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

2. 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

3. Objectives Xerox Resources Portal and User Administration Features
Types of Inquiries
Links
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4. 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
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5.
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6. The Xerox New Mexico Medicaid Web Portal
Non Secure Features
Secure Features requires login
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7. The Xerox NM Medicaid Web Portal Login Page
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8. 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.
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9. Web Registration – “How-To”
Complete every field
that contains an asterisk
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10. 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
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11. Electronic Funds Transfers (EFT)
Step One: Click on EFT Administration
Step Two: Enter EIN (Federal Tax ID) or SSN
and click on submit
ONLY the Master Administrator will have this access
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12. User Privileges
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13. Claims Entry

14. 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.
15-03 Supplement on Multiple Topics, including ICD-10, Billing Using Paper Claims, etc.
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15. 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
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16. Adjustments and Voids
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17. Adding Templates
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18. Claims Re-Bill
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19. Eligibility Claim Status Prior Authorization Payment History
Types of Inquiries
Eligibility
Claim Status
Prior Authorization
Payment History

20. Eligibility Inquiry
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21. 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)
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22. Eligibility Inquiry
The “SSN-style” ID number
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23. 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.
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24. Update: 09/11/2015

25. Eligibility Inquiry continued
This person is blind receiving SSI COE 003
Please note: This person has both Managed Care and TPL.
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26. Eligibility Claim Status Prior Authorization Payment History
Types of Inquiries
Eligibility
Claim Status
Prior Authorization
Payment History

27. 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
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28. Claim Status Inquiry
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29. 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.
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30. Date Range Inquiry
Note: Unless you are a small provider, this search will probably result in more than 200 claims.
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31. Claim Summary Click on TCN to view specific claim detail
Click on the Recipient ID to go to Recipient Inquiry
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32. 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.
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33. Eligibility Claim Status Prior Authorization Payment History
Types of Inquiries
Eligibility
Claim Status
Prior Authorization
Payment History

34. Prior Authorization Inquiry
Current PA’s are available
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35. Prior Authorization Summary
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36. Eligibility Claims Status Prior Authorization Payment History
Types of Inquiries
Eligibility
Claims Status
Prior Authorization
Payment History

37. Payment History Inquiry
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38. Payment History Inquiry
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39. Reports

40. Reports and Data Files
Providers can pull the last 8 RA’s from the Web Portal
Select PDF Reports to retrieve Remittance Advices
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41. Reports and Data Files Enter Provider ID or NPI and click submit
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42. Remittance Advice Detail
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43. FAQ’s/ Links/Contact Us

44. Provider Information
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45. FAQs
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46. Links
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47. Contact Us
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48. Provider Enrollment

49. Enroll Online
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50. Check Enrollment Status
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51. New Mexico Medicaid Resources
New Mexico Medicaid Portal –
Claim Inquiries, Eligibility Verification, Electronic Claim Submission, Provider Manuals, E-News
NM Human Services Department –
Supplements, Memos, Provider Billing Packets and Policy
Xerox State Healthcare, LLC: Provider Relations Call Center – (800) option 6 or (505) option 6. Claim Status, Eligibility, Prior Authorization, Medicaid Updates
Xerox State Healthcare, LLC. Provider Relations Helpdesk –
Claim research assistance and general Medicaid inquiries
Xerox State Healthcare, LLC. HIPAA Helpdesk –
Assistance on NM Web Portal, EDI inquiries, and Online Claim Submission with DDE (Direct Data Entry)
Xerox State Healthcare, LLC. Provider Enrollment Helpdesk -
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
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52. 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
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