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MO HealthNet Internet Provider Training Program Presented by the Provider Education Unit MO HealthNet Division. Proper Completion of the Online Medicare Part A Crossover Claim. Presented by the Provider Education Unit MO HealthNet Division.

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MO HealthNet Internet Provider Training Program Presented by the Provider Education Unit


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slide1
MO HealthNet Internet Provider Training Program

Presented by the Provider Education Unit

MO HealthNet Division

MO HealthNet Division

proper completion of the online medicare part a crossover claim
Proper Completion of the Online Medicare Part A Crossover Claim

Presented by the Provider Education Unit

MO HealthNet Division

MO HealthNet Division

slide3

To file a claim go to the Internet Web site www.emomed.com and log on. This will bring up the eProvider Home Page. At the top of each page is a “Help” button in the form of a question mark. You can print out field-by-field instructions.

MO HealthNet Division

slide4

CLAIM MANAGEMENT

MO HealthNet Division

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NEW XOVER CLAIM

MO HealthNet Division

slide7

PARTICIPANT DCN

PARTICIPANT LAST NAME

PARTICIPANT FIRST NAME

PATIENT ACCOUNT NUMBER

PARTICIPANT MEDICARE ID (HIC)

MO HealthNet Division

slide8

PARTICIPANT DCN

PARTICIPANT LAST NAME

PARTICIPANT FIRST NAME

PATIENT ACCOUNT NUMBER

PARTICIPANT MEDICARE ID (HIC)

MO HealthNet Division

slide9

PARTICIPANT DCN

PARTICIPANT LAST NAME

PARTICIPANT FIRST NAME

PATIENT ACCOUNT NUMBER

PARTICIPANT MEDICARE ID (HIC)

MO HealthNet Division

slide10

PARTICIPANT DCN

PARTICIPANT LAST NAME

PARTICIPANT FIRST NAME

PATIENT ACCOUNT NUMBER

PARTICIPANT MEDICARE ID (HIC)

MO HealthNet Division

slide11

PARTICIPANT DCN

PARTICIPANT LAST NAME

PARTICIPANT FIRST NAME

PATIENT ACCOUNT NUMBER

PARTICIPANT MEDICARE ID (HIC)

MO HealthNet Division

slide12

DATE OF SERVICE

PARTICIPANT STATUS

LIFETIME RESERVED DAYS

ADMISSION DATE

COVERED DAYS

NON-COVERED DAYS

CO-INSURANCE DAYS

MO HealthNet Division

slide13

DATE OF SERVICE

PARTICIPANT STATUS

LIFETIME RESERVED DAYS

ADMISSION DATE

COVERED DAYS

NON-COVERED DAYS

CO-INSURANCE DAYS

MO HealthNet Division

slide14

DATE OF SERVICE

PARTICIPANT STATUS

LIFETIME RESERVED DAYS

ADMISSION DATE

COVERED DAYS

NON-COVERED DAYS

CO-INSURANCE DAYS

MO HealthNet Division

slide15

DATE OF SERVICE

PARTICIPANT STATUS

LIFETIME RESERVED DAYS

ADMISSION DATE

COVERED DAYS

NON-COVERED DAYS

CO-INSURANCE DAYS

MO HealthNet Division

slide16

DATE OF SERVICE

PARTICIPANT STATUS

LIFETIME RESERVED DAYS

ADMISSION DATE

COVERED DAYS

NON-COVERED DAYS

CO-INSURANCE DAYS

MO HealthNet Division

slide17

DATE OF SERVICE

PARTICIPANT STATUS

LIFETIME RESERVED DAYS

ADMISSION DATE

COVERED DAYS

NON-COVERED DAYS

CO-INSURANCE DAYS

MO HealthNet Division

slide18

DATE OF SERVICE

PARTICIPANT STATUS

LIFETIME RESERVED DAYS

ADMISSION DATE

COVERED DAYS

NON-COVERED DAYS

CO-INSURANCE DAYS

MO HealthNet Division

slide19

MEDICARE PROVIDER NPI

ATTENDING PROVIDER NPI

BILLED CHARGES

DIAGNOSIS CODES

SURGERY PROCEDURE CODES & DATE

TYPE OF BILL

MO HealthNet Division

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MEDICARE PROVIDER NPI

ATTENDING PROVIDER NPI

BILLED CHARGES

DIAGNOSIS CODES

SURGERY PROCEDURE CODES & DATE

TYPE OF BILL

MO HealthNet Division

slide21

MEDICARE PROVIDER NPI

ATTENDING PROVIDER NPI

BILLED CHARGES

DIAGNOSIS CODES

SURGERY PROCEDURE CODES & DATE

TYPE OF BILL

MO HealthNet Division

slide22

MEDICARE PROVIDER NPI

ATTENDING PROVIDER NPI

BILLED CHARGES

DIAGNOSIS CODES

SURGERY PROCEDURE CODES & DATE

TYPE OF BILL

MO HealthNet Division

slide23

MEDICARE PROVIDER NPI

ATTENDING PROVIDER NPI

BILLED CHARGES

DIAGNOSIS CODES

SURGERY PROCEDURE CODES & DATE

TYPE OF BILL

MO HealthNet Division

slide24

MEDICARE PROVIDER NPI

ATTENDING PROVIDER NPI

BILLED CHARGES

DIAGNOSIS CODES

SURGERY PROCEDURE CODES & DATE

TYPE OF BILL

MO HealthNet Division

slide25

SAVE CLAIM HEADER

MO HealthNet Division

slide26

REVENUE CODE

DAYS/UNITS BILLED

SAVE DETAIL LINE TO CLAIM

MO HealthNet Division

slide27

REVENUE CODE

DAYS/UNITS BILLED

SAVE DETAIL LINE TO CLAIM

MO HealthNet Division

slide28

REVENUE CODE

DAYS/UNITS BILLED

SAVE DETAIL LINE TO CLAIM

MO HealthNet Division

slide29

REVENUE CODE

DAYS/UNITS BILLED

SAVE DETAIL LINE TO CLAIM

MO HealthNet Division

slide30

REVENUE CODE

DAYS/UNITS BILLED

SAVE DETAIL LINE TO CLAIM

MO HealthNet Division

slide31

REVENUE CODE

DAYS/UNITS BILLED

SAVE DETAIL LINE TO CLAIM

MO HealthNet Division

slide33

FILING INDICATOR

OTHER PAYER ID

OTHER PAYER NAME

PAID DATE

MO HealthNet Division

slide34

FILING INDICATOR

OTHER PAYER ID

OTHER PAYER NAME

PAID DATE

MO HealthNet Division

slide35

FILING INDICATOR

OTHER PAYER ID

OTHER PAYER NAME

PAID DATE

MO HealthNet Division

slide36

FILING INDICATOR

OTHER PAYER ID

OTHER PAYER NAME

PAID DATE

MO HealthNet Division

slide37

PAID AMOUNT

TOTAL DENIED AMOUNT

RA REMARK CODES

PAYER AT HEADER LEVEL

SAVE OTHER PAYER DATA & MANAGE CODES

MO HealthNet Division

slide38

PAID AMOUNT

TOTAL DENIED AMOUNT

RA REMARK CODES

PAYER AT HEADER LEVEL

SAVE OTHER PAYER DATA & MANAGE CODES

MO HealthNet Division

slide39

PAID AMOUNT

TOTAL DENIED AMOUNT

RA REMARK CODES

PAYER AT HEADER LEVEL

SAVE OTHER PAYER DATA & MANAGE CODES

MO HealthNet Division

slide40

PAID AMOUNT

TOTAL DENIED AMOUNT

RA REMARK CODES

PAYER AT HEADER LEVEL

SAVE OTHER PAYER DATA & MANAGE CODES

MO HealthNet Division

slide41

PAID AMOUNT

TOTAL DENIED AMOUNT

RA REMARK CODES

PAYER AT HEADER LEVEL

SAVE OTHER PAYER DATA & MANAGE CODES

MO HealthNet Division

slide42

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MO HealthNet Division

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CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MO HealthNet Division

slide44

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MO HealthNet Division

slide45

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

SAVE CODES TO OTHER PAYER

MO HealthNet Division

slide46

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

SAVE CODES TO OTHER PAYER

MO HealthNet Division

slide47

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

SAVE CODES TO OTHER PAYER

MO HealthNet Division

slide48

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

SAVE CODES TO OTHER PAYER

MO HealthNet Division

slide49

SAVE OTHER PAYER TO CLAIM

MO HealthNet Division

slide50

SUBMIT CLAIM

MO HealthNet Division

slide51

FILING INDICATOR

OTHER PAYER ID

OTHER PAYER NAME

PAID DATE

MO HealthNet Division

slide52

FILING INDICATOR

OTHER PAYER ID

OTHER PAYER NAME

PAID DATE

MO HealthNet Division

slide53

FILING INDICATOR

OTHER PAYER ID

OTHER PAYER NAME

PAID DATE

MO HealthNet Division

slide54

FILING INDICATOR

OTHER PAYER ID

OTHER PAYER NAME

PAID DATE

MO HealthNet Division

slide55

PAID AMOUNT

TOTAL DENIED AMOUNT

RA REMARK CODES

PAYER AT HEADER LEVEL

SAVE OTHER PAYER DATA & MANAGE CODES

MO HealthNet Division

slide56

PAID AMOUNT

TOTAL DENIED AMOUNT

RA REMARK CODES

PAYER AT HEADER LEVEL

SAVE OTHER PAYER DATA & MANAGE CODES

MO HealthNet Division

slide57

PAID AMOUNT

TOTAL DENIED AMOUNT

RA REMARK CODES

PAYER AT HEADER LEVEL

SAVE OTHER PAYER DATA & MANAGE CODES

MO HealthNet Division

slide58

PAID AMOUNT

TOTAL DENIED AMOUNT

RA REMARK CODES

PAYER AT HEADER LEVEL

SAVE OTHER PAYER DATA & MANAGE CODES

MO HealthNet Division

slide59

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MO HealthNet Division

slide60

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MO HealthNet Division

slide61

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MO HealthNet Division

slide62

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MEDICARE DEDUCTIBLE MINUS THE INSURANCE COMPANY PAYMENT

MO HealthNet Division

slide63

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MEDICARE DEDUCTIBLE MINUS THE INSURANCE COMPANY PAYMENT

MO HealthNet Division

slide64

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MEDICARE DEDUCTIBLE MINUS THE INSURANCE COMPANY PAYMENT

MO HealthNet Division

slide65

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MO HealthNet Division

slide66

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MO HealthNet Division

slide67

CLAIM GROUP CODE

CLAIM ADJUSTMENT REASON CODE

ADJUSTMENT AMOUNT

MO HealthNet Division

slide68

SAVE CODES TO OTHER PAYER

MO HealthNet Division

slide69

SAVE OTHER PAYER TO CLAIM

MO HealthNet Division

slide70

SUBMIT CLAIM

MO HealthNet Division

slide71

CLAIM RECEIVED

COPY CLAIM

PAYMENT DETAILS

MO HealthNet Division

slide72

CLAIM RECEIVED

COPY CLAIM

PAYMENT DETAILS

MO HealthNet Division

slide73

CLAIM RECEIVED

COPY CLAIM

PAYMENT DETAILS

MO HealthNet Division

slide74

NEW CLAIM

FINISH

MO HealthNet Division

slide75

NEW CLAIM

FINISH

MO HealthNet Division

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Thank you again for participating in this training program. If you have questions regarding the information in this presentation, please contact the Provider Education Unit at 573-751-6683.

MO HealthNet Division