HP Provider Relations October 2010 Web interChange Basic Functions

Web interChange Basic FunctionsOctober Agenda –Objectives –Indiana Medicaid Web Site –What is Web interChange? –How to Enroll in Web interChange –Administration Menu –Check/Remittance Advice (RA) Inquiry –Claim Inquiry –Claim Submission Institutional Professional Dental –Eligibility Inquiry –Password Reset –Questions

Web interChange Basic FunctionsOctober Objectives –Become familiar with the Indiana Medicaid Web site –Know how to enroll to use Web interChange –Become familiar with Web interChange functions

Introduce Indiana Medicaid Web site

Web interChange Basic FunctionsOctober Member Tab –Qualification Guidelines –Medicaid Programs –Apply for Medicaid Benefits –Check Application Status –Search for a Provider –Choose a Health Plan –Presumptive Eligibility –Pharmacy Information

Web interChange Basic FunctionsOctober Indiana Medicaid Member Web Site

Web interChange Basic FunctionsOctober Indiana Medicaid Member Web Site

Web interChange Basic FunctionsOctober Provider Tab –Link to the Web interChange –Provider Enrollment –Banners – Bulletins – Newsletters –Workshop Information –Provider Education and Assistance –News and Announcements

Web interChange Basic FunctionsOctober Indiana Medicaid Provider Web Site

Web interChange Basic FunctionsOctober Indiana Medicaid Provider Web Site

Web interChange Basic FunctionsOctober Provider Tab

Learn Web interChange

Web interChange Basic FunctionsOctober What is Web interChange? Web interChange is an interactive Web application that allows providers to: –Submit claims –Submit voids or adjustments –Review processed claims –Verify members’ eligibility –Obtain and print check/Remittance Advice (RA) information

Web interChange Basic FunctionsOctober How to Enroll –Access Web interChange from the Indiana Health Coverage Programs (IHCP) Web site at: –Download the interChange Administrator Request Form –Complete and mail or fax forms to: HP Indiana Title XIX Electronic Solutions Help Desk 950 N. Meridian Street Suite 1150 Indianapolis, IN Fax number: (317)  Web interChange is free.

Web interChange Basic FunctionsOctober How to Enroll –Each provider must assign a Web interChange administrator –In addition to the enrollment form, providers must send a note of acknowledgement on company letterhead indicating the owner approves the person completing the request form as a Web interChange administrator for the organization –By signing, the owner acknowledges that he or she has read and understood the document and agreed to the terms and conditions as they describe the role that the administrator will perform

Web interChange Basic FunctionsOctober How to Enroll

Web interChange Basic FunctionsOctober How to Enroll

Web interChange Basic FunctionsOctober How to Enroll

Web interChange Basic FunctionsOctober Logon Screen

Web interChange Basic FunctionsOctober Administration Functions –Create Users –Update Users –Reset Passwords –Reactivate Users –Administer Groups –Maintain Provider Profile –Maintain User Lists

Web interChange Basic FunctionsOctober Administration Functions

Web interChange Basic FunctionsOctober Check/RA Inquiry Accessing paperless RAs through Web interChange Three Easy Steps –Step 1 – From the Web interChange menu, select Check/RA Inquiry. On the Check/RA Inquiry page, enter the desired search criteria and click Submit. A list of checks and RAs (most recent first) displays. The link to download the RA displays even when there is no payment If no check was issued in conjunction with the RA, the check number displays as “ ” The Provider/National Provider Identifier (NPI) fields populate based on the user’s security

Web interChange Basic FunctionsOctober Check/RA Inquiry Accessing paperless RAs through Web interChange –Step 2 – Click on the PDF icon to the right of the check number (in the “Download RA” column) The RA opens as a PDF document in a new window Downloaded RAs have a Family and Social Services Administration (FSSA) watermark If users wish to save copies of RAs for their records, they can use the “Save a Copy” feature of Adobe Acrobat Reader  RAs can also be printed from Adobe Acrobat Reader –Step 3 – If the desired RA is not displayed, change the search criteria at the top of the Check/RA Inquiry page RAs are available in Web interChange for four weeks

Web interChange Basic FunctionsOctober Check/RA Inquiry

Web interChange Basic FunctionsOctober Check/RA Inquiry

Web interChange Basic FunctionsOctober Claim Inquiry –Check status of claims By member number and date of service RA date Date of service –Print proof of timely filing –Show more claim information Review claim explanation of benefit information –Copy, void, and replace claims

Web interChange Basic FunctionsOctober Claim Inquiry

Web interChange Basic FunctionsOctober Claim Inquiry

Web interChange Basic FunctionsOctober Claim Inquiry

Web interChange Basic FunctionsOctober Claim Inquiry

Web interChange Basic FunctionsOctober Claim Inquiry

Web interChange Basic FunctionsOctober Claim Submission Institutional billing

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – header information –NPI – choose appropriate when applicable –Member recipient ID (RID) –Member name –Patient account number – assigned by the provider –Attending physician NPI –Operating Physician NPI (when applicable) –Other Physician NPI (PMP) – when applicable –Type of bill –From date of service –Thru date of service –Covered days –Patient status

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – header information –Admission type –Admission date –Admission hour – when applicable –Diagnosis codes –E code – when applicable –Principal procedure – when applicable –Condition code – when applicable –Value code –Occurrence code – when applicable –POA Indicator – when applicable –Additional codes – when applicable

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – header information

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – additional billing codes

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – additional billing codes

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – additional billing codes

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – additional billing codes

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – additional billing codes

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – additional billing codes

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – detail information –Revenue code –Procedure code and modifier(s) – when applicable –Date of service –Units –Total charge –Save detail –Copy/add detail – when applicable –Submit claim

Web interChange Basic FunctionsOctober Claim Submission Institutional billing – detail information

Web interChange Basic FunctionsOctober Claim Submission Professional

Web interChange Basic FunctionsOctober Claim Submission Professional – header information –NPI – choose appropriate when applicable –Postal code or taxonomy – when applicable –Member recipient ID (RID) –Member name –Patient account number – assigned by the provider –Referring NPI – when applicable –Certification code – when applicable –Place of service –Pregnancy – if applicable –Last menstrual period – if applicable –Accident related – if applicable –Diagnosis code

Web interChange Basic FunctionsOctober Claim Submission Professional – header information

Web interChange Basic FunctionsOctober Claim Submission Professional – header information

Web interChange Basic FunctionsOctober Claim Submission Professional – detail information –From date of service –Thru date of service –Place of service –Procedure code –Modifier(s)– when applicable –Related diagnosis – when applicable –Units –Total charge –Emergency – when applicable –EPSDT – when applicable –Rendering NPI –NDC information – when applicable –Save detail –Copy/add detail – when applicable –Submit claim

Web interChange Basic FunctionsOctober Claim Submission Professional – detail information

Web interChange Basic FunctionsOctober Claim Submission Dental

Web interChange Basic FunctionsOctober Claim Submission Dental – header information –NPI – choose appropriate when applicable –Postal code or taxonomy – when applicable –Member recipient ID (RID) –Member name –Patient account number – assigned by the provider –Place of service –Emergency – when applicable –Accident-related – when applicable

Web interChange Basic FunctionsOctober Claim Submission Dental – header information

Web interChange Basic FunctionsOctober Claim Submission Dental – detail information –Date of service –Procedure code –Tooth number – when applicable –Surface – when applicable –Units –Total charge –Rendering NPI –Save detail –Copy/add detail – when applicable –Submit claim

Web interChange Basic FunctionsOctober Claim Submission Dental – detail information

Web interChange Basic FunctionsOctober Eligibility Inquiry –NPI – choose appropriate when applicable –Postal code or taxonomy – when applicable –Search Member recipient ID (RID) SSN Medicare ID Name and date of birth –From date –To date Search by individual date of service

Web interChange Basic FunctionsOctober Eligibility Inquiry

Web interChange Basic FunctionsOctober Password Reset Users may reset their own password utilizing the “Reset Password” function Administrators may reactivate a user who is inactive for lack of use (has not logged on for 90 days)

Find Help Resources available

Web interChange Basic FunctionsOctober Helpful Tools Avenues of resolution –IHCP Web site at –IHCP Provider Manual (Web, CD-ROM, or paper) –Customer Assistance Local (317) All others –Written Correspondence HP Provider Written Correspondence P. O. Box 7263 Indianapolis, IN –Provider field consultant View a current territory map and contact information online at

Q&A