Instructions for entering claims
Contents
1. r What access do you want to grant NoAccess C Read Access to S r Do you want to be asked again amp Always ask me Never ask me again for this Never ask me again a i for this site at the bottom and then click OK c Provider folders will appear Click on your folder on the left tab folder name will be provided by Western Highlands and contain your provider ID There will be an inbox and an outbox c on Client is the hard drive on your computer providers on Harvard is the folder assigned to you on the Western Highlands server E1 36208 _AHCC Fie Edit View Favorites Tods Help Back gt amp A Search Folders Ey Address fa 36208_AHCC Folders x ep Desktop my Documents 5 g My Computer a 3 Floppy S amp S Local Disk C amp Local Disk D 2 CD Drive E S amp S c on Client v HA TT amp amp E E 36071_MTNL 36073_Nv H E 36117 _ESNC a E 36123_UNMH GY 36167_HZRC a E 36168_55MC 36208 _AHCC Control Panel E3 g My Network Places fal Recycle Bin amp providers on harvard x freed st nee Inbox provider deposits 837 files N A for DDE billing Outbox Western Highlands deposits Explanation of Benefits d Click on c on Client V This is your hard drive Copy your 837 file from there and then paste it int2. Service Date 2 3 a Procedure Code Secondary Modifier 5 Units zz 6 Amount Billed ts 7 Authorization Number OS 8 Attending Provider NPI select one gt 3 Taxonomy Number select one gt 10 Service Facility Location NPI select one 14 12 Zip 4 Service Facility Location 12 Optional To help connect to your records Your Client ID sl 13 Your Claim ID 9 Match the numbers to the notes below for an explanation 15 Back Add Clam Exit Last updated 4 4 2008 3 4 Field Definitions 1 Clear Form Button Click here to clear the contents of all fields this will not remove any successfully entered claims but is designed to allows you to start over with a clean form You can also just type over existing text to start a new claim 2 Client ID Type the Western Highlands six digit client identification number and tab you should either see the client s name or initials 3 Service Date Either type the date or click on the question mark for a calendar Type the numbers without slashes to speed things up For example if you type 102506 and tab it will correctly format to 10 25 2006 automatically 4 Procedure Code Type the correct code or click on the question mark for a picklist Include applicable modifiers Letters must be uppercase don t use spaces or dashes 5 Secondary Modifier Secondary Modifiers identify units of service provided by the Qualified Professional Q
3. P and Non Qualified Professional non QP staff members If your claim submission does not require Secondary Modifiers tab to the next field Secondary Modifiers are two characters long and all capital letters Type U3 when billing a service provided by Qualified Professionals Type U4 when billing for a service provided by Non Qualified Professionals Denial error 077 Missing Invalid 2 Modifier appears when incorrect data has been been entered for the 2 modifier Denial error 078 Secondary procedure modifier invalid for procedure on date of service appears when a 2 modifier is entered and it s not required for the procedure code and or date of service billed 6 Units Enter the specified billing units 7 Amount Billed Enter your usual customary fee Do not enter the but do use a decimal and cents if applicable 8 Authorization Number Type the Western Highlands authorization number This number is present on the Western Highland s Letter of Notification you received authorizing the service 9 Attending Provider NPI This is the NPI representing the attending provider If billing Enhanced Services enter the NPI number associated with the DMA Community Intervention Number registered with WH and DMA If billing Outpatient Behavioral Health OBH codes enter the NPI number associated with the DMA Individual Clinician s Direct Enrolled Number you have registered with WH and DMA Last up
4. Western Highlands Network Direct Data Entry User s Manual 1 Logging into the Western Highlands Network a Go to the csg westernhighlands org website you do not need to enter www or http b Login with user name and password provided by Western Highlands c This is the initial screen after logging in you may not have all of these icons LP TT a Om nmm Western Highlands Network A LOCALI MANAGRMFNT ENTITY A Top ry Up Provider Shares i a contain your inbox and outbox Printers Program Provider Provider Neighborhood Shares Shares Client Drives The Western Highlands Network messages that may occur i If you wish to use the late WH CCIS is used to 32 bit Windows you can enter data or claims Log Off Select the icon below to ir in the WH system _ S MetaFrame Presentatio Other clients are available 2 Accessing your inbox and outbox for 837 s or EOB s a Under Applications click on Provider Shares Client Drives b If the Citrix Security box appears click on full access and never ask me again for this site You may not get this until you try to open a folder You should only get this prompt the first time you use the system Last updated 4 4 2008 1 i f CITRIX server application is requesting access to your local client files If the security box appears select Full Access at the top and Never ask me again
5. dated 4 4 2008 4 If billing neither an Enhanced Service nor OBH procedure code enter the NPI number associated with the Western Highlands provider number registered with Western Highlands 10 Taxonomy Number This is the attending provider Taxonomy number Choose from the list provider Contact Western Highlands to add a Taxonomy if not present within the list 11 Service Facility Location NPI This is the NPI representing the service location were services were provided as registered with Western Highlands and or DMA 12 Service Facility Location Zip 4 This is the zip 4 Western Highlands has registered within the chosen Service Facility Location NPI 13 amp 14 Optional Fields The optional fields are not needed by Western Highlands but are available to help you link claims to your own numbers 15 Use the Add Claim button to submit each claim and the Exit button when you are finished 5 After the form is filled out click the Add Claim button If there are no errors your claim will be displayed at the bottom of the page You may need to scroll down to see this If there is an error you will receive a brief explanation and will need to correct the issue before that claim can be entered You may continue to submit new claims or click exit if you are finished The successfully entered claims will have an edit and a delete button to make corrections you can make corrections at anytime during the day but each new day you
6. o the inbox Please name your files with the submission date the first four letters of your provider name and A B C etc For example Smith Group Home would be 080506SMITA O80506SMITB etc Then notify Western Highlands diane westernhighlands org that you have put an 837 file in the folder and it s ready to be picked up Western Highlands staff will notify you when it has been picked up and when it s been processed Pick up your EOB in the outbox It can be copied and pasted to your computer through the same c on client link Last updated 4 4 2008 3 Direct Data Entry Functions Claims Data Entry a Under Applications click on WH CCIS and log into the Netsmart System you will need to make sure your pop up blocker is off at this point it s in the tools menu Then click the link for direct data entry b Use the tab key or a mouse click to move between the fields the enter key will not work c Clicking on the question mark will bring up a search window If you know what to type in the box you do not need to select it from the question mark list Letters must be uppercase d Always use the exit button at the bottom of the window to close the program do not use the X in the upper right hand corner to exit e The Clear Form button just erases the data fields it does not delete claims that were accepted Clear Form 4 Add New Claim Provider Provider Name Contract Staff Your Name Client ID ha 2
7. start off with a clean page 6 If you entered claims you will be given the opportunity to print a report that summarizes what you have entered Click Exit at the bottom of the screen then choose which type of report you want The best choice is usually print all successfully submitted claims entered today If you need help Toll Free 800 671 6560 Local 828 225 2785 Ext 2139 is Don Petit in the IS department Logging in passwords access to clients Ext 2191 is Marlene Lewis in the Claims department billing errors and issues Last updated 4 4 2008 5
Download Pdf Manuals
Related Search