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Presented by: IGI Health

OrbiteConnect: Electronic Remittance Advice and Eligibility Verification. Presented by: IGI Health. For more information, please email us at: orbitconnect.support@igiusa.com Or call us at: 877-444-7194. Landing Page. www.orbitconnect.net. Log In.

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Presented by: IGI Health

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  1. OrbiteConnect: Electronic Remittance Advice and Eligibility Verification • Presented by: • IGI Health For more information, please email us at: orbitconnect.support@igiusa.com Or call us at: 877-444-7194

  2. Landing Page www.orbitconnect.net

  3. Log In Type in your user name and password

  4. New Features • For providers who currently use OrbiteConnect, you will be able to access • four new features within your account: • Additional Services Option (found under Billing Account Admin Tab) • Services Status (found under Billing Account Admin Tab) • ERA Tab • Eligibility Tab

  5. Getting Started • For those providers, who wish, to use these Additional Services, there are a few simple steps required to complete • the process. • 1. Enrolling with the Health Plans- The first step to getting these services operational, is by indicating through the portal, which health plans you require which particular service. • First, go to the “Payer Registrations” tab. Here you will find all the health plans that your account is active with. We have now added two columns for ERA and Eligibility, and under these columns we will have check-boxes aside the health plans, that offer the respective service. You will be able to select the boxes you desire. • Then you will need to select “Save” to update the changes. • From here, OrbiteConnect will handle the enrollment process with the selected health plans for the services requested. • 2. Assigning the Sub-Menu(s), In order for the respective service Tab to appear when you log-in, you will first need to “Assign” the respective Sub-Menu(s) using the defined process below. • Inside the “Users” tab, you will select “Edit” on the first listed User. • Under “Available Menu Functions”, you will be able to select ERA or Eligibility, and “Add” it to the “Assigned Menu Functions”. • Under “Available Sub Menu Functions”, you will be able to select the required ERA or Eligibility Sub Menus, and “Add” it to the “Assigned Sub Menu Functions”. • Once the required services are “Assigned”, you will need to click “Submit” to save the changes. • You should now be able to see the respective service tabs on your log-in page. • Repeat the process for all required Users in the account. The services will be available for the selected payers, pending confirmation of payment and / or approval from the respective health plan (s).

  6. Payers Registration Click on “Billing Account Admin Tab” then “Payer Registrations” option

  7. Assign To User (s) When you click on ERA, you see this option When you click on Eligibility, you see these options Always hit ‘Submit’ when finished. So it will save your changes.

  8. Approval Process • Payers require an account to be sent for approval before you are able to receive your ERA’s. • HealthPartners is the ONLY Payer that requires approval for Eligibility. • Once your payment is confirmed for the non-free payers, aside from UCare, • Sanford & MHP, we will transmit your request to the payer for approval. • For Providers who require ERA reports from UCare, it is MANDATORY to complete the EFT (Electronic Fund Transfer) forms. These forms can be located in the link Provided in your account, under “Payer Registrations”. • Once the request is approved by UCare, OrbiteConnect will begin receiving your • ERA files.

  9. Payment Information

  10. Agreement Form

  11. Payment Process: Step 1

  12. Payment Process: Step 2 Monthly Option Chosen Yearly Option Chosen

  13. Payment Confirmation • Once you complete your payment you will be brought to the Payment Receipt screen, shown here. • You may take a print out of your receipt for your records by clicking on the below option “Print payment receipt”.

  14. Receiving ERA’s

  15. Search Option The ERA Tab will bring the user to the following screen, once you click on Remittance: The user has the ability to search for Electronic Remittance Advice reports using a number of different search criteria: • By Payer • By Provider • By remittance Check/EFT Date ranges • By Check/EFT Date, Payer Run Date or Check/EFT Trace Number - (this information is available at the top of all ERA reports when displayed) • By Remittance Payment Amount criteria (e.g. Greater Than, Less Than, or Equal To)

  16. View and Mark Options The ERA Tab will bring the user to the following screen: • The user has three (3) View options: • “All” – view all ERA reports available based on the search criteria • “Read” – view the ERA reports that have been previously viewed • “Unread” – view the ERA reports that have not yet been viewed • The Mark As option allows the user to mark ERA reports as “Read” or “Unread.”

  17. ERA View List Once a search is submitted, the resulting View List will be displayed. The list will contain all Remittance Advice reports that are available for the selected criteria. • To view any report, select the explorer icon. • To print any report, select the PDF icon. • At any time the user can mark the listed ERA report(s) as “Read” in the “Viewed” column by checking the box displayed. This can be helpful when keeping track of all ERAs that have been previously viewed or printed.

  18. The ERA Report • Once an ERA report has been selected from the displayed list, the ERA report will be displayed. • ERA Report Sections: • Print PDF icon • Remittance Header • Payer Information • Payee Information • Claim Information • Claim Payment and • Adjustment • *includes service line information • Legend

  19. Provider Adjustments • There may be times when a Remittance Advice includes Provider level adjustments that may affect the total remittance payment amount. These adjustments are NOT associated with any particular claim, but with the Provider itself. • For example, the Payer may charge a penalty for filing claims late. Because the penalty is not tied to a specific claim, but to a number of claims, the adjustment is on the resulting remittance amount. • The report below displays the Provider Adjustments report.

  20. Verifying Eligibility

  21. Eligibility Verification Request The Eligibility Tab will bring the user to the following screen, once you click on Inquiry.

  22. Different Payer

  23. 270 Response File • The 271 Response file is generated immediately. The following sections are included: • Payer Information • Provider Information • Subscriber Information • Dependent Information • Benefits Information

  24. Benefits Information • Benefits Information can be accessed by scrolling down the screen. The following information is included: • Service Type • Coverage Level • In-Network • Benefit Type • Benefit Period • Amount • Period Qualifier • Authorization • Message

  25. No Coverage Information If no coverage information is found for a particular subscriber, the following screen will appear.

  26. Transaction Report • Clicking on the Transaction List will bring the user to the following screen. • Users should click on View to access the Reports and Responses (#, Transaction ID, Report 270 File, Response 271 File, Transaction Date & Response Type).

  27. FOR MORE INFORMATION OR ASSISTANCE: Email Us At: orbitconnect.support@igiusa.com Or Call Us At: 877-444-7194

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