1. 03-23-05 October 2006 Web interChange - Basic Presentation Presented by the EDS Provider Field Consultants

2. Web interChange - Basic Presentation October 2006 page 2 Agenda What is Web interChange? How to Enroll in Web interChange Overview Verifying Member Eligibility Check Write Web interChange Claims Submission –Institutional –Coordination of Benefits –Professional –Dental Claim Inquiry Questions Welcome and Announcements

3. Web interChange - Basic Presentation October 2006 page 3 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. - Inquire about previously received payments. - Submit prior authorizations (if applicable).

4. Web interChange - Basic Presentation October 2006 page 4 Access Web interChange from the Indiana Health Coverage Programs (IHCP) Web site at: https://interchange.indianamedicaid.com https://interchange.indianamedicaid.com Download Web interChange enrollment forms. Complete and mail or fax forms to: EDS Indiana Title XIX Electronic Solutions Helpdesk 950 N. Meridian Street Suite 1150 Indianapolis, Indiana 46204-4288 Fax number: (317)488-5185 Send original enrollment forms by mail, even if sending them by fax. Web interChange is free. How to Enroll

5. Web interChange - Basic Presentation October 2006 page 5 Each provider must assign an Administrator to oversee the daily functions of your individual practice or group. 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 an 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. Enrollment Requirements Administrator

6. Web interChange - Basic Presentation October 2006 page 6 Overview Web interChange Logon Screen

7. Web interChange - Basic Presentation October 2006 page 7 Overview Web interChange Home Page

8. Web interChange - Basic Presentation October 2006 page 8 Verifying Member Eligibility Eligibility Inquiry Window

9. Web interChange - Basic Presentation October 2006 page 9 Verifying Member Eligibility The following enhanced member-related features are available through Web interChange: County caseworker, county information, and case identification numbers Detailed TPL information Online TPL update requests Note: These features are not available through the Automated Voice Response (AVR) or the OMNI swipe machine.

10. Web interChange - Basic Presentation October 2006 page 10 Check Write Check Inquiry Window

11. Web interChange - Basic Presentation October 2006 page 11 Web interChange Claims Submission Institutional Billing

12. Web interChange - Basic Presentation October 2006 page 12 Web interChange Claims Submission Institutional Billing – Header Information

13. Web interChange - Basic Presentation October 2006 page 13 Web interChange Claims Submission Institutional Billing – Additional Billing Codes

14. Web interChange - Basic Presentation October 2006 page 14 Web interChange Claims Submission Institutional Billing – Diagnosis Information

15. Web interChange - Basic Presentation October 2006 page 15 Web interChange Claims Submission Institutional Billing – Procedure Information

16. Web interChange - Basic Presentation October 2006 page 16 Web interChange Claims Submission Institutional Billing – Condition Code Information

17. Web interChange - Basic Presentation October 2006 page 17 Web interChange Claims Submission Institutional Billing – Occurrence Code Information

18. Web interChange - Basic Presentation October 2006 page 18 Web interChange Claims Submission Institutional Billing – Occurrence Span Information

19. Web interChange - Basic Presentation October 2006 page 19 Web interChange Claims Submission Institutional Billing – Value Code Information

20. Web interChange - Basic Presentation October 2006 page 20 Web interChange Claims Submission Attachment Information

21. Web interChange - Basic Presentation October 2006 page 21 Web interChange Claims Submission Institutional Attachment Information

22. Web interChange - Basic Presentation October 2006 page 22 Web interChange Claims Submission Institutional Note Information

23. Web interChange - Basic Presentation October 2006 page 23 Web interChange Claims Submission Institutional Note Information

24. Web interChange - Basic Presentation October 2006 page 24 Web interChange Claims Submission Benefit Information

25. Web interChange - Basic Presentation October 2006 page 25 Web interChange Claims Submission Institutional Benefit Information

26. Web interChange - Basic Presentation October 2006 page 26 Web interChange Claims Submission Institutional Benefit Information

27. Web interChange - Basic Presentation October 2006 page 27 Web interChange Claims Submission Institutional Benefit Information - Additional

28. Web interChange - Basic Presentation October 2006 page 28 Web interChange Claims Submission Institutional Billing – Detail Information

29. Web interChange - Basic Presentation October 2006 page 29 Web interChange Claims Submission Institutional Detail Benefit Information

30. Web interChange - Basic Presentation October 2006 page 30 Web interChange Claims Submission Coordination of Benefits Information (COB) Medicare crossover claims require: –Payer ID and Payer Name –Subscriber name, Primary ID, Relationship Code, Gender, and date of birth –Claim Filing Code, MA or MB Third Party Liability (TPL) claims require: –Payer ID and the Payer Name is the name of the TPL insurer with no spaces –TPL/Medicare Paid Amount –Subscriber name, Primary ID, relationship code, gender, and date of birth –The Claim Filing Code is not used A quick reference guide is available to assist with claims submission. Locate it from the HELP option.

31. Web interChange - Basic Presentation October 2006 page 31 Web interChange Claims Submission Medicare Payer IDs for Crossover Claims Obtain a complete list of Payer IDs from the following Web sites: –IHCP Home Page at www.indianamedicaid.com www.indianamedicaid.com –Coordination of Benefit instructions on Web interChange

32. Web interChange - Basic Presentation October 2006 page 32 Web interChange Claims Submission Professional Billing

33. Web interChange - Basic Presentation October 2006 page 33 Web interChange Claims Submission Professional Billing – Header Information

34. Web interChange - Basic Presentation October 2006 page 34 Web interChange Claims Submission Professional Billing – Detail Information

35. Web interChange - Basic Presentation October 2006 page 35 Web interChange Claims Submission Professional and Dental Attachment Information

36. Web interChange - Basic Presentation October 2006 page 36 Web interChange Claims Submission Dental Billing

37. Web interChange - Basic Presentation October 2006 page 37 Web interChange Claims Submission Dental Billing – Header Information

38. Web interChange - Basic Presentation October 2006 page 38 Web interChange Claims Submission Dental Billing – Detail Information

39. Web interChange - Basic Presentation October 2006 page 39 Claim Inquiry Claim Inquiry Window

40. Web interChange - Basic Presentation October 2006 page 40 Claim Inquiry Claim Inquiry Window Copy Function

41. Web interChange - Basic Presentation October 2006 page 41 Claim Inquiry Claim Inquiry Window Copy Function – Show Me More Button

42. Web interChange - Basic Presentation October 2006 page 42 Claim Inquiry Claim Inquiry Window Copy Function – Old Claim ICN Information

43. Web interChange - Basic Presentation October 2006 page 43 Claim Inquiry Claim Inquiry Window Copy Function – New Claim ICN Information

44. Web interChange - Basic Presentation October 2006 page 44 Questions

45. 03-23-05 October 2006 page 45 EDS 950 N. Meridian St., Suite 1150 Indianapolis, IN 46204 Presentation by EDS Provider Field Consultants EDS and the EDS logo are registered trademarks of Electronic Data Systems Corporation. EDS is an equal opportunity employer and values the diversity of its people. © 2005 Electronic Data Systems Corporation. All rights reserved.