Learning Resources
Frequently Asked Questions
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WEB TOOL |
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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 member says that he/she no longer has the insurance on file?If a member no longer has the insurance policy that is seen on the Web Tool, the provider can refer the member to their eligibility counselor/worker, or complete the Health Insurance Information Referral Form (HIIRF) to update the member’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. | |