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Michigan Medicaid on BCBSM web-DENIS PowerPoint PPT Presentation


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Michigan Medicaid on BCBSM web-DENIS. Eligibility Requests and Responses. Agenda. Web-DENIS Information Review of the Process Medicaid on web-DENIS Functionality How to access web-DENIS Web-DENIS Examples. Web-DENIS Information:. Collaborative effort between BCBSM and MDCH. - PowerPoint PPT Presentation

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Michigan Medicaid on BCBSM web-DENIS

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Michigan Medicaid on BCBSM web-DENIS

Eligibility Requests and Responses


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Agenda

  • Web-DENIS Information

  • Review of the Process

  • Medicaid on web-DENIS Functionality

  • How to access web-DENIS

  • Web-DENIS Examples


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Web-DENIS Information:

  • Collaborative effort between BCBSM and MDCH.

  • Internet based eligibility verification system.

  • Available to Medicaid Providers free of charge (Participating and Non-Participating BC/BS providers)

  • Participating BC/BS Providers are already familiar with using web-DENIS.


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The Process

Provider Site

Internet

``

270 Request

Eligibility Files

271 Response

MDCH

MPHI Database

BCBSM web-DENIS


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Medicaid on web-DENIS Functionality

  • User can submit single request or roster request (up to 10 requests at one time).

  • Single Date of Service is entered but user receives eligibility for the entire month.

  • Provides the following eligibility information:

    • Medicaid (Title XIX) - Coverage not active

    • ABW - Pending Eligibility

    • MOMS - Third Party Liability (TPL)

    • CSHCS (Title V) - Dental Information

  • Coming in July – MIChild eligibility.


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How to access web-DENIS

  • Providers need to go to the BC/BS website at

  • www.BCBSM.com .

  • Then click on the ‘Provider’ tab (See the next slide

  • for an example).


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How to access web-DENIS

  • Login Screen (See next slide for an example):

  • Current web-DENIS users can enter their user ID and password on this screen

  • Information on how to obtain access to web-DENIS is also available for providers on this screen.


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How to access web-DENIS

  • Welcome Providers Screen (See next slide for an example).

  • Click on the ‘web-DENIS’ link in the left column.

  • Links to the MDCH website are also available on this screen for Medicaid Providers.


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How to access web-DENIS

  • Welcome to web-DENIS screen (See next slide for an

  • example):

  • Click on the ‘Subscriber Information’ link listed on this screen.


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How to access web-DENIS

  • Subscriber Information Screen (See next slide for an example):

  • Click on ‘Eligibility/Coverage/COB’ link on this screen (See the next slide)


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How to access web-DENIS

  • Eligibility Coverage Screen (See next slide for an example):

  • Enter the Beneficiary ID in the ‘Contract Number’ field (this can be left blank).

  • Then click on the ‘Medicaid’ radio button and then click on the ‘Enter’ button.


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How to access web-DENIS

  • Eligibility Benefit Inquiry Screen (See next slide for an example):

  • Enter the Beneficiary ID. If you do not have the Beneficiary ID, you may search using the Beneficiary Last Name, First Name, and Date of Birth.

  • Choose your Medicaid Provider Type from the drop down list and then enter in your Provider ID into the input fields as labeled.

  • Enter the date of service that you are inquiring on. (The entire month of eligibility information will be returned to you.)

  • Click on ‘Enter’ to begin your search.


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Example # 1

  • Eligibility Response:Beneficiary with

  • Fee for Service Medicaid (See next Slide).


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Example # 2

  • Eligibility Response:Beneficiary with

  • No coverage (See next slide).


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Example # 3

  • Eligibility Response:Beneficiary enrolled in

  • A Medicaid Health Plan (See next slide).


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Example # 4

  • Eligibility Response:Beneficiary enrolled in

  • An ABW County Health Plan (See next slide).


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Questions

  • Contact Provider Inquiry at 1-800-292-2550 or e-mail providersupport@michigan.gov .

  • Technical Problems, contact BCBSM at 1-877-BLUE-WEB (1-877-258-3932).