Tuesday, July 16, 2024, 4:07 PM
Site: Healthy Connections Medicaid E-Learning
Course: Learning Resources (Learning Resources)
Glossary: Frequently Asked Questions

If you are checking a new person’s eligibility, can you add them to your recipient list from that screen?

Yes, there is a button to do that.

If you are missing information, will the Web Tool process the claim anyway?

Yes and no; there are basic required fields that are denoted by asterisks, however if you forget modifiers, the Web Tool won’t recognize that.

If you copy an entire Web Tool batch over, can you choose which claims to submit?

Yes

If you have primary diagnosis codes, do you have to add additional codes?

No, you just need the primary code.

If you make an error and you submit the claim on the Web Tool, is there a way to cancel or make a correction that same day?

Once a claim is submitted via the Web Tool, there is no way to cancel or make a correction to the submitted claim that same day.  Once the claim has gone through the payment cycle, you will be able to see if the claim has been rejected, paid, or suspended.  You will then be able to make corrections to the claim before resubmitting as a new claim.

In the Web Tool's status section, do claims purge based on batch ID?

They purge based on the check date.

Is the EFT form used for MCOs as well?

No, they have their own forms and billing systems.

Is the Web Tool claim ID number automatically entered?

Yes.

Is the Web Tool updated daily?

Yes, the Web Tool is updated every night.

Is there a limit to the number of claims in a Web Tool batch?

There is not a limit to the number of claims in a batch.