03-23-05October 2006
Web interChange - Basic PresentationWeb interChange - Basic Presentation
Presented by the EDS Provider Field Consultants
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AgendaAgenda
• 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
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What is Web interChange?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).
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• Access Web interChange from the Indiana Health Coverage Programs (IHCP) Web site at: 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 EnrollHow to Enroll
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• 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 RequirementsEnrollment RequirementsAdministrator
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OverviewOverviewWeb interChange Logon Screen
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OverviewOverviewWeb interChange Home Page
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Verifying Member EligibilityVerifying Member EligibilityEligibility Inquiry Window
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Verifying Member EligibilityVerifying 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.
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Check WriteCheck WriteCheck Inquiry Window
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Header Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Additional Billing Codes
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Diagnosis Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Procedure Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Condition Code Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Occurrence Code Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Occurrence Span Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Value Code Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionAttachment Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Attachment Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Note Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Note Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionBenefit Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Benefit Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Benefit Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Benefit Information - Additional
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Detail Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Detail Benefit Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionCoordination 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.
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Web interChange Claims SubmissionWeb interChange Claims SubmissionMedicare Payer IDs for Crossover Claims
• Obtain a complete list of Payer IDs from the following Web sites:
– IHCP Home Page at www.indianamedicaid.com
– Coordination of Benefit instructions on Web interChange
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Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional Billing
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Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional Billing – Header Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional Billing – Detail Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional and Dental Attachment Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionDental Billing
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Web interChange Claims SubmissionWeb interChange Claims SubmissionDental Billing – Header Information
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Web interChange Claims SubmissionWeb interChange Claims SubmissionDental Billing – Detail Information
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Claim InquiryClaim InquiryClaim Inquiry Window
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Claim InquiryClaim InquiryClaim Inquiry Window Copy Function
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Claim InquiryClaim InquiryClaim Inquiry Window Copy Function – Show Me More Button
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Claim InquiryClaim InquiryClaim Inquiry Window Copy Function – Old Claim ICN Information
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Claim InquiryClaim InquiryClaim Inquiry Window Copy Function – New Claim ICN Information
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QuestionsQuestions
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03-23-05October 2006
EDS950 N. Meridian St., Suite 1150Indianapolis, 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.