03-23-05 october 2006 web interchange - basic presentation presented by the eds provider field...

03-23-05October 2006

Web interChange - Basic PresentationWeb interChange - Basic Presentation

Presented by the EDS Provider Field Consultants

Web interChange - Basic Presentation October 2006

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


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).


• 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


• 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


OverviewOverviewWeb interChange Logon Screen


OverviewOverviewWeb interChange Home Page


Verifying Member EligibilityVerifying Member EligibilityEligibility Inquiry Window


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.


Check WriteCheck WriteCheck Inquiry Window


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Header Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Additional Billing Codes


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Diagnosis Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Procedure Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Condition Code Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Occurrence Code Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Occurrence Span Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Value Code Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionAttachment Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Attachment Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Note Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionBenefit Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Benefit Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Benefit Information - Additional


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Billing – Detail Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionInstitutional Detail Benefit Information


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.


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


Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional Billing


Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional Billing – Header Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional Billing – Detail Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionProfessional and Dental Attachment Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionDental Billing


Web interChange Claims SubmissionWeb interChange Claims SubmissionDental Billing – Header Information


Web interChange Claims SubmissionWeb interChange Claims SubmissionDental Billing – Detail Information


Claim InquiryClaim InquiryClaim Inquiry Window


Claim InquiryClaim InquiryClaim Inquiry Window Copy Function


Claim InquiryClaim InquiryClaim Inquiry Window Copy Function – Show Me More Button


Claim InquiryClaim InquiryClaim Inquiry Window Copy Function – Old Claim ICN Information


Claim InquiryClaim InquiryClaim Inquiry Window Copy Function – New Claim ICN Information


QuestionsQuestions

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.

03-23-05 october 2006 web interchange - basic presentation presented by the eds provider field...

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