Learning Resources
Frequently Asked Questions
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WEB TOOL |
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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. | |
Is there a way to find a claim in History if you had not submitted it through the Web Tool?No; you can only view that claim’s status. | |
Under the Web Tool's status option, can I check the status of a claim I submit hard copy?Yes, it doesn’t matter the submission method. | |
What form needs to be completed for access to the Web Tool?The trading partner agreement form needs to be completed. | |
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. | |
What is an MHN referral number?If your service requires a referral, the MHN gives you an authorization number. | |
What is the payment cycle?The payment cycle is: Wed-Mon, payments are processed on Tuesday, and payment is received as early as Friday. | |
What is the Web Tool’s Non-Contractual box?The Non-Contractual box is to be selected/entered when the provider is not contracted with the beneficiary’s third party payer. | |
When a claim is in a denied status, can you do an adjustment?You must wait for the rejection, and then do a correction. An adjustment can only be made to a paid claim. | |