1. May 2008 Web interChange - Advanced Presented by EDS Provider Relations Field Consultants Insert photo here

2. 2/ May 2008 Web interChange – Advanced Presentation Agenda Session Objectives Live Demonstration Medicare Crossover Billing Third Party Liability (TPL) Billing Attachment Feature Void, Copy & Replacing Claims Provider Profile Help & FAQ Questions

3. 3/ May 2008 Web interChange – Advanced Presentation Session Objectives Following this session, providers will: Understand how to bill crossover claims on web interChange Understand how to bill TPL claims on web interChange Learn the difference between crossovers and TPL Learn how to eliminate paper claims and speed up reimbursement by using the Attachment feature Increase knowledge of the Void, Copy and Replace features Know how to use Provider Profile Know where to access online Help and FAQ

4. 4/ May 2008 Web interChange – Advanced Presentation Medicare Crossovers Definition: A claim filed with Medicaid after Medicare has paid the claim –Ideally, the crossover process will happen automatically –Can be filed on web interChange, even when Medicare does not make a payment Use Attachment feature to submit the EOB if Medicare does not make a payment Medicare denied details are not crossovers and should be submitted on a separate TPL claim All other insurers, including Medicare HMOs, are TPL claims, and not crossovers If no payment due from Medicaid, providers are not required to file crossover claims to Medicaid

5. 5/ May 2008 Web interChange – Advanced Presentation Billing Crossovers & TPL on web interChange Click on Help to find Quick Reference Guides for Dental, Medical & Institutional Claims. –Guides provide step-by-step instructions for Crossover and TPL billing Process is very similar for UB-04, CMS-1500 and Dental claims Process is very similar for entering crossover information versus TPL information From Claim Submission menu, select: –Institutional Crossover –Outpatient Crossover –Medical Crossover –Regular Claim for TPL (i.e. Medical, Dental)

6. May 2008 Live Demo

7. 7/ May 2008 Web interChange – Advanced Presentation Crossover & TPL Billing

8. 8/ May 2008 Web interChange – Advanced Presentation Click Benefit Information to Enter COB info at Header Level

9. 9/ May 2008 Web interChange – Advanced Presentation COB Information – Header Level

10. 10/ May 2008 Web interChange – Advanced Presentation Benefit Information – Header Level Payer ID (00630 for National Government Services) Payer Name (National Government Services Part B) For TPL, Payer ID and Payer Name are name of insurance company with no spaces, i.e. “abcinsuranceco” TPL/Medicare Amount Paid - enter payment amount for the entire claim Other Payer Subscriber Information –Name –Primary ID –Relationship Code –Gender –DOB –Claim Filing Code (MB) This information is on the insured Save Benefits Save and Close

11. 11/ May 2008 Web interChange – Advanced Presentation Click Detail Benefits Info to Enter COB info at Detail Level (do this for each line item)

12. 12/ May 2008 Web interChange – Advanced Presentation COB Information – Detail Level

13. 13/ May 2008 Web interChange – Advanced Presentation Detail Benefits Information – Detail Level Be sure to highlight Line 1 to enter Detail Benefits Information for Line 1 (2,3,4 etc.) Payer ID TPL/Medicare Amount Paid – enter payment for that detail line only, not the entire claim Save Payer Other Payer Payment Adjustments –Group Code (CO) –Reason Code (1=Deductible, 2=Coinsurance) –Amount Save Group Code Save and Close

14. 14/ May 2008 Web interChange – Advanced Presentation Attachment feature Eliminates paper claim when attachment is needed EDS receives the claim immediately Claim suspends for 45 days, or until attachment is received in the mail Clearly indicate Attachment Control Number at top of attachment – (Example: ACN# 10001 page 1 of 1) Mail the Attachment Cover Sheet and the attachment to: EDS P.O. Box 7259 Indianapolis, IN 46207-7259

15. 15/ May 2008 Web interChange – Advanced Presentation Click on Attachments to enter attachment info

16. 16/ May 2008 Web interChange – Advanced Presentation Attachment Information

17. 17/ May 2008 Web interChange – Advanced Presentation Attachment Cover Sheet

18. 18/ May 2008 Web interChange – Advanced Presentation Void, Copy & Replace Voids and Replacements are HIPAA terms for adjustments Voiding a paid claim deletes the claim from the processing system –The amount paid will be recouped from the provider –Commonly used when claim billed for wrong member Replacing a claim overwrites the original claim with a new, corrected claim. A relationship is maintained between the original claim (mother) and replacement claim (daughter) Copying a claim makes an exact copy of the original claim. There is no relationship between the original and the copied claim

19. 19/ May 2008 Web interChange – Advanced Presentation Void, Copy & Replace

20. 20/ May 2008 Web interChange – Advanced Presentation Provider Profile Provider Profile allows you to review current information EDS has on file for your provider The following information can be viewed and printed for each location –Name/Address –Specialty –License and CLIA numbers –Medicare/DMERC numbers –Rendering providers –Electronic Funds Transfer –Tax ID –PMP The information is derived from your provider enrollment applications and updates It is very important to keep this information accurate and up-to-date

21. 21/ May 2008 Web interChange – Advanced Presentation Provider Profile

22. 22/ May 2008 Web interChange – Advanced Presentation Provider Profile Inquiry

23. 23/ May 2008 Web interChange – Advanced Presentation Provider Profile Service Location Inquiry

24. 24/ May 2008 Web interChange – Advanced Presentation Help

25. 25/ May 2008 Web interChange – Advanced Presentation Frequently Asked Questions

26. 26/ May 2008 Web interChange – Advanced Presentation IHCP Web site at www.indianamedicaid.comwww.indianamedicaid.com IHCP Provider Manual (Web, CD-ROM, or paper) Customer Assistance –1-800-577-1278, or –(317) 655-3240 in the Indianapolis local area Written Correspondence –P.O. Box 7263 Indianapolis, IN 46207-7263 Provider Relations Field Consultant –View a current territory map and contact information online at www.indianamedicaid.comwww.indianamedicaid.com Helpful Tools Avenues of Resolution

27. May 2008 Questions

28. May 2008 EDS 950 N. Meridian Street, Suite 1150 Indianapolis, IN 46204 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. © 2007 Electronic Data Systems Corporation. All rights reserved.