Learning Resources
Frequently Asked Questions
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THIRD PARTY LIABILITY (TPL) |
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What if a claim is created, but the beneficiary says that he/she no longer has the insurance on file?If a beneficiary no longer has the insurance policy that is seen on the Web Tool, the provider can refer the beneficiary to their eligibility counselor/worker, or complete the Health Insurance Information Referral Form (HIIRF) to update the beneficiary’s third party payer information. Making a change to a policy that already exists in the Medicaid Management Information System (MMIS) takes five days. The HIIRF Form can be faxed to 803-252-0870. | |
Where are the specifics for pay and chase?The specifics for pay and chase are found in Section 2 (polices) and section 3 (billing) of your provider manual. | |
WEB TOOL |
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Are Web Tool lists separated by login?No, your lists are sharable. | |
Can batches be deleted after they are sent?No. Batches cannot be deleted at this time. | |
Can claims be lost via the Web Tool?Generally, they don’t get lost using the web. | |
Can I check claim status on the Web Tool?Yes. Key in the NPI or provider ID number and the recipient ID number and press submit. | |
Can I do a span date on the Web Tool?Yes, by entering in information in the to and from fields. | |
Can we find edit codes on the Web Tool?No, however the edit code listing is found in Appendix 1 of your provider manual. | |
Can Web Tool Lists be sorted by provider?Not at this time. The Lists can be sorted by who created them. | |
Can Web Tool users in the same organization see each other’s claim information?Users in the same organization based on the provider’s NPI number will be able to see claim information entered by other users. | |