 25Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Benefit Information
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page 26Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Benefit Information
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page 27Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Benefit Information - Additional
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page 28Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Detail Information
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page 29Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Detail Benefit Information
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page 30Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionCoordination of Benefits Information (COB)
• Medicare crossover claims require:
– Payer ID and Payer Name
– Subscriber name, Primary ID, Relationship Code, Gender, and date of birth
– Claim Filing Code, MA or MB
• Third Party Liability (TPL) claims require:
– Payer ID and the Payer Name is the name of the TPL insurer with no spaces
– TPL/Medicare Paid Amount
– Subscriber name, Primary ID, relationship code, gender, and date of birth
– The Claim Filing Code is not used
A quick reference guide is available to assist with claims submission. Locate it from the HELP option.
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page 31Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionMedicare Payer IDs for Crossover Claims
• Obtain a complete list of Payer IDs from the following Web sites:
– IHCP Home Page at www.indianamedicaid.com
– Coordination of Benefit instructions on Web interChange
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page 32Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional Billing
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page 33Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional Billing – Header Information
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page 34Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional Billing – Detail Information
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page 35Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional and Dental Attachment Information
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page 36Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionDental Billing
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page 37Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionDental Billing – Header Information
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page 38Web interChange - Basic Presentation October 2006
Web interChange Claims SubmissionWeb interChange Claims SubmissionDental Billing – Detail Information
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page 39Web interChange - Basic Presentation October 2006
Claim InquiryClaim InquiryClaim Inquiry Window
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page 40Web interChange - Basic Presentation October 2006
Claim InquiryClaim InquiryClaim Inquiry Window Copy Function
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page 41Web interChange - Basic Presentation October 2006
Claim InquiryClaim InquiryClaim Inquiry Window Copy Function – Show Me More Button
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page 42Web interChange - Basic Presentation October 2006
Claim InquiryClaim InquiryClaim Inquiry Window Copy Function – Old Claim ICN Information
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Claim InquiryClaim InquiryClaim Inquiry Window Copy Function – New Claim ICN Information
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QuestionsQuestions
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03-23-05October 2006
EDS950 N. Meridian St., Suite 1150Indianapolis, IN 46204
Presentation by EDS Provider Field Consultants
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