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

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Presentation on theme: "MO HealthNet Internet Provider Training Program Presented by the Provider Education Unit MO HealthNet Division 1."— Presentation transcript:

1

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 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. 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 MO HealthNet Division104


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