Web Portal Presentation (Overview) Presented by Xerox State Healthcare, LLC Provider Relations

Purpose This training will provide an overview of the New Mexico Medicaid Web Portal. The training will familiarize providers with the types of inquiries and features the web portal possesses. Update: 09/11/2015

Objectives Xerox Resources Portal and User Administration Features Types of Inquiries Links Update: 09/11/2015

Resources New Mexico Medicaid Online Provider Information Provider Login Screen Notices Provider E-News Newsletters Medicaid Provider Relations Call Center Provider Communication Updates Provider Field Representative Provider Webinars Open Forums and Live Training Sessions Update: 09/11/2015

https://nmmedicaid.acs-inc.com/static/index.htm https://nmmedicaid.acs-inc.com/static/index.htm Update: 09/11/2015

The Xerox New Mexico Medicaid Web Portal Non Secure Features Secure Features requires login Update: 09/11/2015

The Xerox NM Medicaid Web Portal Login Page Update: 09/11/2015

Web Registration Large Organizations with Multiple Billing Provider Numbers Organizations with multiple billing provider numbers have to register each billing provider number in the web portal in order to inquire on claims, Prior Authorizations (PA) and payment history, as well as to access Remittance Advices (RA) and PAs used unit reports for each of their billing provider numbers. Update: 09/11/2015

Web Registration – “How-To” Complete every field that contains an asterisk Update: 09/11/2015

Web Administration Organizational Chart Master Administrator Supervisor has “User Admin” privileges Supervisor has “User Admin” privileges Supervisor has “User Admin” privileges Staff Staff Staff Staff Staff Staff Staff Staff Staff Staff have Inquiry privileges only Update: 09/11/2015

Electronic Funds Transfers (EFT) Step One: Click on Email EFT Administration Step Two: Enter EIN (Federal Tax ID) or SSN and click on submit ONLY the Master Administrator will have this access Update: 09/11/2015

User Privileges Update: 09/11/2015

Claims Entry

Clean Claim Paper Submissions Providers will be able to continue to bill on paper when they are submitting a claim with a proper attachment. Important Note: Faxed claims are unacceptable and will not be processed by Xerox. Please visit the link below for policy regarding paper claim billing. http://www.hsd.state.nm.us/providers/Registers_and_Supplements.aspx 15-03 Supplement on Multiple Topics, including ICD-10, Billing Using Paper Claims, etc. Update: 09/11/2015

Claims Entry Feature Ability to submit a CMS-1500, UB-04, and ADA Dental claim forms. Adjust and Void online submitted claims Add and Manage Templates Claim Re-bill Update: 09/11/2015

Adjustments and Voids Update: 09/11/2015

Adding Templates Update: 09/11/2015

Claims Re-Bill Update: 09/11/2015

Eligibility Claim Status Prior Authorization Payment History Types of Inquiries Eligibility Claim Status Prior Authorization Payment History

Eligibility Inquiry Update: 09/11/2015

Eligibility Inquiry The system will default the current date for date of service. You can use any DOS within the past 2 years. Date spans can be used. Recipients can be searched using: Recipient ID (this is the “SSN” style ID number, Medicaid ID, temporary SSN etc. 942XXXXXX) SSN and date of birth OR…. Last name, first name, date of birth (information needs to match what is on the Omnicaid system) Update: 09/11/2015

Eligibility Inquiry The “SSN-style” ID number Update: 09/11/2015

Eligibility Inquiry If the recipient is eligible on the date entered, the response will include: Category of Eligibility (COE) and description All lock-ins Medicare information Third Party Liability (TPL) information Long Term Care information, IF there is a long term care span (abstract) on file for the date entered that matches the inquiring provider number. Update: 09/11/2015

Update: 09/11/2015

Eligibility Inquiry continued This person is blind receiving SSI COE 003 Please note: This person has both Managed Care and TPL. Update: 09/11/2015

Eligibility Claim Status Prior Authorization Payment History Types of Inquiries Eligibility Claim Status Prior Authorization Payment History

91308700085000001 What is a Transaction Control Number (TCN)? The twelfth digit in an adjustment/ void TCN will either be: 1= Debit 2= Credit The first digit indicates what the claim “media” is: 2 = electronic crossover 3 = other electronic claim 4 = system generated claim or adjustment 8 = paper claim 9 = Web portal claim entry Batch number The last two digits of the year the claim was received The claim number within the batch. The numeric day of the year. This is the Julian Date - this represents the date the claim was received by Xerox: this claim was received the 87th day of 2013, or March 28, 2013 Update: 09/11/2015

Claim Status Inquiry Update: 09/11/2015

Single DOS Inquiry This simple search might not find the claim if the DOS on the claim was mis-keyed or the recipient ID was not correctly entered. Be sure you are entering the correct data. Update: 09/11/2015

Date Range Inquiry Note: Unless you are a small provider, this search will probably result in more than 200 claims. Update: 09/11/2015

Claim Summary Click on TCN to view specific claim detail Click on the Recipient ID to go to Recipient Inquiry Update: 09/11/2015

More on Claim Inquiry Keep the following in mind as you use claim inquiry: You will only see claims paid and denied to the provider number you are logged in under or have selected if you are logged in with an NPI. If your search yields more than 200 results, you will only see the first 200 and a message will appear telling you that has happened. Narrow your criteria if this happens. Update: 09/11/2015

Eligibility Claim Status Prior Authorization Payment History Types of Inquiries Eligibility Claim Status Prior Authorization Payment History

Prior Authorization Inquiry Current PA’s are available Update: 09/11/2015

Prior Authorization Summary Update: 09/11/2015

Eligibility Claims Status Prior Authorization Payment History Types of Inquiries Eligibility Claims Status Prior Authorization Payment History

Payment History Inquiry Update: 09/11/2015

Payment History Inquiry Update: 09/11/2015

Reports

Reports and Data Files Providers can pull the last 8 RA’s from the Web Portal Select PDF Reports to retrieve Remittance Advices Update: 09/11/2015

Reports and Data Files Enter Provider ID or NPI and click submit Update: 09/11/2015

Remittance Advice Detail Update: 09/11/2015

FAQ’s/ Links/Contact Us

Provider Information Update: 09/11/2015

FAQs Update: 09/11/2015

Links Update: 09/11/2015

Contact Us Update: 09/11/2015

Provider Enrollment

Enroll Online Update: 09/11/2015

Check Enrollment Status Update: 09/11/2015

New Mexico Medicaid Resources New Mexico Medicaid Portal – https://nmmedicaid.acs-inc.com/static/index.htm Claim Inquiries, Eligibility Verification, Electronic Claim Submission, Provider Manuals, E-News NM Human Services Department – http://www.hsd.state.nm.us/mad/ Supplements, Memos, Provider Billing Packets and Policy Xerox State Healthcare, LLC: Provider Relations Call Center – (800) 299 - 7304 option 6 or (505) 246 - 0710 option 6. Claim Status, Eligibility, Prior Authorization, Medicaid Updates Xerox State Healthcare, LLC. Provider Relations Helpdesk – NMProviderSUPPORT@xerox.com Claim research assistance and general Medicaid inquiries Xerox State Healthcare, LLC. HIPAA Helpdesk – HIPAA.Desk.NM@xerox.com Assistance on NM Web Portal, EDI inquiries, and Online Claim Submission with DDE (Direct Data Entry) Xerox State Healthcare, LLC. Provider Enrollment Helpdesk - NMEnrollmentSUPPORT@xerox.com Provider Enrollment Applications, Forms & Instructions NM Medicaid Recipient Helpdesk – (888) 997 – 2583 or (505) 247 – 1042 Eligibility inquiries, Fee-for-Service Replacement Medicaid Identification Card, Enroll or change a Managed Care Organization and Eligibility application status Update: 09/11/2015

Summary Explained Portal and User Administration Demonstrated features Reviewed the different Types of Inquiries Gave Xerox Resources Provided guidance of where to go for provider information and links Update: 09/11/2015