UB-04/ INSTITUTIONAL FALL WORKSHOP 2013

Transcription

1 UB-04/ INSTITUTIONAL FALL WORKSHOP 2013

2 The New Provider Portal and the screenshots included in this presentation are for demonstration purposes only and are subject to change. The information in this presentation is current as of September 2013.

3 AGENDA Compatibility Accessing the New Provider Portal Logging on Overview of New Welcome Page Claims Submission Third Party Liability (TPL) & Crossover Claim Inquiry

4 AGENDA (cont.) New Changes Member Focused Viewing Payment History Provider Search Quick Facts FAQs Resources Questions

5 COMPATIBLE WITH Internet Explorer 8 & 9 Firefox Google Chrome Adobe Reader X (to view PASRR)

6 HOW TO ACCESS NEW PORTAL Provider Secure Sites SoonerCare Secure Site The Same Way

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8 thunder

9 FORGOT PASSWORD

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11 Medical Hospital Medical Hospital A 1XXX111XX A

12 SUBMITTING THE UB/04 INSTITUTIONAL CLAIM

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15 STEP Medical Hospital

16 STEP 2

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18 STEP 3

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20 PAID

21 C O P Y

22 T P L

23 TPL- PAID

24 Step 1 CARRIER DENIED Step 3

25 HARD-COPY ATTACHMENTS Insurance denial required.

26 Auto populated

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28 Institutional - Suspended Institutional - Suspended Your Institutional Claim was successfully submitted. The claim status is Suspended. The Claim ID is

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30 UPLOADING ATTACHMENTS Attached are Dr. s chart notes.

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32 Institutional - Suspended Institutional - Suspended Your Institutional Claim was successfully submitted. The claim status is Suspended. The Claim ID is

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34 Denial Reasons Error Codes

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38 C R O S S O V E R

39 CLAIM INQUIRY

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41 $2, /05/201 3 $3, $2, $

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43 Your Institutional Claim V O I D

44 Institutional Claim

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47 TRADE FILES

48 Medical Hospital

49 Medical Hospital

50 NEW CHANGES

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52 MEMBER FOCUSED VIEWING

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56 PAYMENT HISTORY

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58 Medical Hospital

59 Medical Hospital

60 Medical Hospital $5.00 $5.00 $5.00

61 Steps to set WordPad as default application to open TXT files Click "Start," "Default Programs" and the "Set Your Default Programs" link near the top of the window. Click "WordPad" in the left pane of the Set Your Default Programs screen. Click "Set This Program As Default" to make WordPad the default editor for all TXT, DOCX, RTF and ODT files. Click "Choose Defaults for This Program" to make WordPad the default editor for file extensions you select. Click the box next to each file extension you want the program to open (please choose TXT to allow RAs to open in proper format), then click "Save." Click "OK" to close the Set Your Default Programs window

62 Steps to configure Wrap to Window (word-wrap) in WordPad Click "View" tab. Click "Word wrap" dropdown. Select "Wrap to window"

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65 QUICK FACTS

66 Home Health - 36 visits per calendar year FQHC - PPS rate set at time of enrollment - No zero or decimals in covered days For example 4.00 should be 4

67 NODOS (Notification Of Date Of Service) - Verify eligibility first - Check by name, DOB, & SSN NB1 (Newborn) - If mother has SoonerCare, do NB1 immediately. Otherwise eligibility will not be backdated.

68 PROVIDER SEARCH

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71 Search Results

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73 MapQuest View

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76 Ima Soonerfan Bobby SoonerCare NPI XYZ A

77 FREQUENTLY ASKED QUESTIONS o o o o o When is the new Portal going live? o Winter 2013/2014 How will I get to the applications (Provider Enrollment, NB1, NODOS, DMH Budgets, etc.)? o These applications will not be changing. There will still be links on the new Portal. What is the data limit for File Transfer? o 10 MB per submission I am a clerk that is linked with several different provider ID s. Will I still be able to switch between them? o Yes, there will still be an option to switch provider ID. Will I be able to remove TPL from a member s file on the new Portal? o No, you will still have to use the TPL-1 form.

78 RESOURCES On-site Training - HP Field Consultants and OHCA Field Representatives Claims, eligibility, or policy questions - OHCA Call Center (800) , option 1 Hours of operation: Monday-Thursday: 8:00am-7:00pm Friday: 8:00am-5:00pm Saturday: 9:00am-1:00pm Secure Site logons and PIN resets - Internet Help Desk (800) , option 2, option 1 Hours of operation: Monday-Friday: 8:00am-noon & 1:00pm-5:00pm Electronic batch questions - EDI Help Desk (800) , option 2, option 2 Hours of operation: Monday-Friday: 8:00am-noon & 1:00pm-5:00pm

79 QUESTIONS