OptumInsight Training – Provider/Client 5010 837P PO BOX Solution HEC Manage Provider Information Changes: Billing Provider Address and Pay-To Address January 3, 2012

Purpose of Training Document (Provider/Client): What is the purpose the Billing Provider/Pay-To Address Training Document? To provide OptumInsight’s Providers and Clients with a full understanding of the upcoming changes to the Health-e Claim Manage Provider Information screens. To provide OptumInsight’s new and existing Health-e Claims submitters with the detailed instructions on how they can make the required changes or updates to their Billing Provider Address within Manage Provider Information. Required if currently using a post office box or lockbox as their Billing Provider Address. Will include: Step-by-step instructions on how to make these necessary changes. Screen-shots of Manage Provider Information screen changes.

Summary of the Manage Provider Information Changes: Why is the Billing Provider Address changing within the OptumInsight Health-e Claim Manage Provider Information? The adoption of 5010 standards has required many changes, including to the transactions that are a part of the HIPAA regulation. One of the most impactful changes that the industry is working through as part of this adoption is the requirement that the Billing Provider Address (2010AA) submitted on a claim be a physical (street) address. Once 5010 is implemented with each health plan, Providers can no longer submit a post office box or lockbox as the Billing Provider Address (2010AA). Claims submitted in this manner WILL REJECT. However, Providers can submit the post office box or lockbox for payment or correspondence in the Pay-to Address (2010AB). For Health-e Claim submitters, which would include Direct Data Entry and Print Image submitters, OptumInsight has developed a solution that includes an update to the Health-e Network Services Manage Provider Information section. This change includes adding a Pay-To Address under the Billing Provider. As a result of this solution, organizations will be able set up both a Billing Address and a Pay-to Address. The Delivery Date of this solution into the OptumInsight Production environment is 01/26/2012.

Getting Started: Go to: http://www.enshealth.com Select “Client Access Login”.

Getting Started (cont.): Log into the OptumInsight (ENS Health) Medical Claims Center. This will require the Client / User / S&S Tech to Login as the OptumInsight Submitter.

Getting Started (cont.): Once on the Health-e Network Services home page: Select “Manage Provider Information”.

How to change the Billing Provider Address: Once the Manage Provider Information screen is visible: Locate the Billing Address in question (PO BOX in Address column). Select “Edit”.

How to change the Billing Provider Address (cont.): NOTE: The Billing Address screen displays a PO BOX in the Address 1* field in the Billing Address section. This MUST be changed (claims will reject).

How to change the Billing Provider Address (cont.): Step 1 (Remove Billing Provider Address) : Delete the PO BOX information from the Billing Provider Address 1 field. Delete City (if physical address City is different). Delete Zip Code (if physical address Zip Code is different).

How to change the Billing Provider Address (cont.): Step 2 (Change/Enter Billing Provider Address): Enter the Physical Street Address into the Address 1 field. Enter the City. Enter the Zip Code.

How to change the Billing Provider Address (cont.): Step 3 (Enter Pay-To Address – PO BOX): Enter the original PO BOX information into the Address 1 field. Enter the City. Select State from State drop-down field. Enter the Zip Code.

How to change the Billing Provider Address (cont.): Step 4 (Verify Billing Address and Pay-To Address): Verify all details entered on the screen are correct. If correct, Select “Save”.

How to change the Billing Provider Address (cont.): Step 5 (Final): Once Billing Provider and Pay-To Provider Addresses have been saved, you should see the following screen. Select “Manage Provider Information”.

How to change the Billing Provider Address (cont.): Once the Manage Provider Information screen is visible: Locate the Billing Address in question. NOTE: The physical street address is now visible in the Address column. Address change is now complete. At this point, claims submitted via Health-e Network will now go out to the payer with the physical street address in the 2100AA Loop, and the Pay-To Provider PO BOX address in the 2100AB Loop.

Thank You. http://www.ingenix.com/hipaa-5010/clearinghouse-readiness/ For additional 5010 information: http://www.ingenix.com/hipaa-5010/clearinghouse-readiness/