Emdeon Dental Service Connect for Providers (EDC-Providers) User Guide

Transcription

1 Emden Dental Service Cnnect fr Prviders (EDC-Prviders) User Guide August 2015 Versin Burnham Street Suth Windsr, CT

2 Table f Cntents TABLE OF CONTENTS... 2 INTRODUCTION... 3 MINIMUM SYSTEM REQUIREMENTS... 3 ACCESS EDC-PROVIDERS... 4 EDC-PROVIDERS REGISTRATION... 5 PRODUCT ENROLLMENT... 9 ELIGIBILITY CLAIM STATUS & ERA EDC-PROVIDERS HOME ELIGIBILITY CLAIM SEARCH REPORTS ERA/EFT SEARCH PAYER ENROLLMENT EFT ADMINISTRATIVE TOOLS LOG OUT Burnham Street Suth Windsr, CT

3 Intrductin Emden places great value in its partners. In an effrt t allw the greatest efficiency between Emden and its partners, an internet based prvider services applicatin is available that allws prviders t access claim, eligibility, claim status, Electrnic Remittance Advice (ERA) and Electrnic Funds Transfer (EFT) infrmatin n a 24/7 basis. This guide cvers registratin, accunt management, claim status, eligibility, ERA/EFT enrllment, and reprting. Althugh EDC-Prviders is very intuitive, we hpe yu find this reference guide t be a valuable additin t yur use f Emden Dental s internet based services. Emden values yu as a client and prvider f dental services and desires t make yur experience a beneficial ne. Please nte: The use f the EDC-Prviders and its assciated displays shuld nt be relied upn as a guarantee f payment r eligibility fr any given insurance carrier inquiry. The infrmatin prvided via EDC-Prviders is based n infrmatin prvided directly frm the insurance carrier. Minimum System Requirements Micrsft Internet Explrer 10 r later Mzilla Firefx Ggle Chrme 220 Burnham Street Suth Windsr, CT

4 Access EDC-Prviders T access EDC-Prviders, brwse t The page displayed will be similar t the page belw (this page may change frm time t time, withut ntice, t represent the varius current and new prducts and services available frm Emden Dental): If yu are new t EDC-Prviders, simply click n Register fr Emden Dental Cnnect t begin the registratin prcess. If yu have already created an accunt, simply click n Emden Dental Cnnect Lgin t utilize the applicatin. If yu have any questins abut the EDC-Prviders, click n fr cntact infrmatin. 220 Burnham Street Suth Windsr, CT

5 EDC-Prviders Registratin Registratin: Upn selecting Register fr Dental Cnnect frm the Emden Dental hme page, yu will be directed t the Emden Dental Cnnect Registratin page. Click Next t begin the registratin prcess: 220 Burnham Street Suth Windsr, CT

6 Terms & Cnditins: If yu have nt previusly accepted the Terms & Cnditins, yu will be prmpted t d s nw. Please review the dcument, click the I accept the Terms and Cnditins check bx and Next t cntinue: 220 Burnham Street Suth Windsr, CT

7 Accunt/Authrized User Infrmatin: Please prvide infrmatin regarding yur practice and the user wh will access the EDC-Prviders accunt. The user will be required t create a User ID and Passwrd befre prceeding. Fields marked with an asterisk (*) are required. If yu d nt cmplete a field marked with an (*), yu will receive an errr after clicking Next. Upn cmpletin, click Next : Yur User ID can be up t 20 characters and must nt include spaces. Yur passwrd must be between 8-12 characters and must include at least ne number, ne lwer case character, ne upper case character, and ne special character (e.g.!, &, # ). 220 Burnham Street Suth Windsr, CT

8 Accunt Cnfirmatin: Once yu have entered all the required infrmatin, yu will receive the fllwing cnfirmatin page. Click Finish t cntinue: Accunt Creatin: When yu have cmpleted the registratin prcess, yu will receive an EDC- Prviders accunt creatin cnfirmatin page accmpanied by available prduct infrmatin. The prducts may be accessed directly frm this screen via the available link r via the Return t Hme link: 220 Burnham Street Suth Windsr, CT

9 Prduct Enrllment Once a user accunt has been created successfully, yu may begin t take advantage f the prducts available via EDC-Prviders. T start using any ne f these prducts, please enrll by selecting the apprpriate link frm the EDC-Prviders Hme page: 220 Burnham Street Suth Windsr, CT

10 Eligibility EDC-Prviders ffers eligibility and benefits verificatin t help simplify and streamline patient access. Eligibility and benefit infrmatin can be verified in real-time via an easy-t-read statement prviding imprtant c-pay, deductible, and cverage s as well as plan limitatins. Eligibility Enrllment: T purchase and enrll fr eligibility, prceed with the fllwing steps: Enter the Number f Prviders within yur practice and click Update. The Mnthly Fee and Transactins Included in Mnthly Fee will change based n the value entered. If yu have been prvided with a prmtin r partner cde, please enter it in the apprpriate field and click Apply. Any changes assciated with these cdes will be displayed after the cde has been applied. Click Cntinue : 220 Burnham Street Suth Windsr, CT

11 Purchase Details: Enter the preferred billing methd (Credit Card r Direct Debit) fr the eligibility prduct and click Purchase : 220 Burnham Street Suth Windsr, CT

12 Purchase Cnfirmatin: A cnfirmatin page will be displayed detailing the prduct purchase and billing details. Review the summary fr accuracy and click Cntinue : 220 Burnham Street Suth Windsr, CT

13 Prvider Verificatin: If yu are nt an Emden claims custmer, yu can enrll fr the eligibility prduct via Fax. The Fax Authrizatin frm will be presented t the user upn clicking Cntinue frm the Purchase Service screen. Click, Print This Page : If yu are an existing Emden claims custmer, yu can enrll fr the eligibility prduct immediately by adding and verifying the Tax Ids that yu use t submit claims. This is dne via the Claim Status & ERA Enrllment link fund n the EDC-Prviders Hme page. 220 Burnham Street Suth Windsr, CT

14 Cancel Eligibility Prduct: If yu n lnger wish t utilize the eligibility prduct ffered thrugh EDC- Prviders, yu may cancel it by cmpleting the fllwing steps: Select My Accunt Manage Prducts : The Billing Summary screen will be displayed. Click Cancel : 220 Burnham Street Suth Windsr, CT

15 The fllwing cnfirmatin message will be displayed. Click OK : Yu will be redirected back t the Billing Summary screen. The eligibility prduct will n lnger be displayed as an active prduct: 220 Burnham Street Suth Windsr, CT

16 *Imprtant Billing Infrmatin: There is n charge fr the eligibility service during the first mnth f use. Hwever, nce eligibility prduct is billed it s dne s at mnthly rate. Invices fr this prduct are prcessed and mailed the mnth fllwing yur cancellatin. Therefre, if the eligibility prduct is cancelled at any time during the current mnth, the invice fr the current mnth s charges will nt be received until the fllwing mnth. Example: September 2013: Eligibility prduct purchased N charge fr the mnth f September Octber 2013: Eligibility prduct active First eligible mnth fr billing Nvember 2013: Eligibility prduct cancelled n 11/10/13 Prvider charged fr Octber 2012 eligibility use December 2013: Prvider charged fr Nvember 2012 eligibility use 220 Burnham Street Suth Windsr, CT

17 Claim Status & ERA Thrugh EDC-Prviders, claim status and tracking has never been easier. Claim infrmatin is cmpiled and presented in an easy-t-use cnsistent layut, allwing yu t track claims thrughut the adjudicatin prcess. In additin t claim status, EDC users can search, view, and print ERAs fr thse payers in which they have enrlled. The ERA service is available t any prvider submitting claims thrugh Emden. T enrll fr real time claim status and ERA services, yu will need t prvide additinal claims infrmatin abut yur dental practice. (Please nte: This enrllment prcess will enable bth Claim Status and ERA services. Hwever, if yu d nt wish t utilize the ERA service, yu will nt be required t d s). Click Cntinue : 220 Burnham Street Suth Windsr, CT

18 Add a New Tax Id: In rder t enrll in the claim status/era service, we will need t determine if yu submit electrnic claims thrugh Emden Dental. This will be accmplished by entering the Tax Id(s) and name that yur ffice uses t submit claims. After entering all Tax Id s, click Save Tax Id : Please Nte: Only register Tax Ids that have been used by yur dental ffice t submit claims, adding ther Tax Ids may cause cnfusin when yu attempt t btain tracking r status infrmatin as the Tax Ids will nt have any claims assciated with them. 220 Burnham Street Suth Windsr, CT

19 Verify yur New Tax Id: Befre this Tax Id can be used, we must verify it. This is dne by supplying us with tw pieces f infrmatin frm tw dental claims that were submitted using this Tax Id. We perfrm this verificatin t ensure that nly authrized individuals can view yur claims and prtect yur patients' Persnal Health Infrmatin. Enter the Subscriber Id and Ttal Claim Amunt f tw dental claims submitted in the last 30 days, click Submit : If the Tax Id and claim cmbinatin are nt fund in ur system, yu will receive a message indicating such. If yu cntinue t receive this message and feel yu are entering the crrect infrmatin, please cntact ur custmer supprt department at Verificatin Cmplete: After yur Tax Id(s) have been verified successfully, the fllwing cnfirmatin page will be displayed t the user. Click ERA Enrllment if yu wish t begin the ERA Enrllment prcess r the Return t Hme link: 220 Burnham Street Suth Windsr, CT

20 EDC-Prviders Hme Once a user has lgged int the system r successfully created a new accunt they will be able take advantage f the services fr which they have enrlled. Only services yu have purchased will be displayed. If yu wuld like t add services, yu may click n My Accunt Manage Prducts and add services t yur accunt: Claim Search: Click t search fr submitted claims. Eligibility: Click t verify patient eligibility and benefits. Claim Status: Click t btain the current status and tracking n submitted claims. Reprts: Click fr access t the mst cmmnly used reprts (e.g. Claim summaries, Claims by Payer, and Rejected Claims). ERA/EFT Search (Electrnic Remittance Advice/Electrnic Funds Transfer): Click t search and btain a printable view f an ERA/EFT. EFT Dashbard: Click t manage EFT setup. 220 Burnham Street Suth Windsr, CT

21 Eligibility Selecting the Eligibility Inquiry menu ptin directs the user t the Eligibility Inquiry search screen. Eligibility infrmatin prvided is limited t the infrmatin prvided by the payer. Eligibility infrmatin prvided in EDC-Prviders is nt a guarantee f eligibility; hwever the infrmatin is retrieved in realtime frm the payer. Select a Payer: Frm the Eligibility Inquiry screen, the user can select the payer fr which they desire t check patient eligibility. If the payer name has an * next t its listing, this payer requires special enrllment in rder t submit an eligibility inquiry in real-time. Navigate t Payer Enrllment Eligibility menu item t enrll with a payer t submit eligibility inquiries. If yu are unable t lcate the desired payer in the drp dwn list, the payer is nt currently partnered with Emden fr real-time eligibility. Hwever, check this list ften as Emden is wrking t cnstantly add new payers: 220 Burnham Street Suth Windsr, CT

22 Enter Search Infrmatin: Enter search infrmatin based n the payer yu chse frm the drp dwn list. The fields will change based n the payer selected. Only use the dependent sectin if yu require infrmatin n a dependent (items marked as required in the dependent sectin are nly required if yu are inquiring n a dependent). Upn entering search criteria, click Submit : 220 Burnham Street Suth Windsr, CT

23 Search Results: The infrmatin displayed as a result f yur query is limited t the infrmatin prvided in real-time t Emden by the payer and is nt a guarantee f eligibility. If the search was successful, eligibility and benefit infrmatin will presented. If an errr ccurs (e.g. Subscriber Nt fund), that infrmatin will als be available t the user. The display is printable, via the print buttn. T cnduct anther search, click New Search : 220 Burnham Street Suth Windsr, CT

24 Claim Search EDC-Prviders allws a user t btain claim detail, status, and tracking infrmatin fr claims submitted thrugh the Emden Dental platfrm. The instructins belw describe the use f the varius types f search selectins available t yu. Search fr Claims: Cnduct a search fr specific claims utilizing the search criteria ptins available: Select Tax Id: Select the Tax Id frm the drp dwn list that is assciated with the claims being searched. Select Search Type: Select the type f search yu wuld like t cnduct (Please nte: the search display will change based n the Search Type selected). Upn entering the infrmatin fr the selected Search Type, click Submit Search Claim by Date: All Claims: Search fr all claims sent fr the date entered. Accepted Claims Only: Search fr all claims that were sent successfully by Emden and accepted by the payer. Rejected Claims Only: Search fr all claims rejected by either Emden r the payer. 220 Burnham Street Suth Windsr, CT

25 Date Type: Select either Date f Service r Date Prcessed frm the drp dwn menu. Chse a single date r a date range by clicking n the calendar icn r by typing in the dates directly using the crrect frmat (MM/DD/YYYY). Rendering Prvider Last Name: Enter rendering prvider s last name exactly as it was entered n the submitted electrnic claim. This is an ptinal field. By Patient Name: Treatment Lcatin: Select the lcatin where the treatment was rendered (ptinal). Patient Last Name: Enter a patient last name exactly as it was entered n the submitted electrnic claim. This is a required field. Patient First Name: Enter a patient first name exactly as it was entered n the submitted electrnic claim. This is an ptinal field. Date Type: Select either Date f Service r Date Prcessed frm the drp dwn menu. Chse a single date r a date range by clicking n the calendar icn r by typing in the dates directly using the crrect frmat (MM/DD/YYYY). Rendering Prvider Last Name: Enter rendering prvider s last name exactly as it was entered n the submitted electrnic claim. This is an ptinal field. By Payer Name: Payer Name: Select an available payer frm the drp dwn bx. Date Type: Select either Date f Service r Date Prcessed frm the drp dwn menu. Chse a single date r a date range by clicking n the calendar icn r by typing in the dates directly using the crrect frmat (MM/DD/YYYY). Rendering Prvider Last Name: Enter rendering prvider s last name exactly as it was entered n the submitted electrnic claim. This is an ptinal field. Claim Search Results: View claims that were submitted t Emden electrnically based n the criteria yu have chsen. Each clumn may be srted by ascending r descending rder by clicking n the title f the clumn. An arrw will appear next t the title that was selected fr srting. The directin f the arrw indicates whether the srt is in ascending r descending rder: The result grid is made up f the fllwing details: Patient: Patient last, first name as listed n the claim. Service: Date f service as listed n the claim. Prcessed: Date the claim was prcessed by Emden. Rendering Prvider: Prvider last, first name as listed n the claim. Amt: Ttal charge amunt as listed n the claim. Payer: Name f the payer t which the claim was submitted. 220 Burnham Street Suth Windsr, CT

26 Status: Displays and A fr an accepted claim, r an R fr a claim that was rejected by either Emden r the payer. Rejected claims will always appear in red. T view claim status and tracking infrmatin, click n the A status indicatr. Lcatin: If a lcatin was specified as a search filter, the results will nly return claims that were submitted by the selected lcatin. 220 Burnham Street Suth Windsr, CT

27 Claim Detail: Click n the Patient Name t view the claim detail. The claim detail display cnsists f claim infrmatin that was riginally submitted t Emden and subsequently frwarded t the payer: This screen can be printed fr yur files by clicking print. Click shw claim status t view the detailed claim status display fr this claim. 220 Burnham Street Suth Windsr, CT

28 Claim Status: The claim status display prvides yu with claim status and tracking infrmatin abut the claim yu selected. The infrmatin related specifically t payer claim status is limited t the infrmatin prvided by the specific payer. Claim Status is nt a guarantee f payment and the accuracy f the claim status is limited t infrmatin prvided t Emden by the payer: The claim status display made up f the fllwing infrmatin as it was prvided by bth Emden and the payer: Finalized Claim Status: Displays current infrmatin regarding claim status. Claim Tracking: Displays claim transmissin status step by step. Real Time Claim Status Item Detail: Displays service line claim status infrmatin. This screen can be printed fr yur files by clicking print. Click shw claim detail t return t the claim detail screen fr this claim. 220 Burnham Street Suth Windsr, CT

29 Reprts Selecting the Reprts ptin frm the Services menu item prvides the user quick and easy access t the mst cmmnly used claim reprts. Select a Tax Id (s) and a Reprt Date. Click n the reprt link f yur chice frm the list available. T select multiple Tax Ids, hld the CTRL Key while clicking n a Tax Id. If mre than ne Tax Id is selected, the claim cunts will be gruped by Tax Id. In additin, yu can srt further by Site Id. Please check this bx befre clicking n yur reprt chice: 220 Burnham Street Suth Windsr, CT

30 Claim Summary Reprt: This reprt prvides a cunt f claims prcessed by Emden n the current business day. The cunt is further brken dwn by the number f claims prcessed electrnically, the number f claims printed/mailed/rejected by Emden, and the ttal charge amunt f the claims: Claims by Payer (Daily, Weekly, Mnthly, and Yearly): These fur reprts differ nly in the preset date range that they cver. The fur reprts cver claims prcessed by Emden n the current business day, week t date (starting n Sunday), mnth t date, and year t date. The cunt is brken dwn by payer name, the number f claims prcessed electrnically, and the ttal charge amunt f the claims: 220 Burnham Street Suth Windsr, CT

31 Claim Summary Reprt by Specified Date: Get a summary fr a single day using the first date field. Als Includes week, mnth, and year t date summaries: Claims by Payer by Date Range: Get a list f claims submitted by payer fr a specified date range: 220 Burnham Street Suth Windsr, CT

32 Rejected Claims: This reprt displays a list f claims that were rejected fr the date range entered by the user (Enter date under Claim Submissin Reprts by Date Range sectin. By default, that timeframe is set t the current business day. The reprt includes claims that were rejected by Emden Dental and the payer. The rejected claims are listed individually and brken dwn by patient name, Insured ID, the payer name, rendering prvider name, date the service, ttal charge f the claim, and reasn fr the rejectin: 220 Burnham Street Suth Windsr, CT

33 ERA/EFT Search Selecting the ERA/EFT Search ptin frm the Services menu item directs the user t the ERA/EFT Search screen. If a user enrlls t receive ERA/EFT frm a payer(s), they can search, view, and print thse ERA/EFTs via this screen. In rder t begin receiving ERA/EFTs frm ur supprted payers, yu must first enrll. See the sectin n ERA and EFT enrllment fr mre details n this prcess. Search fr ERA/EFT: Cnduct a search fr ERA/EFTs utilizing the search criteria ptins available. Please nte: At a minimum, a Tax Id and Date must be prvided t cnduct a search. Click Submit : A search can be further refined by cmpleting ne r mre f the text bxes listed belw: Payee Name: Enter the name f the payee in which payment is being made t. Payer: Select the payer that is assciated with the ERAs being searched. Patient Last Name: Enter the last name f the patient as it submitted n the claim. 220 Burnham Street Suth Windsr, CT

34 Patient First Name: Enter the first name f the patient as it was submitted n the claim. Insured ID: Enter the insured ID f the patient as it was submitted n the claim. Date: Enter either the ERA prcess date r a claim date f service. Check r EFT Number: Enter the Check r EFT Number under which the ERA was issued. Patient Cntrl Number: Enter the patient cntrl # as it was submitted n the claim. ERA/EFT Search Results: View ERA/EFTs that were received by Emden based n the criteria yu have chsen. Each clumn may be srted by ascending r descending rder by clicking n the title f the clumn. An arrw will appear next t the title that was selected fr srting. The directin f the arrw indicates whether the srt is in ascending r descending rder: The result grid is made up f the fllwing details: Date Prcessed: Effective date as listed n the ERA/EFT. Payer Name: Name f the payer as listed n the ERA/EFT. Payee Name: Name f the payee as listed n the ERA/EFT. # Claims: The ttal number f claims cntained within the ERA/EFT. Charged: Ttal charge amunt f all claims listed within the ERA/EFT. Paid: Ttal paid amunt f all claims listed within the ERA/EFT. Check/EFT Number: Check r EFT number as listed within the ERA/EFT. Remit Advice: A Y link will be displayed if an image f the remittance advice is available. 220 Burnham Street Suth Windsr, CT

35 ERA Detail: The details f any ERA/EFT can be viewed by clicking Date n the ERA/EFT Search Result screen. A new windw will pen and display the ERA. Click print t print a cpy f the ERA/EFT as shwn: The ERA/EFT detail display is a human readable representatin f the payment data. Included in the display are Payer/Payee Identificatin, Financial, Prvider, and Claim/Service Payment infrmatin. 220 Burnham Street Suth Windsr, CT

36 Payer Enrllment Select the Payer Enrllment menu item t enrll with payers fr Eligibility, ERA, and EFT. The Batch Claim menu item will direct the user t the dental batch claim enrllment frms. When yu submit an enrllment request t Emden Dental, we nt nly perfrm the submissin fr yu, but yu can regularly check the Enrllment sectin t retrieve status infrmatin n yur request(s). Eligibility Enrllment: Sme payers require special enrllment fr access t their real-time eligibility and benefit infrmatin. Payers that require eligibility enrllment can be viewed by clicking Make an enrllment request and seeing if a specific payer is listed. If a request has been made, the request will appear n this page with status infrmatin and any applicable ntes related t yur submissin: 220 Burnham Street Suth Windsr, CT

37 Make an Enrllment Request: Select the payer yu that wish t enrll with frm the drp dwn bx: 220 Burnham Street Suth Windsr, CT

38 Enter Enrllment Infrmatin: Enter yur prvider infrmatin in this sectin. Required infrmatin may vary by payer. Enter the prvider infrmatin in the apprpriate fields. Click "Submit:" Visit ften t check n the status f yur enrllment request r t make additinal enrllment requests: 220 Burnham Street Suth Windsr, CT

39 ERA Enrllment: Befre yu can receive ERAs frm payers yu must first enrll with thse payers. T enrll thrugh EDC-Prviders, click Payer Enrllment ERA : ERA Enrllment List: The first time yu enrll with a particular Tax Id yu will be asked t prvide sme additinal demgraphic infrmatin which will help us prcess yur enrllment quickly. Sme f the frm will be pre-filled frm the accunt infrmatin yu already prvided during registratin. Cmplete the required fields and click Submit : 220 Burnham Street Suth Windsr, CT

40 Once the Tax Id infrmatin has been saved, yu will be ready t begin enrlling. This page will display yur Tax Id details and any current ERA enrllments. Yu may edit yur Tax Id details at any time by clicking the Edit TIN/EIN Details buttn. T enrll with a new Payer, click Add New ERA Payer : 220 Burnham Street Suth Windsr, CT

41 Add ERA Enrllment: Select the payer with whm yu wish t enrll. If the payer requires additinal infrmatin, text bxes and/r radi buttns will be displayed t enter that infrmatin. Click Add Enrllment t submit the enrllment: Yur enrllment will be submitted and yu will be returned t yur enrllment list. Yu may nly enrll each Tax Id nce with each payer, hwever, if yur riginal enrllment is denied, yu may attempt t enrll again. 220 Burnham Street Suth Windsr, CT

42 Dwnlad Enrllment Frm: Sme payers require a prvider t fill ut and mail/fax a printed frm in additin t electrnic enrllment. In this case, yu will be redirected t a page cntaining a link t dwnlad the frm: The PDF dcuments cntain all the infrmatin yu need t successfully cmplete yur enrllment including hw t cmplete the frm and where t send it. The frm can be printed and cmpleted by hand r yu may type yur infrmatin directly int the frm frm within Adbe Reader. Yu can then print the frm with yur infrmatin ppulated. 220 Burnham Street Suth Windsr, CT

43 Upn cmpleting the frm, clse the windw and click Return t Enrllment Hme : Enrllment Tracking: When yur enrllment is cmplete yu will return t the enrllment list. Yu can utilize this page at any time t track the status f yur enrllments. Als, if yu need t dwnlad a frm again, a dwnlad link fr each enrllment is prvided fr yur cnvenience: Discntinue ERAs: Once yu begin t receive ERAs frm a payer, yu must cntact the payer in rder t discntinue the service. Emden will cntinue t allw yu t search, view, and print yur ERAs until they have been discntinued. Als, yu will be able t see any ERAs that yu received prir t discntinuing the service with that payer. The prcedure fr discntinuing ERAs varies frm payer t payer. Yu can dwnlad a PDF with an explanatin f the prcess fr each payer at: Burnham Street Suth Windsr, CT

44 EFT Electrnic funds transfer enrllment is anther free and valuable ffering via EDC-Prviders. EFT is a payment methd utilizing electrnic means (as cntrasted with paper checks) t transfer mnies between parties. Prviders typically receive their EFT payments faster than they wuld receive a check via the mail and may reduce administrative steps assciated with issuing r depsiting payments. The EFT Enrllment prcess is made up f three steps. Each step must be cmpleted in rder t submit an enrllment request. T enrll fr EFT services, select the click here link frm the EDC-Prviders Hme page r via Payer Enrllment EFT : 220 Burnham Street Suth Windsr, CT

45 Prvider Infrmatin (Step 1): Enter yur prvider demgraphic infrmatin including identifier and cntact infrmatin in the designated sectins prvided. Upn cmpleting all sectin within step 1, click Next : Prvider Identifiers Infrmatin: Enter yur Prvider Federal Tax Id (TIN) r Emplyer Identificatin Number (EIN) and Natinal Prvider Identifier (NPI). A Nickname may als be entered t uniquely identify the Prvider Identifiers cmbinatin. (Attentin brkers: The NPI field will be replaced with a field t enter yur Brker Agency ID ): 220 Burnham Street Suth Windsr, CT

46 Multiple Prvider Identifier cmbinatins can be added by selecting the Add Anther Prvider Identifiers Infrmatin link. When the link is selected, an additinal tab will appear. T remve an additinal cmbinatin, select the Remve this Prvider Identifiers link: Prvider Cntact Infrmatin: Enter the cntact infrmatin f the persn wh will be authrized t discuss EFT related issues: 220 Burnham Street Suth Windsr, CT

47 Multiple cntacts can be added by selecting the Add Anther Prvider Cntact Infrmatin link. When the link is selected, an additinal tab will appear. T remve an additinal cntact, select the Remve this Prvider Cntact Inf link: Click Next when cmplete: 220 Burnham Street Suth Windsr, CT

48 Financial Institutin & Submissin Infrmatin (Step 2): Enter yur financial institutin infrmatin where EFT depsits will be made and an authrized signature cnfirming the reasn fr submissin (e.g. New Enrllment). All fields are required. Multiple banks can be added by selecting the Add Anther Financial Institutin Infrmatin link. When the link is selected, an additinal tab will appear. T remve a financial institutin, select the Remve this Financial Institutin link: 220 Burnham Street Suth Windsr, CT

49 Enter the printed name and title f persn submitting the enrllment. Click Next : Payment Distributin (Step 3): Select yur Tax Id/NPI/Bank Accunt #/Bank Name and desired Payer, t establish yur payment distributin setup. Upn cmpleting yur selectins, click Add Payer : Upn clicking Add Payer, the payment distributin selectin results will be displayed in a result grid belw the drp dwn menus. T delete a Tax Id, Bank, and Payer relatinship, click the red X in the Delete clumn fr the rw yu wuld like t remve. (Attentin Brkers: The Tax Id/NPI/Bank Accunt #/Bank Name clumn header will read Tax Id/Brker Agency Id/ Bank Accunt #/Bank Name and ppulate the Brker Agency Id rather than NPI that was entered during step ne). Once all relatinships have been added, click Next : 220 Burnham Street Suth Windsr, CT

50 Summary (Step 4): A summary f the cllected entries frm Step 1-3 will be prvided fr the users review. Click Submit t send yur enrllment request fr review, r Previus t return t prir steps and make crrectins: Upn clicking Submit, the user will be prmpted t cnfirm their submissin. T submit yur enrllment request click OK, therwise select Cancel t return t the summary screen t make changes: 220 Burnham Street Suth Windsr, CT

51 EFT Enrllment Frm: Upn clicking OK the user will be directed t the EFT Enrllment Frm screen t create a prefilled Enrllment and Authrizatin Frm. T create the frm, click "Create Frm": The user will be prmpted t Open r Save the frm: 220 Burnham Street Suth Windsr, CT

52 A tw page prefilled frm will be displayed. Read the instructins n page ne, sign and date the authrizatin frm (page tw), and fax, r mail the cmpleted frm t Emden: Please nte: T check the status f yur EFT Enrllment request, please return t the EDC-Prviders website at any time and click n the EFT Enrllment link n the hme page. 220 Burnham Street Suth Windsr, CT

53 Upn receipt f the Enrllment and Authrizatin Frm, Emden will review and prcess yur enrllment request accrdingly. At that time, the fllwing will be generated advising f the receipt and status: The EFT Status will change t display a similar message, with additinal instructins t the prvider t mnitr their financial institutin accunt fr a small depsit. This depsit will be used t validate the enrlled financial institutin accunt. Click Return t Hme t return t the EDC-Prviders hme page: Once the depsit has been made t the enrlled financial institutin accunt, access the EDC- Prviders and click n the link n the hme page t validate the depsited amunt: 220 Burnham Street Suth Windsr, CT

54 The link will direct the user t the Verify EFT Bank Accunt screen. Enter the depsited amunt in the text bx prvided and click Submit : Upn clicking Submit, yur depsit amunt will be validated. If the validatin is successful, the fllwing screen will be displayed cnfirming the depsit amunt. Click Return t Hme t return t the EDC-Prviders hme page: Please Nte: There is a maximum f three failed attempts when entering the depsited amunt. After the third failed attempt, the Verify EFT Bank Accunt screen will lck and display a LOCKED message t the user. In the event this ccurs, please cntact dental supprt at and advise the representative f the issue. Due t security, Emden will issue a request fr a new depsit t be made int the enrlled financial institutin accunt. 220 Burnham Street Suth Windsr, CT

55 Once the EFT enrllment has been finalized and apprved, the Status will change advising that the enrllment has been apprved and finalized. Click Return t Hme t return t the EDC-Prviders hme page: EFT Dashbard: Once an EFT enrllment has been finalized and apprved, a user can manage their EFT activities via the EFT Dashbard, which is accessible frm the EDC-Prviders hme page. The dashbard prvides a snapsht f the current EFT activity and allws user maintain and manage all aspects f their EFT accunt: 220 Burnham Street Suth Windsr, CT

56 The fllwing functins are available via this screen: Add Payers, Prvider Identifiers, Prvider Cntact, and Financial Institutin recrds. Delete ( ) Payers, Prvider Identifiers, Prvider Cntact, and Financial Institutin recrds. Deleting a Payer, Prvider Identifiers, r a Financial Institutin will prmpt the user t cnfirm their request befre prceeding. (Please nte: The last active recrd fr any ne f these EFT categries cannt be deleted. If yu wuld like t pt ut f EFT, please use the Cancel EFT ptin). Edit ( ) Prvider Infrmatin, Prvider Identifiers, and Prvider Cntact recrds. (Please nte: Only Nickname is available fr edit n the Prvider Identifiers screen. If yu wuld like t change a Prvider Identifier cmbinatin, please delete the recrd and add a new ne). Print ( ) Financial Institutin infrmatin (Available when a financial institutin recrd is in a pending status t allw the user the ability t re-print the EFT Bank Accunt Add/Delete Authrizatin Frm). View the detailed activity f any recrd by clicking n the link in the Status clumn. Cancel the EFT service prvided thrugh Emden. Return t the EDC-prviders hme page. Cancel EFT: If yu wuld like t pt ut f the EFT service prvided thrugh Emden, click the Cancel EFT buttn lcated at the bttm left f the EFT dashbard: 220 Burnham Street Suth Windsr, CT

57 Clicking Cancel EFT will direct the user t the Cancel EFT cnfirmatin screen: Review and accept the terms and cnditins assciated with cancelling EFT selecting the check bx. Upn selecting the check bx, the Cancel EFT buttn will be activated. Click Cancel EFT t cmplete the prcess and generate the financial institutin cancellatin frm. Sign and date the cancellatin frm and fax r t the fax #/ identified n the frm. When cmpleted clse the frm and click n the Back t EFT Dashbard link: 220 Burnham Street Suth Windsr, CT

58 The status f EFT Payers and Financial Institutin recrds n the EFT Dashbard will be changed t Pending Deactivatin immediately: Upn Emden finalizing the cancellatin, the status will display as Inactive : 220 Burnham Street Suth Windsr, CT

59 Administrative Tls The Accunt Administratin tls are accessible frm the My Accunt menu item. All administrative functins are accessed frm this menu. This page is nly accessible by accunt administratrs. Manage Tax Ids: Allws a user t edit, add r remve Tax Ids. Managing Tax Ids may be necessary if prviders are added r remved frm yur dental practice. If yu remve all f yur Tax Ids, sme services may becme unavailable. T edit r remve a Tax Id, click the radi buttn next t their name and then click the apprpriate buttn. T add a new Tax Id, click Add Tax Id : 220 Burnham Street Suth Windsr, CT

60 Edit Tax Id: The Nickname is the nly editable field n this screen. If yu wish t change the Tax Id Nickname, change the text in the field and click Save Tax Id : Remve Tax Id: T remve a Tax Id, click the radi buttn next t the Tax Id t be remved. Click the Remve Tax Id buttn. A cnfirmatin bx will appear cnfirming yu wuld like t remve the selected Tax Id. Click OK : 220 Burnham Street Suth Windsr, CT

61 Add Tax Id: Enter the Tax Id yu wish t add and a Nickname, Click Save Tax Id. Yu will be prmpted t verify the new Tax Id by prviding details frm tw claims submitted within the last 120 days using this Tax Id. Once yu have verified the Tax Id yu will be able t use it in yur search: 220 Burnham Street Suth Windsr, CT

62 Manage Services, Billing, and Prmtins: Allws a user t enter a prmtin cde, manage services, and enter/manage billing details: Current Prmtins: Click n Enter Prmtin Cde if yu have been prvided with a prmtin cde that is valid fr EDC-Prviders r view any past prmtins that yu have already utilized. Services: Click n Cancel t remve yur current service selectins. Billing Details: Click n Enter/Change Payment Details t change, update r mdify yur current billing infrmatin r t add billing infrmatin after a prmtin has expired (nly applies t prmtins that have a free trial perid fr pay services). 220 Burnham Street Suth Windsr, CT

63 Billing Histry: The billing histry shws all charges by billing mnth including mnthly fees and charges fr transactins ver the included transactin alltment. In additin, any applicable payer pass-thrugh charges will als be displayed: Billing Detail: The details f any billing mnth can be viewed by clicking the Billing Mnth date link: 220 Burnham Street Suth Windsr, CT

64 Manage Users: Allws a user t add, remve, and edit accunt sub-users. This sectin is nly available t accunt administratrs: Edit User: Editing a user allw yu t change the users First and Last name, Passwrd, User ID, and accessible Tax Ids and Services. A user can als be granted Administrative Rights frm this screen. Upn cmpleting yur edits, Click Save User : 220 Burnham Street Suth Windsr, CT

65 Remve User: T remve a user, click the radi buttn next t the user t be remved. Click the Remve User buttn. A cnfirmatin bx will appear cnfirming yu wuld like t remve the selected User. Click OK : Add New User: When adding a new user yu will be required t prvide the users First and Last name, new User ID and Passwrd. In additin, the new user can be granted access t specific Tax Ids and Services available n the accunt. Administrative Rights can als be granted frm this screen. Upn cmpleting yur edits, Click Save User : 220 Burnham Street Suth Windsr, CT

66 Edit Accunt Cntact Infrmatin: Allws a user t mdify dental ffice accunt cntact infrmatin. This sectin will mdify the EDC-Prviders billing infrmatin assciated with yur ffice. Please ensure this infrmatin is accurate, Upn cmpleting yur edits, Click Save Changes : 220 Burnham Street Suth Windsr, CT

67 Lg Out When yu are finished with yur EDC-Prviders sessin, please remember t click Lg Out in the upper right hand crner f the screen. This will ensure that yur sessin is prperly terminated and will help t prtect yur patient PHI. Please nte: The EDC-Prviders sessin will autmatically time-ut after a perid f inactivity. This will require the user t lg back int the system. The time ut is necessary t ensure PHI is prperly prtected. 220 Burnham Street Suth Windsr, CT