Learning Resources
Frequently Asked Questions
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If the Web Tool says they have 2 visits but the beneficiary 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 recipient list from that screen?Yes, there is a button to do that. | |
If you are missing information, will the Web Tool process the claim anyway?Yes and no; there are basic required fields that are denoted by asterisks, however if you forget modifiers, the Web Tool won’t recognize that. | |
If you copy an entire Web Tool batch over, can you choose which claims to submit?Yes | |
If you have a multiline claim and only one line needs recouping, you still complete an adjustment?Yes, claims are 100% adjusted, all lines will be replaced. | |
If you have primary diagnosis codes, do you have to add additional codes?No, you just need the primary code. | |
If you know a service isn’t covered, do you still file to the other carrier?Yes, you still file to the other carrier to obtain a valid denial. Three denials should be kept on file each year. | |
If you make an error and you submit the claim on the Web Tool, is there a way to cancel or make a correction that same day?Once a claim is submitted via the Web Tool, there is no way to cancel or make a correction to the submitted claim that same day. Once the claim has gone through the payment cycle, you will be able to see if the claim has been rejected, paid, or suspended. You will then be able to make corrections to the claim before resubmitting as a new claim. | |
In the Web Tool's status section, do claims purge based on batch ID?They purge based on the check date. | |
Is an adjustment only done when you have been paid?Yes, only paid claims can receive an overpayment or underpayment. | |