Learning Resources
Frequently Asked Questions
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WEB TOOL |
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Will systems recognize a duplicate claim if it is denied?No, because it did not process. | |
Will voids show up on the remit?Yes | |
Will Web Tool list information auto-update for you as changes are made?No, it is not tied to another system. Updates are your responsibility. | |
Would you ever get locked out of the Web Tool if you put your password in wrong?No, there is no limit on password attempts. | |
WEB TOOL: CHECK ELIGIBILITY |
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How can you find out MHN info for a member?A provider can verify Medical Homes Network enrollment on the eligibility section of the Web Tool under the “Beneficiary Special Program Data” section. | |
If a member isn’t eligible, will the Web Tool show ineligible?Yes, information is listed in red. | |
If the Web Tool says they have 2 visits but the member goes somewhere else, how do we know if they have anymore visits?Web Tool is updated nightly; you should always check and if they are out of visits, let them know before providing services. | |
If you are checking a new person’s eligibility, can you add them to your member list from that screen? Yes, there is a button to do that.Yes, there is a button to do that. | |
Is the Web Tool updated daily?Yes, the Web Tool is updated every night. | |
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. | |