certified family home training - idmedicaid.com documentation/certified famil… · certified...
TRANSCRIPT
![Page 1: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/1.jpg)
Idaho Department of Health & Welfare
Certified Family Home Training
![Page 2: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/2.jpg)
Idaho Department of Health & Welfare
Overview
• Trading Partner Account registration and sign-in
• Prior Authorization
• Patient Roster
o Eligibility
o Claim Submission
▪ Copy Last Claim
• Claim Status
• Remittance Advice
2
![Page 3: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/3.jpg)
Idaho Department of Health & Welfare
Navigating the Secure Portal
3
![Page 4: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/4.jpg)
Idaho Department of Health & Welfare
Navigating the Secure Portal
4
![Page 5: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/5.jpg)
Idaho Department of Health & Welfare
Prior Authorization
5
![Page 6: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/6.jpg)
Idaho Department of Health & Welfare
View Authorization
6
Note: Authorizations are issued by DHW.
![Page 7: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/7.jpg)
Idaho Department of Health & Welfare
View Authorization
7
![Page 8: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/8.jpg)
Idaho Department of Health & Welfare
View Authorization
8
![Page 9: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/9.jpg)
Idaho Department of Health & Welfare
Patient Roster
9
![Page 10: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/10.jpg)
Idaho Department of Health & Welfare
View Patient Roster
10
![Page 11: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/11.jpg)
Idaho Department of Health & Welfare
View Patient Roster
11
![Page 12: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/12.jpg)
Idaho Department of Health & Welfare
View Patient Roster
12
![Page 13: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/13.jpg)
Idaho Department of Health & Welfare
Eligibility
13
![Page 14: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/14.jpg)
Idaho Department of Health & Welfare
Participant Eligibility
14
Why should you verify eligibility?
• To verify a participant has Medicaid coverage on actual date of service
• To review a participant’s eligibility plan, coverage codes, and healthy connections provider
Note: Medicaid card does not guarantee current Medicaid coverage.
![Page 15: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/15.jpg)
Idaho Department of Health & Welfare
Verifying Eligibility
15
Three ways to verify eligibility:
• MACS — Medicaid Automated Customer Service 1(866)686-4272
• HIPAA compliant vendor software• Health PAS-OnLine Trading Partner
To obtain eligibility information from one of these systems, submit two pieces of identifying information from the following list:
• Medicaid ID number (ten digits)• Social Security Number (SSN) • Last Name, First Name • Date of Birth
![Page 16: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/16.jpg)
Idaho Department of Health & Welfare
Patient Roster | Verify Eligibility
16
![Page 17: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/17.jpg)
Idaho Department of Health & Welfare
Eligibility | A&D Waiver Coverage
17
![Page 18: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/18.jpg)
Idaho Department of Health & Welfare
Eligibility | DD Waiver Coverage
18
![Page 19: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/19.jpg)
Idaho Department of Health & Welfare
Eligibility | Enhanced Coverage
19
![Page 20: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/20.jpg)
Idaho Department of Health & Welfare
Eligibility | Medicare Medicaid Coordinated Plan (MMCP)
20
![Page 21: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/21.jpg)
Idaho Department of Health & Welfare
Eligibility | Idaho Medicaid Plus (IMPlus)
21
![Page 22: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/22.jpg)
Idaho Department of Health & Welfare
Claim Submission
22
![Page 23: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/23.jpg)
Idaho Department of Health & Welfare
Patient Roster | Submit Claim
23
![Page 24: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/24.jpg)
Idaho Department of Health & Welfare
Claim Submission | Professional Claim (1500)
24
![Page 25: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/25.jpg)
Idaho Department of Health & Welfare
Claim Submission | Confirmation
25
• The claim ID displays in the upper left corner of the confirmation page.
• Select Adjudicate Claim to identify outstanding edits.
• Select the Edit Claim button to modify this claim.
(For example, if you realize the dates of service are incorrect, you can immediately fix the claim.)
![Page 26: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/26.jpg)
Idaho Department of Health & Welfare
Claim Submission | Copy Last Claim
26
Copy Last Claim will copy over some information from the last claim submitted for this participant. However, it is important to review all fields to either add additional or correct pre-populated information.
![Page 27: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/27.jpg)
Idaho Department of Health & Welfare
View Claim Status
27
![Page 28: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/28.jpg)
Idaho Department of Health & Welfare
View Claim Status
28
![Page 29: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/29.jpg)
Idaho Department of Health & Welfare
Search Criteria
29
![Page 30: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/30.jpg)
Idaho Department of Health & Welfare
Remittance Advice
30
![Page 31: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/31.jpg)
Idaho Department of Health & Welfare
Viewing RAs
31
![Page 32: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/32.jpg)
Idaho Department of Health & Welfare
RA Banner Page
32
![Page 33: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/33.jpg)
Idaho Department of Health & Welfare
RA Detail
33
![Page 34: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/34.jpg)
Idaho Department of Health & Welfare
RA Summary Page
34
![Page 35: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/35.jpg)
Idaho Department of Health & Welfare
Provider Relations Consultants
35
Region 1 and the state of [email protected]
Region 2 and the state of [email protected]
Region 3 and the state of [email protected]
Region 4 and all other states [email protected]
Region 5 and the state of [email protected]
Region 6 and the state of [email protected]
Region 7 and the state of [email protected]
![Page 36: Certified Family Home Training - idmedicaid.com Documentation/Certified Famil… · Certified Family Home Training. Please take a few minutes to complete the survey that will be emailed](https://reader033.vdocument.in/reader033/viewer/2022043013/5faf0988c2dfae2c167166fb/html5/thumbnails/36.jpg)
Idaho Department of Health & Welfare
Thank you for attending our Certified Family Home
Training.
Please take a few minutes to complete the survey that will be emailed following this presentation. This
provides us with valuable information for future trainings.