Transcript HP Enterprise Business Template Angle Light 4:3 Purple

Web interChange
Basic Functions
HP Provider Relations
October 2010
Agenda
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Objectives
Indiana Medicaid Web Site
What is Web interChange?
How to Enroll in Web interChange
Administration Menu
Check/Remittance Advice (RA)
Inquiry
– Claim Inquiry
– Claim Submission
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Institutional
• Professional
• Dental
– Eligibility Inquiry
– Password Reset
– Questions
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Objectives
– Become familiar with the Indiana Medicaid Web site
– Know how to enroll to use Web interChange
– Become familiar with Web interChange functions
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Introduce
Indiana Medicaid Web site
Member Tab
– Qualification Guidelines
– Medicaid Programs
– Apply for Medicaid Benefits
– Check Application Status
– Search for a Provider
– Choose a Health Plan
– Presumptive Eligibility
– Pharmacy Information
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Indiana Medicaid Member Web Site
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Indiana Medicaid Member Web Site
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Provider Tab
– Link to the Web interChange
– Provider Enrollment
– Banners – Bulletins –
Newsletters
– Workshop Information
– Provider Education and
Assistance
– News and Announcements
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Indiana Medicaid Provider Web Site
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Indiana Medicaid Provider Web Site
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Provider Tab
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Learn
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
– Obtain and print check/Remittance Advice (RA) information
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How to Enroll
– Access Web interChange from the Indiana Health Coverage
Programs (IHCP) Web site at:
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https://interchange.indianamedicaid.com/Administrative/logon.aspx
– Download the interChange Administrator Request Form
– Complete and mail or fax forms to:
HP Indiana Title XIX
Electronic Solutions Help Desk
950 N. Meridian Street
Suite 1150
Indianapolis, IN 46204-4288
Fax number: (317) 488-5185
Web interChange is free.
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How to Enroll
– Each provider must assign a Web interChange administrator
– 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 a Web interChange 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
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How to Enroll
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How to Enroll
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How to Enroll
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Logon Screen
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Administration Functions
– Create Users
– Update Users
– Reset Passwords
– Reactivate Users
– Administer Groups
– Maintain Provider Profile
– Maintain User Lists
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Administration Functions
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Check/RA Inquiry
Accessing paperless RAs through Web interChange
Three Easy Steps
– Step 1 – From the Web interChange menu, select Check/RA
Inquiry. On the Check/RA Inquiry page, enter the desired search
criteria and click Submit. A list of checks and RAs (most recent first)
displays.
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The link to download the RA displays even when there is no payment
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If no check was issued in conjunction with the RA, the check number displays as
“000000000”
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The Provider/National Provider Identifier (NPI) fields populate based on the user’s
security
Web interChange Basic Functions
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Check/RA Inquiry
Accessing paperless RAs through Web interChange
– Step 2 – Click on the PDF icon to the right of the check number (in
the “Download RA” column)
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The RA opens as a PDF document in a new window
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Downloaded RAs have a Family and Social Services Administration (FSSA)
watermark
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If users wish to save copies of RAs for their records, they can use the “Save a Copy”
feature of Adobe Acrobat Reader
 RAs can also be printed from Adobe Acrobat Reader
– Step 3 – If the desired RA is not displayed, change the search
criteria at the top of the Check/RA Inquiry page
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RAs are available in Web interChange for four weeks
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Check/RA Inquiry
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Check/RA Inquiry
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Claim Inquiry
– Check status of claims
• By member number and date of service
• RA date
• Date of service
– Print proof of timely filing
– Show more claim information
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Review claim explanation of benefit information
– Copy, void, and replace claims
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Claim Inquiry
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Claim Inquiry
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Claim Inquiry
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Claim Inquiry
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Claim Inquiry
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Claim Submission
Institutional billing
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Claim Submission
Institutional billing – header information
– NPI – choose appropriate when applicable
– Member recipient ID (RID)
– Member name
– Patient account number – assigned by the provider
– Attending physician NPI
– Operating Physician NPI (when applicable)
– Other Physician NPI (PMP) – when applicable
– Type of bill
– From date of service
– Thru date of service
– Covered days
– Patient status
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Claim Submission
Institutional billing – header information
– Admission type
– Admission date
– Admission hour – when applicable
– Diagnosis codes
– E code – when applicable
– Principal procedure – when applicable
– Condition code – when applicable
– Value code
– Occurrence code – when applicable
– POA Indicator – when applicable
– Additional codes – when applicable
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Claim Submission
Institutional billing – header information
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Claim Submission
Institutional billing – additional billing codes
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Claim Submission
Institutional billing – additional billing codes
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Web interChange Basic Functions
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Claim Submission
Institutional billing – additional billing codes
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Claim Submission
Institutional billing – additional billing codes
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Web interChange Basic Functions
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Claim Submission
Institutional billing – additional billing codes
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Claim Submission
Institutional billing – additional billing codes
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Claim Submission
Institutional billing – detail information
– Revenue code
– Procedure code and modifier(s) – when applicable
– Date of service
– Units
– Total charge
– Save detail
– Copy/add detail – when applicable
– Submit claim
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Claim Submission
Institutional billing – detail information
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Claim Submission
Professional
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Claim Submission
Professional – header information
– NPI – choose appropriate when applicable
– Postal code or taxonomy – when applicable
– Member recipient ID (RID)
– Member name
– Patient account number – assigned by the provider
– Referring NPI – when applicable
– Certification code – when applicable
– Place of service
– Pregnancy – if applicable
– Last menstrual period – if applicable
– Accident related – if applicable
– Diagnosis code
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Claim Submission
Professional – header information
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Claim Submission
Professional – header information
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Claim Submission
Professional – detail information
– From date of service
– Emergency – when applicable
– Thru date of service
– EPSDT – when applicable
– Place of service
– Rendering NPI
– Procedure code
– NDC information – when
applicable
– Modifier(s)– when
applicable
– Save detail
– Related diagnosis – when
applicable
– Copy/add detail – when
applicable
– Units
– Submit claim
– Total charge
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Claim Submission
Professional – detail information
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Claim Submission
Dental
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Claim Submission
Dental – header information
– NPI – choose appropriate when applicable
– Postal code or taxonomy – when applicable
– Member recipient ID (RID)
– Member name
– Patient account number – assigned by the provider
– Place of service
– Emergency – when applicable
– Accident-related – when applicable
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Claim Submission
Dental – header information
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Claim Submission
Dental – detail information
– Date of service
– Procedure code
– Tooth number – when applicable
– Surface – when applicable
– Units
– Total charge
– Rendering NPI
– Save detail
– Copy/add detail – when applicable
– Submit claim
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Claim Submission
Dental – detail information
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Eligibility Inquiry
– NPI – choose appropriate when applicable
– Postal code or taxonomy – when applicable
– Search
• Member recipient ID (RID)
• SSN
• Medicare ID
• Name and date of birth
– From date
– To date
• Search by individual date of service
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Eligibility Inquiry
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Password Reset
Users may reset their own password utilizing the “Reset Password”
function
Administrators may reactivate a user who is inactive for lack of use (has
not logged on for 90 days)
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Find Help
Resources available
Helpful Tools
Avenues of resolution
– IHCP Web site at www.indianamedicaid.com
– IHCP Provider Manual (Web, CD-ROM, or
paper)
– Customer Assistance
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Local (317) 655-3240
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All others 1-800-577-1278
– Written Correspondence
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HP Provider Written Correspondence
P. O. Box 7263
Indianapolis, IN 46207-7263
– Provider field consultant
• View a current territory map and contact
information online at
http://provider.indianamedicaid.com
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Q&A