presented by: igi health

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Presented by: IGI Health

OrbiteConnect:

OrbiteConnect 101

&

Filing A CMS 1500 e-claim

For more information, please email us at:

orbitconnect.support@igiusa.com

Or call us at: 877-444-7194

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Statutes require electronic submission of health insurance claims, eligibility inquiries and responses, remittance advices in a standard format by July 2009.

What & WhyWhat & Why

What?

Explore your options for compliance with the law!

One set of data standards for providers and payers, transmitted electronically, has proven to reduce costs, streamline health care transactions, and improve the delivery of health care services.

Why?

Single set of billing codes could reduce costs by $60 million in alone.

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All health care providers who check eligibility, submit claims and/or receive RAs, as well as all health plans, including Department of Human Services (DHS)-administered Health Care Programs (MHCP).

Who, When & HowWho, When & How

Who?

When? Eligibility verification inquiry and response (270/271) – Jan. 15, 2009 Professional, institutional, dental, pharmacy and medical codes (837P, 837I, 837D and NCPDP 5.1) - July 15, 2009 Payment and Remittance Advices (835) - Dec. 15, 2009

How?The Department of Health consulted with the Administrative Uniformity Committee to create uniform standard companion guides for these transactions.

How can providers easily comply with these guidelines?

OrbiteConnect: Gateway to standardized electronic claims submission

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How Will Providers Be Able To How Will Providers Be Able To Comply? Comply?

In order to assist those health care providers that do not have a system in place to comply, health plans are offering a web based tool to easily submit claims electronically. Health plans have contracted with IGI to supply and manage this tool.

Providers can use this tool to submit claims FREE of charge, with these payers and over 100’s of other payers that are available.

Blue Cross and Blue Shield of MN FirstPlan of MN HealthPartners Medica Metropolitan Health Plan PreferredOne Sanford Health Plan UCare ChiroCare (CCMI) Itasca Medical Care PrimeWest Health South Country Health Alliance HSM

www.orbiteconnect.net

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Can Any Provider Use The Tool?Can Any Provider Use The Tool?

Special transportation vendorsTaxi driversLicensed psychologistsChiropractorsHome care providersPersonal care assistants

Yes!

ALL providers can use OrbiteConnect, regardless of size – although the tool was developed with small practitioners in mind.

Typical targeted providers include:

Care coordinatorsHome modification providersCarpentersLanguage interpreters and translatorsDentistsAnd others

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Use IGI For Other Services & To Use IGI For Other Services & To Meet Other Mandates Meet Other Mandates

Register with OrbiteConnect to conduct the following ERA – Mandate effective December 15, 2009 Eligibility Verification – Mandate effective January 15, 2009

Expanded Payer Service Register with over 100’s of new payers through OrbiteConnect

Conduct Credit Card Transactions

E-Prescribing - Mandate effective January 1, 2011 All providers, group purchasers, prescribers, and dispensers must establish and

maintain an electronic prescription drug program that complies with the applicable standards, directly or through an intermediary, prescriptions and prescription-related information using electronic media

EHR (Electronic Health Record Service) –Mandate effective January 1, 2015 All hospitals and health care providers must have in place an interoperable

electronic health records system within their hospital system or clinical practice setting. The commissioner of health, in consultation with the Health Information Technology and Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal, including uniform standards to be used for the interoperable system for sharing and synchronizing patient data across systems. The standards must be compatible with federal efforts

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How OrbiteConnect Works

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1) Register Online Health care providers can register with OrbiteConnect at www.orbitconnect.net. This

process takes five minutes and approval is generally immediate.

Some health plans require confirmation of the provider registration before transactions can be sent.

2) Submit Claims Online Providers enter claims by logging on to the website and entering claims information

into an “e-claim” which looks exactly like the paper form providers still use today.

The system flags any errors that providers can immediately correct to ensure compliance with state and HIPAA requirements.

Providers submit claim into the system, and the payer receives data in a standardized, compliant format.

3) Receive Notification Online and Payment from Payer Payers send status reports back to providers through OrbiteConnect, and send

payment to the providers, independently.

Payment cycles on electronic claims are determined by each payer and will vary.

How To Get StartedHow To Get Started

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Landing PageLanding Page

Once you reach the Landing Page, you are able to do the following;1. Register (If you have not done so already)2. Log in to your account (if you have received your confirmation email stating

that the payer (s) have approved your registration)

Returning Users Returning Users

First Time Users First Time Users

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Registering To Use OrbiteConnect-Registering To Use OrbiteConnect-First Time Users-Step 1First Time Users-Step 1

Go to: www.orbiteconnect.net

Click “Register Here”, it will bring you to the following page below.

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Registering To Use OrbiteConnect-Registering To Use OrbiteConnect-First Time Users-Step 2First Time Users-Step 2

Necessary Information:

Provider type: solo, group or billing service

Federal Tax ID number

National Provider ID

UMPI

Tax ID/SSN or other IDs

Health Plans your practice bills

Name and contact information for your administrative user

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Registering To Use MNeConnect-Registering To Use MNeConnect-First Time Users-Step 3First Time Users-Step 3

Approval time takes 3 to 5 business days, regardless of

the payer.

Once a payer has approved your registration, you are able

to log in & set up your account.

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Log InLog In

Type in your user name and password Type in your user name and password

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Account AccessAccount Access

For providers who currently use OrbiteConnect, you will be able to access four new features within your account:1. Additional Services Option (found under Billing Account Admin Tab)2. Services Status (found under Billing Account Admin Tab)3. ERA Tab4. Eligibility Tab

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Set Up Administrative FunctionsSet Up Administrative Functions

Assign “Providers To Users” In order to submit claims to a particular provider, providers must be added to the account and assigned to particular users.

Before you can begin filing claims online, you’ll need to set up your account:

Add “Service Facilities”Service facility information can be added on the account level to expedite completion of claim forms.

Add “Providers”Any provider (s) that render services for your practice or organization must be added on the account level in order for users to access claim forms properly.

Add “Users”If more than one staff member will be submitting claims for your practice, you must add them to the account.

Once you have created and set up your account as indicated above, you will be able to complete and submit claims using OrbiteConnect once

approval from a payer is received.

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Service Facilities - Set UpService Facilities - Set Up

Service Facilities that have been set up already will appear in a table as shown. Service Facilities that have been set up already will appear in a table as shown.

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Provider - Set UpProvider - Set Up

Providers that have been set up already will appear in a table as shown. Providers that have been set up already will appear in a table as shown.

AddProvider

AddProvider

EditProvider

EditProvider

ViewProvider

ViewProvider

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User (s) – Set UpUser (s) – Set Up

Users that have been set up already will appear in a table as shown. Users that have been set up already will appear in a table as shown.

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Web-Based CMS 1500 FormWeb-Based CMS 1500 Form

Identical to the paper

version!

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Web-Based UB04 FormWeb-Based UB04 Form

Identical to the paper

version!

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Web-Based Dental ADA FormWeb-Based Dental ADA Form

Identical to the paper

version!

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Accessing Claim FormsAccessing Claim Forms

In order to access the claim forms that you have registered for (CMS 1500, UB-04 & ADA), you need to insure that your “Pop Up Blocker” is turned off.

Claim Access will open a new window as a pop up.

Click on your “Claims Tab”

Then click on “Claims Access”

A pop up window appears with your claim form tab (s)

Once you click on the Claim Form Tab that you want to submit to the payer, you have the option for Primary, Secondary & Tertiary to choose from.

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Attachment ScreenAttachment Screen

Attachment Option is located at the bottom of your claim form, as shown here

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Claim Status Claim Status Report

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Claim Status From Payer ReportClaim Status From Payer Report

Once you enter in your appropriate search criteria and click “Search”, your report appears below, as shown here along with an option to export it into excel.

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Registering With Additional Registering With Additional Payers – Step 1Payers – Step 1

Click on “Billing Account Admin Tab” then “Payer Registrations” option

Search for a particular payer and transaction type, by entering in your search criteria into the appropriate search fields.

Then click on “Search”

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Registering With Additional Registering With Additional Payers – Step 2Payers – Step 2

Check the “Transaction Type Boxes” required for each of the Payer Names

Click “Add”

You shall see in your “View / Update Results” the payers that you have added to your account, you must click on “SAVE” to save the changes to your account

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Special Features Of The System Special Features Of The System

Patient information database Patient information has to be entered only once; info is then stored for future use.

Attachments Additional documentation can be submitted to payers by electronically attaching them to the claim form.

Secondary claim filing capability Providers can bill to secondary and tertiary payers using the system.

Line item form for including supplementary info such as drug codes Each service line includes an addition data form to include extra info.

Claim status reports from both IGI Health and health plans Providers can use the portal to check the status of a claim.

Diagnoses and procedure code favorites list Providers can create their own quick links to avoid tedious scrolling or memorization.

Batch Upload Providers can upload multiple files at once to avoid manual key-in of each claim.

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FOR MORE INFORMATION OR ASSISTANCE:

Email Us At: orbitconnect.support@igiusa.com

Or

Call Us At: 877-444-7194