HP Provider Relations October 2010 Web interChange Basic Functions.

HP Provider RelationsOctober 2010

Web interChange Basic Functions

Web interChange Basic Functions October 20102

Agenda– 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

• Institutional• Professional• Dental

– Eligibility Inquiry– Password Reset– Questions


Objectives

– Become familiar with the Indiana Medicaid Web site

– Know how to enroll to use Web interChange

– Become familiar with Web interChange functions

IntroduceIndiana 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


Indiana Medicaid Member Web Site


Provider Tab

– Link to the Web interChange

– Provider Enrollment

– Banners – Bulletins – Newsletters

– Workshop Information

– Provider Education and Assistance

– News and Announcements


Indiana Medicaid Provider Web Site


Provider Tab

LearnWeb 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


How to Enroll

– Access Web interChange from the Indiana Health Coverage

Programs (IHCP) Web site at: • https://interchange.indianamedicaid.com/Administrative/logon.aspx

– Download the interChange Administrator Request Form

– Complete and mail or fax forms to:HP Indiana Title XIXElectronic Solutions Help Desk950 N. Meridian StreetSuite 1150Indianapolis, IN 46204-4288Fax number: (317) 488-5185

Web interChange is free.

https://interchange.indianamedicaid.com/Administrative/logon.aspx


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


How to Enroll


Logon Screen


Administration Functions

– Create Users

– Update Users

– Reset Passwords

– Reactivate Users

– Administer Groups

– Maintain Provider Profile

– Maintain User Lists


Administration Functions


Check/RA InquiryAccessing 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.

• The link to download the RA displays even when there is no payment

• If no check was issued in conjunction with the RA, the check number displays as “000000000”

• The Provider/National Provider Identifier (NPI) fields populate based on the user’s security


Check/RA InquiryAccessing paperless RAs through Web interChange

– Step 2 – Click on the PDF icon to the right of the check number (in the “Download RA” column) • The RA opens as a PDF document in a new window

• Downloaded RAs have a Family and Social Services Administration (FSSA) watermark

• 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 • RAs are available in Web interChange for four weeks


Check/RA Inquiry


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• Review claim explanation of benefit information

– Copy, void, and replace claims


Claim Inquiry


Claim SubmissionInstitutional billing


Claim SubmissionInstitutional 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



– 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


Claim SubmissionInstitutional billing – additional billing codes


Claim SubmissionInstitutional 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


Claim SubmissionInstitutional billing – detail information


Claim SubmissionProfessional


Claim SubmissionProfessional – header information


– Postal code or taxonomy – when applicable


– Member name


– 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


Claim SubmissionProfessional – detail information

– From date of service

– Thru date of service


– Procedure code

– Modifier(s)– when applicable

– Related diagnosis – when applicable

– Units

– Total charge

– Emergency – when applicable

– EPSDT – when applicable

– Rendering NPI

– NDC information – when applicable

– Save detail


– Submit claim


Claim SubmissionProfessional – detail information


Claim SubmissionDental


Claim SubmissionDental – header information




– Member name



– Emergency – when applicable

– Accident-related – when applicable


Claim SubmissionDental – header information


Claim SubmissionDental – detail information

– Date of service

– Procedure code

– Tooth number – when applicable

– Surface – when applicable

– Units

– Total charge

– Rendering NPI

– Save detail


– Submit claim


Claim SubmissionDental – detail information


Eligibility Inquiry



– Search

• Member recipient ID (RID)

• SSN

• Medicare ID

• Name and date of birth

– From date

– To date

• Search by individual date of service


Eligibility Inquiry


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)

Find HelpResources available


Helpful ToolsAvenues of resolution

– IHCP Web site at www.indianamedicaid.com

– IHCP Provider Manual (Web, CD-ROM, or paper)

– Customer Assistance• Local (317) 655-3240

• All others 1-800-577-1278

– Written Correspondence• HP Provider Written Correspondence

P. O. Box 7263Indianapolis, IN 46207-7263

– Provider field consultant

• View a current territory map and contact information online at http://provider.indianamedicaid.com

http://www.indianamedicaid.com/

http://provider.indianamedicaid.com/

HP Provider Relations October 2010 Web interChange Basic Functions.

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Transcript of HP Provider Relations October 2010 Web interChange Basic Functions.