2. MO HealthNet Internet Provider Training Program Presented by the Provider Education Unit MO HealthNet Division 1

3. Proper Completion of the Online Medicare Part B Crossover Claim Presented by the Provider Education Unit MO HealthNet Division 2

4. To file a claim go to the Internet Web site www.emomed.com and log on under the appropriate NPI and Taxonomy code, if applicable for the claim to be submitted. Enter your user ID and Password. This will bring up the eProvider Home Page. At the top of each page is a “Help” button in the form of a question mark. You can print out field-by-field instructions. www.emomed.com MO HealthNet Division3

5. 4 CLAIM MANAGEMENT

6. MO HealthNet Division5 NEW XOVER CLAIM

7. MO HealthNet Division6 MEDICARE CMS-1500 PART B PROFESSIONAL

8. Participant DCNParticipant Last NameParticipant First Name Patient Account NumberParticipant Medicare ID (HIC) 7MO HealthNet Division

9. Participant DCNParticipant Last NameParticipant First Name Patient Account NumberParticipant Medicare ID (HIC) 8MO HealthNet Division

10. Participant DCNParticipant Last NameParticipant First Name Patient Account NumberParticipant Medicare ID (HIC) 9MO HealthNet Division

11. Participant DCNParticipant Last NameParticipant First Name Patient Account NumberParticipant Medicare ID (HIC) 10MO HealthNet Division

12. Participant DCNParticipant Last NameParticipant First Name Patient Account NumberParticipant Medicare ID (HIC) 11MO HealthNet Division

13. 12 Medicare Provider NPIHospitalization Dates Save Claim HeaderDiagnosis Codes

14. MO HealthNet Division13 Medicare Provider NPIHospitalization Dates Save Claim HeaderDiagnosis Codes

15. MO HealthNet Division14 Medicare Provider NPIHospitalization Dates Save Claim HeaderDiagnosis Codes

16. MO HealthNet Division15 Medicare Provider NPIHospitalization Dates Save Claim HeaderDiagnosis Codes

17. MO HealthNet Division16 Dates of ServicePlace of Service Procedure CodeModifiers

18. MO HealthNet Division17 Dates of ServicePlace of Service Procedure CodeModifiers

19. MO HealthNet Division18 Dates of ServicePlace of Service Procedure CodeModifiers

20. MO HealthNet Division19 Dates of ServicePlace of Service Procedure CodeModifiers

21. MO HealthNet Division20 National Drug CodeDecimal Quantity Diagnosis Code Billed Charges Days/Units Billed

22. MO HealthNet Division21 National Drug CodeDecimal Quantity Diagnosis Code Billed Charges Days/Units Billed

23. MO HealthNet Division22 National Drug CodeDecimal Quantity Diagnosis Code Billed Charges Days/Units Billed

24. MO HealthNet Division23 National Drug CodeDecimal Quantity Diagnosis Code Billed Charges Days/Units Billed

25. MO HealthNet Division24 National Drug CodeDecimal Quantity Diagnosis Code Billed Charges Days/Units Billed

26. MO HealthNet Division25 Paid Amount Performing Provider NPI Save Detail Line to Claim

27. MO HealthNet Division26 Paid Amount Performing Provider NPI Save Detail Line to Claim

28. MO HealthNet Division27 Paid Amount Performing Provider NPI Save Detail Line to Claim

29. MO HealthNet Division28 Dates of Service Place of Service Procedure CodeModifiers

30. MO HealthNet Division29 Dates of Service Place of Service Procedure CodeModifiers

31. MO HealthNet Division30 Dates of Service Place of Service Procedure CodeModifiers

32. MO HealthNet Division31 Dates of Service Place of Service Procedure CodeModifiers

33. MO HealthNet Division32 Diagnosis CodeBilled ChargesDays/Units Billed Paid AmountPerforming Provider NPI Save Detail Line to Claim

34. MO HealthNet Division33 Diagnosis CodeBilled ChargesDays/Units Billed Paid AmountPerforming Provider NPI Save Detail Line to Claim

35. MO HealthNet Division34 Diagnosis CodeBilled ChargesDays/Units Billed Paid AmountPerforming Provider NPI Save Detail Line to Claim

36. MO HealthNet Division35 Diagnosis CodeBilled ChargesDays/Units Billed Paid AmountPerforming Provider NPI Save Detail Line to Claim

37. MO HealthNet Division36 Diagnosis CodeBilled ChargesDays/Units Billed Paid AmountPerforming Provider NPI Save Detail Line to Claim

38. MO HealthNet Division37 Diagnosis CodeBilled ChargesDays/Units Billed Paid AmountPerforming Provider NPI Save Detail Line to Claim

39. MO HealthNet Division38 Filing Indicator Other Payer IDOther Payer NamePaid Date

40. MO HealthNet Division39 Filing Indicator Other Payer IDOther Payer NamePaid Date

41. MO HealthNet Division40 Filing Indicator Other Payer IDOther Payer NamePaid Date

42. MO HealthNet Division41 Filing Indicator Other Payer IDOther Payer NamePaid Date

43. MO HealthNet Division42 Paid AmountTotal Denied AmountRemittance Advice Remark Codes Save Other Payer Data and Manage Codes

44. MO HealthNet Division43 Paid AmountTotal Denied AmountRemittance Advice Remark Codes Save Other Payer Data and Manage Codes

45. MO HealthNet Division44 Paid AmountTotal Denied AmountRemittance Advice Remark Codes Save Other Payer Data and Manage Codes

46. MO HealthNet Division45 Paid AmountTotal Denied AmountRemittance Advice Remark Codes Save Other Payer Data and Manage Codes

47. MO HealthNet Division46 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

48. MO HealthNet Division47 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

49. MO HealthNet Division48 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

50. MO HealthNet Division49 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

51. MO HealthNet Division50 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

52. MO HealthNet Division51 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

53. MO HealthNet Division52 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

54. MO HealthNet Division53 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

55. MO HealthNet Division54 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

56. MO HealthNet Division55 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

57. MO HealthNet Division56 Claim Group CodeClaim Adjustment Reason Code Adjustment AmountSave Codes to Other Payer

58. MO HealthNet Division57 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

59. MO HealthNet Division58 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

60. MO HealthNet Division59 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

61. MO HealthNet Division60 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

62. MO HealthNet Division61 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

63. MO HealthNet Division62 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

64. MO HealthNet Division63 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

65. MO HealthNet Division64 Claim Group CodeClaim Adjustment Reason Code Adjustment AmountSave Codes to Other Payer

66. MO HealthNet Division65 Save Other Payer to Claim

67. MO HealthNet Division66 Submit Claim

68. MO HealthNet Division67 Filing Indicator Other Payer IDOther Payer NamePaid Date

69. MO HealthNet Division68 Filing Indicator Other Payer IDOther Payer NamePaid Date

70. MO HealthNet Division69 Filing Indicator Other Payer IDOther Payer NamePaid Date

71. MO HealthNet Division70 Filing Indicator Other Payer IDOther Payer NamePaid Date

72. MO HealthNet Division71 Paid AmountTotal Denied Amount Save Other Payer Data and Manage Codes

73. MO HealthNet Division72 Paid AmountTotal Denied Amount Save Other Payer Data and Manage Codes

74. MO HealthNet Division73 Paid AmountTotal Denied Amount Save Other Payer Data and Manage Codes

75. MO HealthNet Division74 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

76. MO HealthNet Division75 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

77. MO HealthNet Division76 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

78. MO HealthNet Division77 Associated Line Items Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

79. MO HealthNet Division78 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

80. MO HealthNet Division79 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

81. MO HealthNet Division80 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

82. MO HealthNet Division81 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

83. MO HealthNet Division82 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

84. MO HealthNet Division83 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount

85. MO HealthNet Division84 Claim Group CodeClaim Adjustment Reason Code Adjustment Amount Save Codes to Other Payer

86. MO HealthNet Division85 Associates Line Items Claim Group Code Claim Adjustment Reason Code Adjustment Amount

87. MO HealthNet Division86 Associates Line Items Claim Group Code Claim Adjustment Reason Code Adjustment Amount

88. MO HealthNet Division87 Associates Line Items Claim Group Code Claim Adjustment Reason Code Adjustment Amount

89. MO HealthNet Division88 Associates Line Items Claim Group Code Claim Adjustment Reason Code Adjustment Amount

90. MO HealthNet Division89 Claim Group Code Claim Adjustment Reason Code Adjustment Amount

91. MO HealthNet Division90 Claim Group Code Claim Adjustment Reason Code Adjustment Amount

92. MO HealthNet Division91 Claim Group Code Claim Adjustment Reason Code Adjustment Amount

93. MO HealthNet Division92 Claim Group Code Claim Adjustment Reason Code Adjustment Amount

94. MO HealthNet Division93 Claim Group Code Claim Adjustment Reason Code Adjustment Amount

95. MO HealthNet Division94 Claim Group Code Claim Adjustment Reason Code Adjustment Amount

96. MO HealthNet Division95 Claim Group Code Claim Adjustment Reason Code Adjustment AmountSave Codes to Other Payer

97. MO HealthNet Division96 Save Other Payer to Claim

98. MO HealthNet Division97 Submit Claim

99. MO HealthNet Division98 Claim ReceivedCopy ClaimPayment DetailsPrinter Friendly

100. MO HealthNet Division99 Claim ReceivedCopy ClaimPayment DetailsPrinter Friendly

101. MO HealthNet Division100 Claim ReceivedCopy ClaimPayment DetailsPrinter Friendly

102. MO HealthNet Division101 Claim ReceivedCopy ClaimPayment DetailsPrinter Friendly

103. MO HealthNet Division102 Claim Status New ClaimFinish

104. MO HealthNet Division103 Claim Status New ClaimFinish

105. Thank you again for participating in this training program. If you have questions regarding the information in this presentation, please contact the Provider Education Unit at 573-751-6683. MO HealthNet Division104