Frequently Asked Questions


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Frequently Asked Questions

 

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WEB TOOL

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.


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.



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