Presented by: IGI Health
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Transcript of Presented by: IGI Health
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Presented by: IGI Health
OrbiteConnect:
OrbiteConnect 101
&
Filing A CMS 1500 e-claim
For more information, please email us at:
Or call us at: 877-444-7194
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Statutes require electronic submission of health insurance claims, eligibility inquiries and responses, remittance advices in a standard format by July 2009.
What & WhyWhat & Why
What?
Explore your options for compliance with the law!
One set of data standards for providers and payers, transmitted electronically, has proven to reduce costs, streamline health care transactions, and improve the delivery of health care services.
Why?
Single set of billing codes could reduce costs by $60 million in alone.
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All health care providers who check eligibility, submit claims and/or receive RAs, as well as all health plans, including Department of Human Services (DHS)-administered Health Care Programs (MHCP).
Who, When & HowWho, When & How
Who?
When? Eligibility verification inquiry and response (270/271) – Jan. 15, 2009 Professional, institutional, dental, pharmacy and medical codes (837P, 837I, 837D and NCPDP 5.1) - July 15, 2009 Payment and Remittance Advices (835) - Dec. 15, 2009
How?The Department of Health consulted with the Administrative Uniformity Committee to create uniform standard companion guides for these transactions.
How can providers easily comply with these guidelines?
OrbiteConnect: Gateway to standardized electronic claims submission
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How Will Providers Be Able To How Will Providers Be Able To Comply? Comply?
In order to assist those health care providers that do not have a system in place to comply, health plans are offering a web based tool to easily submit claims electronically. Health plans have contracted with IGI to supply and manage this tool.
Providers can use this tool to submit claims FREE of charge, with these payers and over 100’s of other payers that are available.
Blue Cross and Blue Shield of MN FirstPlan of MN HealthPartners Medica Metropolitan Health Plan PreferredOne Sanford Health Plan UCare ChiroCare (CCMI) Itasca Medical Care PrimeWest Health South Country Health Alliance HSM
www.orbiteconnect.net
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Can Any Provider Use The Tool?Can Any Provider Use The Tool?
Special transportation vendorsTaxi driversLicensed psychologistsChiropractorsHome care providersPersonal care assistants
Yes!
ALL providers can use OrbiteConnect, regardless of size – although the tool was developed with small practitioners in mind.
Typical targeted providers include:
Care coordinatorsHome modification providersCarpentersLanguage interpreters and translatorsDentistsAnd others
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Use IGI For Other Services & To Use IGI For Other Services & To Meet Other Mandates Meet Other Mandates
Register with OrbiteConnect to conduct the following ERA – Mandate effective December 15, 2009 Eligibility Verification – Mandate effective January 15, 2009
Expanded Payer Service Register with over 100’s of new payers through OrbiteConnect
Conduct Credit Card Transactions
E-Prescribing - Mandate effective January 1, 2011 All providers, group purchasers, prescribers, and dispensers must establish and
maintain an electronic prescription drug program that complies with the applicable standards, directly or through an intermediary, prescriptions and prescription-related information using electronic media
EHR (Electronic Health Record Service) –Mandate effective January 1, 2015 All hospitals and health care providers must have in place an interoperable
electronic health records system within their hospital system or clinical practice setting. The commissioner of health, in consultation with the Health Information Technology and Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal, including uniform standards to be used for the interoperable system for sharing and synchronizing patient data across systems. The standards must be compatible with federal efforts
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How OrbiteConnect Works
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1) Register Online Health care providers can register with OrbiteConnect at www.orbitconnect.net. This
process takes five minutes and approval is generally immediate.
Some health plans require confirmation of the provider registration before transactions can be sent.
2) Submit Claims Online Providers enter claims by logging on to the website and entering claims information
into an “e-claim” which looks exactly like the paper form providers still use today.
The system flags any errors that providers can immediately correct to ensure compliance with state and HIPAA requirements.
Providers submit claim into the system, and the payer receives data in a standardized, compliant format.
3) Receive Notification Online and Payment from Payer Payers send status reports back to providers through OrbiteConnect, and send
payment to the providers, independently.
Payment cycles on electronic claims are determined by each payer and will vary.
How To Get StartedHow To Get Started
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Landing PageLanding Page
Once you reach the Landing Page, you are able to do the following;1. Register (If you have not done so already)2. Log in to your account (if you have received your confirmation email stating
that the payer (s) have approved your registration)
Returning Users Returning Users
First Time Users First Time Users
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Registering To Use OrbiteConnect-Registering To Use OrbiteConnect-First Time Users-Step 1First Time Users-Step 1
Go to: www.orbiteconnect.net
Click “Register Here”, it will bring you to the following page below.
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Registering To Use OrbiteConnect-Registering To Use OrbiteConnect-First Time Users-Step 2First Time Users-Step 2
Necessary Information:
Provider type: solo, group or billing service
Federal Tax ID number
National Provider ID
UMPI
Tax ID/SSN or other IDs
Health Plans your practice bills
Name and contact information for your administrative user
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Registering To Use MNeConnect-Registering To Use MNeConnect-First Time Users-Step 3First Time Users-Step 3
Approval time takes 3 to 5 business days, regardless of
the payer.
Once a payer has approved your registration, you are able
to log in & set up your account.
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Log InLog In
Type in your user name and password Type in your user name and password
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Account AccessAccount Access
For providers who currently use OrbiteConnect, you will be able to access four new features within your account:1. Additional Services Option (found under Billing Account Admin Tab)2. Services Status (found under Billing Account Admin Tab)3. ERA Tab4. Eligibility Tab
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Set Up Administrative FunctionsSet Up Administrative Functions
Assign “Providers To Users” In order to submit claims to a particular provider, providers must be added to the account and assigned to particular users.
Before you can begin filing claims online, you’ll need to set up your account:
Add “Service Facilities”Service facility information can be added on the account level to expedite completion of claim forms.
Add “Providers”Any provider (s) that render services for your practice or organization must be added on the account level in order for users to access claim forms properly.
Add “Users”If more than one staff member will be submitting claims for your practice, you must add them to the account.
Once you have created and set up your account as indicated above, you will be able to complete and submit claims using OrbiteConnect once
approval from a payer is received.
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Service Facilities - Set UpService Facilities - Set Up
Service Facilities that have been set up already will appear in a table as shown. Service Facilities that have been set up already will appear in a table as shown.
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Provider - Set UpProvider - Set Up
Providers that have been set up already will appear in a table as shown. Providers that have been set up already will appear in a table as shown.
AddProvider
AddProvider
EditProvider
EditProvider
ViewProvider
ViewProvider
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User (s) – Set UpUser (s) – Set Up
Users that have been set up already will appear in a table as shown. Users that have been set up already will appear in a table as shown.
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Web-Based CMS 1500 FormWeb-Based CMS 1500 Form
Identical to the paper
version!
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Web-Based UB04 FormWeb-Based UB04 Form
Identical to the paper
version!
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Web-Based Dental ADA FormWeb-Based Dental ADA Form
Identical to the paper
version!
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Accessing Claim FormsAccessing Claim Forms
In order to access the claim forms that you have registered for (CMS 1500, UB-04 & ADA), you need to insure that your “Pop Up Blocker” is turned off.
Claim Access will open a new window as a pop up.
Click on your “Claims Tab”
Then click on “Claims Access”
A pop up window appears with your claim form tab (s)
Once you click on the Claim Form Tab that you want to submit to the payer, you have the option for Primary, Secondary & Tertiary to choose from.
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Attachment ScreenAttachment Screen
Attachment Option is located at the bottom of your claim form, as shown here
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Claim Status Claim Status Report
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Claim Status From Payer ReportClaim Status From Payer Report
Once you enter in your appropriate search criteria and click “Search”, your report appears below, as shown here along with an option to export it into excel.
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Registering With Additional Registering With Additional Payers – Step 1Payers – Step 1
Click on “Billing Account Admin Tab” then “Payer Registrations” option
Search for a particular payer and transaction type, by entering in your search criteria into the appropriate search fields.
Then click on “Search”
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Registering With Additional Registering With Additional Payers – Step 2Payers – Step 2
Check the “Transaction Type Boxes” required for each of the Payer Names
Click “Add”
You shall see in your “View / Update Results” the payers that you have added to your account, you must click on “SAVE” to save the changes to your account
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Special Features Of The System Special Features Of The System
Patient information database Patient information has to be entered only once; info is then stored for future use.
Attachments Additional documentation can be submitted to payers by electronically attaching them to the claim form.
Secondary claim filing capability Providers can bill to secondary and tertiary payers using the system.
Line item form for including supplementary info such as drug codes Each service line includes an addition data form to include extra info.
Claim status reports from both IGI Health and health plans Providers can use the portal to check the status of a claim.
Diagnoses and procedure code favorites list Providers can create their own quick links to avoid tedious scrolling or memorization.
Batch Upload Providers can upload multiple files at once to avoid manual key-in of each claim.