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ForwardHealth interChange Provider Portal Information

. ForwardHealth interChange Agenda . Portal information.Enrollment verification information.Review of how to do the following via the Portal:Search for claims.Void claims.Resubmit claims.Future changes to ForwardHealthRemitCORE plan implementationResourcesOnline handbookAlertsUpdatesPro

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ForwardHealth interChange Provider Portal Information

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    1. ForwardHealth interChange Provider Portal Information April 2009

    2. ForwardHealth interChange Agenda Portal information. Enrollment verification information. Review of how to do the following via the Portal: Search for claims. Void claims. Resubmit claims. Future changes to ForwardHealth Remit CORE plan implementation Resources Online handbook Alerts Updates Provider Services Professional Relations Representative Questions

    3. ForwardHealth interChange Portal information Passwords. Security questions.

    4. ForwardHealth interChange Portal information . Password Expire every 60 days and users are prompted to change it. Must have at least eight characters. Must contain at least one uppercase letter, one lowercase letter, and one number. Must not contain your real name or user name. When resetting your password, you cannot use any of your previous eight passwords. If you forgot your password, you can reset it yourself by answering your security questions that you were asked to provide when you changed the initial password you received.

    5. ForwardHealth interChange Portal information (cont.) Security questions User makes up your own security questions, and must not contain any special characters i.e. *, /, ?. Security answers are case sensitive and must not contain any special characters or spaces.

    6. ForwardHealth interChange Portal information (cont.) If the user attempts to log-in 3 times with a incorrect user name or password they will be locked out. Users should only attempt log in twice and then use “Forgot password” using your security questions. They then can reset their passwords. If a user is locked out the lock out will be for one hour. Administrators can not unlock the user accounts. EDI help desk will ask Clerk and Clerk Administrators to wait the one hour for the password reset.

    7. ForwardHealth interChange Enrollment information Benefit plans-Members can have more than 1 plan active Plan with full benefits include: State Supplemental Payment – SSI State Supplemental Income Caretaker Supplement State Supplemental Income Exceptional BC+ Standard Plan BadgerCare Medicaid for Foster Care Medicaid Purchase Plan Medicaid Purchase Plan Waiver Medicaid Medicaid Waiver Medicaid for SSI

    8. ForwardHealth interChange Enrollment information (cont.) Limited benefits Tuberculosis Services Only ,TB. Alien Emergency Services Only, AE. Qualified Medicare Beneficiary, QMB. Qualified Disabled Working Individuals Specified Low-income Medicare Beneficiary Plus, SLMB. Specified Low-income Medicare Beneficiary Plus Presumptive Eligibility - Pregnancy Family Care Non-MA Family Planning Services only

    9. ForwardHealth interChange Enrollment information (cont.) Limited benefits continued Dental Ortho/Dentures Only BC+ Standard EE for Pregnant Women BC+ Benchmark Plan Benchmark EE for Pregnant Women Benchmark Plan and Dental SeniorCare Senior Care Level 1- 0 to 200% FPL Senior Care Level 2- Over 200% FPL Wisconsin Well Woman Program Wisconsin Well Woman Medicaid Wisconsin Chronic Disease

    10. ForwardHealth interChange Enrollment information (cont.) Other enrollment information Managed Care Enrollment. Other Commercial Health Insurance. Medicare. Lock-In Spenddown Deductible

    11. ForwardHealth interChange Portal information — Claims Search for claims. Void claims. Resubmit claims. Update 2008-135Update 2008-135

    28. ForwardHealth interChange Future changes Remit To be more like old RA. Alpha order. Update 2008-135Update 2008-135

    29. ForwardHealth interChange Core Plan Implementation Statewide. Enrollment planned June 2009 Benefits to begin July 2009

    30. ForwardHealth interChange Core Plan Enrollment Wisconsin resident; U.S. citizen or legal immigrant; Age 19 through 64 Do not have children or do not have dependent children, under age 19 living with you; Are not pregnant; Have family income at or below 200% of the federal poverty level guidelines ($1,805 for a single person and $2,428.33 for a married couple);

    31. ForwardHealth interChange Core Plan Enrollment continued Do not have private health insurance coverage when you request Core Plan coverage or in the 12 months before that date; Cannot sign up for insurance from an employer during month of application or next three months; Did not have access to insurance from an employer in the 12 months before you request Core Plan coverage; and Are not getting BadgerCare Plus, Medicaid or Medicare.

    32. ForwardHealth interChange Core Plan Covered Services Doctor visits Hospital services Emergency room visits Emergency ambulance rides Emergency dental services Some prescription drugs Physical therapy Occupational therapy Speech therapy Cardiac rehabilitation Durable medical equipment Disposable medical supplies Dialysis/Kidney-related services Some services covered under the Core Plan will have a co-payment and service limitations. Co-payment amounts are based on income. Enrollment information will indicate no–payment, if member does not have co-pay.

    33. ForwardHealth interChange Core Plan Non-Covered services will include: Non-emergency dental services Chiropractic services Hearing services Routine vision exams Home health care Hospice Inpatient mental health and substance abuse treatment services Non-emergency transportation Nursing home care Podiatry Reproductive health services (these services are covered through BadgerCare Plus Family Planning Waiver Services) Services for children and pregnant women

    34. ForwardHealth interChange Core Plan Additional information Future updates Statewide trainings planned for June 2009

    35. ForwardHealth interChange Where to get help Portal Alerts Updates On-line handbook Update 2008-135Update 2008-135

    36. ForwardHealth interChange Alerts Update 2008-135Update 2008-135

    37. Resources- Professional Relations Representatives Update 2008-135Update 2008-135

    38. Resources- Professional Relations Representatives Update 2008-135Update 2008-135

    39. Resources- Professional Relations Representatives Update 2008-135Update 2008-135

    40. Resources- Professional Relations Representatives hock@wisconsin.gov Update 2008-135Update 2008-135

    41. Resources- Professional Relations Representatives Update 2008-135Update 2008-135

    42. ForwardHealth interChange Questions Update 2008-135Update 2008-135

    44. ForwardHealth interChange Where to get help Provider Services (800) 947-9627 Enrollment, Claims, PA and Certification issues Information to have ready when calling Provider name and NPI or provider ID. Member name and member identification number. Claim number. PA number. DOS. Amount billed. RA. Procedure code of the service in question. Reference to any provider publications that address the inquiry. Update 2008-135Update 2008-135

    45. ForwardHealth interChange Where to get help Professional Relations Representatives Provider education Provider training Update 2008-135Update 2008-135

    46. Resources- Professional Relations Representatives Jude Benish - South Central Wisconsin (608) 836-9428 E-mail judy.benish@wisconsin.gov Joan Buntin – North Central and Dental (715) 675 3190 E-mail joan.buntin@wisconsin.gov Cindy Drury – Southwest Wisconsin (608) 929-4030 E-mail cindy.drury@wisconsin.gov Denise Kruswicki – Northwest Wisconsin (715) 694-2114 E-mail denise.kruswicki@wisconsin.gov Update 2008-135Update 2008-135

    47. Resources- Professional Relations Representatives Teresa Miller – Milwaukee County (262) 695-1915 E-mail teresa.miller@wisconsin.gov Vicky Murphy – Southeast Wisconsin (608) 756-1422 E-mail vicky.murphy@wisconsin.gov Maria Schwartz – Milwaukee County (262) 695-1915 E-mail maria.schwartz@wisconsin,gov Lori Hock – Northeast Wisconsin (920) 465-9425 -E-mail lori.hock@wisconsin.gov Update 2008-135Update 2008-135

    48. ForwardHealth interChange Questions Update 2008-135Update 2008-135

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