Electronic Solutions 1

Electronic Submission of Claims HSCSN is able to accept claims electronically that are processed through EMDEON clearinghouse. It is not necessary that you use EMDEON—only that your claims management company is able to submit claims through EMDEON as a clearinghouse. If you have any questions, contact your claims management provider. To submit claims, you will need the HSCSN Payor ID which is:

Advantages Claims can be tracked electronically Improved patient collections Rapid and accurate payment processing 3

Where? VISIT: PROVIDER SERVICES PROVIDER RESOURCES PROVIDER CLAIMS 4

What Solutions? CLAIMS STATUS (276/277) Check the status of your processed claims on-line. Claims will either be paid or denied DIRECT CLAIMS ENTRY Enter your claims directly into the system ELIGIBILITY (270/271) Check the status of our enrollees on-line. PROVIDER VOUCHER – PDF VERSION Obtain a copy of your voucher online in a PDF format PROVIDER VOUCHER – 835 VERSION Obtain a copy of your voucher in an electronic HIPAA compliant format 5

Important ALL ELECTRONIC SOLUTIONS REQUIRE ENROLLMENT INTO THE PROCESS 6

Claims Status Claims status is an electronic solution to our providers enabling them to check the status of their claims online. The link to their portal is hosted on our website under: Provider Services/Provider Claims: Click on HSCSN Claims Status link » and you will be directed to the portal login page.HSCSN Claims Status link » For instructions click here HSCSN Provider Portal Self-Enrollment Process Instructions.HSCSN Provider Portal Self-Enrollment Process Instructions Self Enrollment Process – when the provider signs up for Claims status link – there is a pre-enrollment process. Provider signs up – then will receive an from Emdeon. The provider must then complete the enrollment process. If a provider signs up for direct claims entry – a pre-enrollment process is still required. Emdeon will then call the provider to walk them through how to enter a claim online. For online help use the Online Support tool to create a trouble ticket.Online Support Alternatively, you can call the toll-free customer support number at

Direct Claims Entry  If you are utilizing the direct claims entry through the claims status portal, please pay attention to links on the home page.  The link on the home page will say “You have X un-worked claim rejections” which serves as both an alert of rejections and a link to the report listing rejections.  To choose to review reports – you must choose this set-up or “opt-in” to receive rejection reports.  If you think you need further education on utilizing the portal for claims entry, please contact the help desk toll-free number at and someone will walk you through the process. 8

Eligibility  If a provider has already signed up to send/receive HIPAA claim status responses, then they do NOT have to sign up separately for Eligibility responses.  The provider just needs to contact their vendor and let the vendor know that they want to also send eligibility requests. The vendor will work out any details with Emdeon.  Similarly, if a provider already has access to Claim status on the HSCSN portal then they do NOT have to sign up separately to view Eligibility.  Providers will already have the ability to log on and check the eligibility. 9

Voucher – PDF Version Click on HSCSN Claims Status link » and you will be directed to the portal login page.HSCSN Claims Status link » Select Payment Tab > More from the main menu. The Payment Additional Resources window appears. Click the “Add, Change, or Remove Providers or Payers” link. The Add, Change, or Remove Providers or Payers window appears. In the Select an Action section, select one of the three options indicating whether to add, change, or remove provider or payer information. In the Enter Provider Information section, enter the provider’s identifying information. Required items are marked with a red asterisk (*). In the Enter Payer Information section, you must enter at least one payer. HSCSN Payer ID is Click Submit. This is a one-time enrollment. You will be notified via when the enrollment process has been completed. Please allow time for the enrollment process to be finalized. If you are not currently using Claims Status – you need to enroll before accessing the Payment Manager. Each enrollment is a one-time enrollment per product. 10

Voucher – PDF Version Once you have been notified that your enrollment is complete, you will be able to sign onto Claims Status Link and enter your information in the Payment: Remit section and obtain a copy of your Provider Voucher as often as needed. 11

Voucher – 835 Version Instructions for Providers who want to sign up for 835 Go to - Click on Set-Up Formshttp:// 12

835 Version 13 That will take you to the “Resource Library”

835 Version Scroll down and click on “ERA Provider Setup Form” 14

835 Version 15 Provider Information goes in this section Your Vendor information goes in this section Need Help??? on.com or call

Questions??? 16