ProviderAccess User Manual For Professional and Dental Providers
Contents
1. webuser Insured Patient Information gt ProviderAccess hlenu gt Claims Administration Contract XAA1 23456789 Date of Birth 01 25 1972 Patient Name Jane Doe Required fields are denoted by an asterisk C insured Information Name Last Doe First Jane Middle rAddress Street fi 23 Park Place City Anywhere State ALABAMA Zip 35004 Other Date of Birth fo 251972 Gender Female gt Patient Information Name Last Doe First Jane Middle Address Street fi 23 Park Place City Anywhere State ALABAMA gt Zip 35004 r Other Date of Birth 01251972 Gender Female gt Patient s Account Number fi 2345678 gt Release of Infnrmatinn Conde Do you have on file a signed statement by the patient authorizing the release of medical billing information for this Yes claim Yes Next Tip Don t forget to add your Patient Account Number Verify the Insured Patient Information on this page to make sure all questions are answered and pre populate fields are accurate If the information is correct press the Next key If the information is not correct select the ProviderAccess link and re key your information If the information is still incorrect contact your EDI Services Representative for assistance Professional eClaims User Manual Rev J2. Submitted Claims Go panies 8 02 09 33 Professional HAA123456789 Accoumt Number DOE JOHN 50 00 Submitted sew o ooo 1049 2006 09 31 12 Professional PPA123456739 Accomt Humber DOE JANE 200 00 Submitted View aM Tip The Claims Administration screen shows all claims that are in a pending status and all claims that have been submitted or processed The claim that you just entered should now appear in the Incomplete and Pending Claims list along with the total claim amount You may now choose to edit submit or delete the claim After the batch is received by Blue Cross and Blue Shield of Alabama the claim will appear in the Submitted and Processed Claims list Note Claims located in the Incomplete and Pending Claims list have not yet been received by Blue Cross and Blue Shield of Alabama for processing Professional eClaims User Manual Rev June 2008 Page 26 of 30 Audit Report Retrieval An audit report is generated by Blue Cross that confirms the receipt of your electronic claims This report specifies whether the submitted claims were accepted for processing or rejected due to an error Normally if we receive your claims before approximately 3 00 p m an audit report will be available the following business day If we receive your claims after approximately 3 00 p m your audit report should be available after two business days From the ProviderAccess page use your mouse to cl
3. f Address infi ormation Street 1 23 Park Place City Anywhere State ALABAMA Zip 35004 Other A A Date of Birth 1251972 Gender Female e Patient s Account Number Release of Information Code Do you have on file a signed statement by the patient authorizing the release of medical billing information for this Yes i claim Next Tip Don t forget to add the Patient Account Number Verify the Insured Patient Information on this page to make sure all questions are answered and pre populate fields are accurate If the information is correct press the Next key If the information is not correct select the ProviderAccess link and re key your information If the information is still incorrect contact your EDI Services Representative for assistance Professional eClaims User Manual Rev June 2008 Page 8 of 30 Claim Information This section contains the information related to the medical services rendered to the patient by the provider The field number corresponds to the box number on the CMS 1500 form Contract AA123456783 Date of Birth 0125 1972 Patient Name Jane Doe Payer ok Insurance ok ls claim accident related Date of current illness Claim Info ok Line Info ok Date of Accident Onset date of current illness Type of Accident Auto Accident State Dates Patient unable to work in current occupation First Name of Referring Physician
4. rp M BlueCross BlueShield About Us Contact Us Careers Help vA of Alabama Seach Home gt Providers gt ProviderAccess gt Audit Reports You are signed in as vebuser Audit Reports and Batch Messages k Provider Access Menu View Audit Report and Batch Messages Enter a valid Submitter ID f View Audit Report only Click on the drop down date list and select your desired report date Click submit to view this report on this screen You will also have the ability to print this report rr M BlueCross BlueShield About Us Contact Us Careers Help VAY of Alabama Dh Search Home gt Providers gt ProviderAccess gt Audit Reports You are signed in as webuser Select Date k Provider Access Menu This application allows you to view your Audit Report for specific dates Choose a Date and then click Submit Submitter ID Mot Entered Enter Submitter ID Current Location NPI 1234567890 Date Audit Report Format POF HTML To view the Audit Report as a Portable Document Format PDF file you will need Adobe Acrobat Reader free software that view and print POF files If you do not already have this software installed on your computer you may install it by selecting Click on be Get Acrobat Reader box below Acre BS Acrobat Reader the Audit Report as HTML no additional software is required at when printing your audit reports the PDF for
5. Claim Type This claim is being submitted as Contract Number First Name Middle Initial Last Name Date of Birth Gender Last date of service for this claim Next You are signed in as wabuser gt ProviderAccess Menu gt Claims Administration Anesthesia Dental Home Health Professional Institutional Primary Secondary Professional eClaims User Manual Rev June 2008 Page 12 of 30 Choose the correct option for patient relationship to insured that applies to your claim Payer Information i BlueCross BlueShield About Us Contact Us Careers Help mi WZ OF Alabama ee Home gt Providers gt ProviderAccess gt eClaims You are signed in as 510234 Payer Information gt ProviderAccess Menu gt Claims Administration Contract XAA1 23456789 Date of Birth 01 28 1975 Patient Name Jane Doe Required fields are denoted by an asterisk Primary Payer Commercial gt Payer Name Member ID HICN ABC INSURANCE ABCI 23456789 Secondary Payer BCBS Payer Name Member ID HICN BCBS of Alabama KAAT 23456769 Patient Relationship to Insured Professional eClaims User Manual Rev June 2008 Page 13 of 30 INSURED PATIENT INFORMATION Verify that all information returned on this screen is correct A BlueCross BlueShield About Us Contact Us Careers Help AV of Alabama o s sS
6. accessed through Payee Functions This section is referred to as the Payee Based application and allows a user to view payment history refund billing invoices along with remittance refund balance activity and claim refilling information reports About Us Careers Contact Us Fraud amp Abuse HIPAA Privacy Notice Privacy Statement Legal Disclaimer This site and all contents are Copyright 2008 Blue Cross and Blue Shield of Alabama Professional eClaims User Manual Rev June 2008 Page 4 of 30 Click on the words Claim Entry eClaims r M BlueCross BlueShield About Us Contact Us Careers Help UN of Alabama Home gt Providers gt ProviderAccess gt Location Menu You are signed in as webu er ProviderAccess Menu F Man Menu k ProviderSccess User Manuals PHYSICIAN NAME HERE k Provider Publications NPI 1234567090 k Change Location Location ID 51012345 k Payee Menu 123 GET WELL DRIVE BIRMINGHAM AL 35244 Change Location Please select the e Practice Management application you would like to perform from the list below To perform additional transactions please return to this page to select your next function Patient Information t Eligibility and Benefits t Summary Plan Description Claim Information 3 Claim Entry eClaims K Audit Reports Claim Status Fee Schedules t PMD Fee Schedule t April 1 2008 PMD Fee Changes Special Bulletin BS 2003 05 October 1 2007 PMD Fee Changes
7. ia UY of Alabama Home gt Providers gt ProviderAccess gt eClaims You are signed inps wehneer Claims Administration New Claim Incomplete and Pending Claims Date Created Claim Type Contract Number h rana Patient Name Claim Amount Submit All Pending Claims 1120006 10 59 00 professional 00123456789 42345678 DOE JANE 175 00 Pending Edt Submit Delete 11 20 2006 10 28 53 Professional 0123456789 42345678 DOE JANE 175 00 Pending Edit Submit Delete Submitted and Processed Claims Select all submitted claims or processed claims by date Submitted Claims gt Claims Date Crested Claim Type Cortract Number eee ee Patient Name 1025 2006 02 09 22 Professional HAA123456789 Accoumt Number DOE JOHN 50 00 Subm View 1013 2006 09 31 12 Professional PPA123456789 Account Number DOE JANE 200 00 Submitted View eClaims allows a user to select a date to view submitted or processed claim files Professional eClaims User Manual Rev June 2008 Page 21 of 30 Required fields are Verify that all information is correct denoted by an asterisk Member Information Ee Home gt Providers gt ProviderAccess gt eClaims You are signed in as webucer M em b er Info rm ati on gt ProviderAccess Menu gt Claims Administration Required fields are denoted by an asterisk C Choose the correct Claim Type Anesthesia Dental Home
8. 12006 a help window mm ale nim No Delete to appear Help ANAO na Windows provide r ae nim No Delete a description 1 Wt it a of the chosen Me e No _ Delete ield ale TT No _ Delete a m LC vo i aa This section contains the information related to the medical services rendered to the patient by the provider The field number corresponds to the box number on the CMS 1500 form You may key up to 10 line items on this screen After completion click the Next button If there are no errors the claim will be accepted and you will be forwarded to the Claims Administration screen If you have more than 10 line items you must add a new claim to enter the additional line items Professional eClaims User Manual Rev June 2008 Page 10 of 30 Edit Submit or Delete any pending claims Claims Administration Ga BlueCross BlueShield About Us Contact Us Careers Help me WY O Alabama _ Home gt Providers gt ProviderAccess gt eClaims You are signed in as webuser Claims Administration New Claim Submit All Pending Claims Incomplete and Pending Claims Date Created Claim Type Contract Number gei Patient Name Claim Amount 11132006 02 25 13 02 25 15 Professional 400123456789 12345678 DOE JANE 150 00 Pending Edit Submit teenie 01 36 44 Professional 400123456789 42345678 DOE JANE 175 00 Pending Edi
9. 2 06 08 02 06 08 179 30 CLAIM NBR 0450903763 so 250509 CONT MED REC PAT CNTL PATIENT NAME FROM DOS THRU DOS CLAIM CHARGES XAG 123456789 BALL JR 02 05 08 02 05 08 484 00 i 4 X pa LJ UU tal id 4 tofi7 b bI Ui Use arrows to view the next page Rejected claim immediately follows the Accepted Claims totals This section contains a list of all claims that were rejected Each of these claims will have an associated error number and message explaining why it was rejected Note Remember that errored claims have not been accepted by Blue Cross and Blue Shield of Alabama and we keep no further record of them these claims should be corrected and resubmitted as new claims Professional eClaims User Manual Rev June 2008 Page 30 of 30
10. 3 2006 02 03 33 Professional HAA123456789 Accout Number DOE JOHN 30 00 1019 2006 09 21 12 professional PPA123456789 Account Number DOE JANE eClaims allows a user to select a date to view submitted or processed claims Professional eClaims User Manual Rev June 2008 Page 6 of 30 Choose the Claim Type Claim Type d This claim is being submitted as Primary O Secondary Required fields are Member Information denoted by an asterisk Enter all information in required fields Home gt Providers gt ProviderAccess gt eClaims You are signed in as webueer Member Information gt Provider4ccess Menu gt Claims Administration Required fields are denoted by an asterisk C Anesthesia Dental Home Health Professional Institutional Contract Number First Name Middle Initial Last Name Date of Birth Gender Choose either Primary or Secondary claim Last date of service for this claim Next Tip Choosing the correct claim type will allow the appropriate screen to appear i e Home Health Prescription Number NDC Code Anesthesia Days or Units Payer Information Verify that all information is accurate Select the Patient Relationship to Insured field and choose the option that applies to your claim Lar BlueCross BlueShield About Us Contact Us Careers Help
11. 3 3 73349 Claim Info ok rocedures Services or Supplies Dates of Service Facility Type From To mmddyyyy Code POST CPT HCPCS Modifiers Delete 4 b Fa o iREEEEREER Delete z Delete N Tip Place your mouse on the question mark fora help window Delete _ 4 Delete gt to appear Help windows provide a description of the chosen field Delete Delete Delete N E gt Z Z Z zZ Z Z Z Z o oO oO m m a D D a O 4 4 4 4 4 4 4 Delete N D ddd sd od dd as TITTI Delete 4 fos2a0e fos2008 fos2o0s fos2a08 lt Nex Professional eClaims User Manual Rev June 2008 Page 25 of 30 Submit your claim Claims Administration ar BlueCross BlueShield About Us Contact Us Careers Help ies UY of Alabama a Home gt Providers gt ProviderAccess gt eClaims You are signed in as Claims Administration weahncer New Claim Submit All Pending Claims Incomplete and Pending Claims E Professional 400123456789 123456789 DOE JANE 475 00 Pending legit Submit Delete TEn Professional 400123456789 12345678 DOE JANE 175 00 Pending Edit Submit Delete Submitted and Processed Claims Select all submitted claims or processed claims by date
12. DOE JANE 175 00 Pending Submit Delete en Professional 00123456789 12345678 DOE JANE 175 00 Pending Edit Submit Delete Submitted and Processed Claims Select all submitted claims or processed claims by date Submitted Claims gt Go pasame a8 02 09 33 professional YAW 193456789 Account Number DOE JOHN 30 00 Submitted View 1071972006 083192 Professional PPA123456789 Account Number DOE JANE 200 00 Submitted View Tip The Claims Administration screen shows all claims that are in a pending status and all claims that have been submitted or processed The claim that you just entered should now appear in the Incomplete and Pending Claims list along with the total claim amount You may now choose to edit submit or delete the claim After the batch is received by Blue Cross and Blue Shield of Alabama the claim will appear in the Submitted and Processed Claims list Note Claims located in the Incomplete and Pending Claims list have not yet been received by Blue Cross and Blue Shield of Alabama for processing Professional eClaims User Manual Rev June 2008 Page 20 of 30 Corrected Claims eClaims allows a user to submit all pending claims by placing your mouse on Claims Administration the highlighted words and clicking the left mouse To create a new claim click the word New Claim button ar BlueCross BlueShield About Us Contact Us ff areers Help
13. Health Professional Institutional This claim is being submitted as Primary Secondary claim type Contract Number First Name Middle Initial Last Name Date of Birth Gender Last date of service for this claim Next Choose the type of claim that is submitted Primary or Secondary Payer Information Verify that all information is correct Select the Patient Relationship to Insured field and choose the option that applies to your claim Ta BlueCross BlueShield About Us Contact Us Careers Help VAY of Alabama EEE Search Home gt Providers gt ProviderAccess gt eClaims You are signed in as webuser Payer Information gt ProviderAccess Menu gt Claims Administration Contract XAA1 23456789 Date of Birth 01 25 1972 Patient Name jane Doe Required fields are denoted by an asterisk Payer inc Primary Payer BCBS gt Payer Name Member ID HICN BCBS of Alabama KAAT 23456789 Patient Relationship to Insured gt Patient Relationship to Insured Professional eClaims User Manual Rev June 2008 Page 22 of 30 Verify that all information returned on this page is accurate Insured Patient Information ie BlueCross BlueShield About Us Contact Us Careers Help mi VY Of Adame m Home gt Providers gt ProviderAccess gt eClaims You are signed in as
14. Injectable Drugs t January 2007 PMD Fee Changes Special Bulletin BS 2006 27 Professional eClaims User Manual Rev June 2008 Page 5 of 30 Provider Submitter Identification l Please contact our web desk at Verify the Plan Code and the Provider Number are correct 205 220 6899 if a Submitter Enter your Submitter Billing ID Billing ID is needed ar BlueCross BlueShield About Us Contact Us Careers Help VAY of Alabama fl Search Home gt Providers gt ProviderAccess gt eClaims You are signed in as webuser Provider Submitter Identification gt ProviderAccess hlenu Identification Plan Code 510 Provider Number 12345 Submitter Billing ID WEBOOO00 Submit Claims Administration eClaims allows a user to submit all pending claims by clicking Submit All To create a new claim click the word New Claim Pending Claims AT BlueCross BlueShield About Us Contact Us Careers Help GY of Alabama m Home gt Providers gt ProviderAccess gt eClaims You are signed in as webuser Claims Administration SE New Claim Submit All Pending Claims Incomplete and Pending Claims Date Created Claim Type Contract Number e rates Patient Name Claim Amount Submitted and Processed Claims Select all submitted claims or processed claims by date Submitted Claims gt Go Date Created Claim Type Contract Number Patient Account Patient Name Number 102
15. Level Note This page is returned ONLY if you do not have line level payment information ar BlueCross BlueShield About Us Contact Us Careers Help US of Alabama sd Search Home gt Providers gt ProviderAccess gt eClaims You are signed in as T Primary Payer Payment Information Claim Level gt ProviderAccess Menu gt Claims Administration Contract AA1 23456789 Date of Birth 01 28 1972 Patient Name JANE DOE Required fields are denoted by an asterisk C Payer ok chro be Enter the claim level payment information from the Primary payer Primary Payer Name ABC INSURANCE ini Primary Payer Contract Number ABC123456789 Line Info ok Primary Payer Claim Level Adjustments Payment Details Num Group Total Charges Submitted Total Paid Amount Payment Date Claim Level inc Click on the question mark to pull up a help window Tip This page provides a user with the ability to key in other insurance information per line item Professional eClaims User Manual Rev June 2008 Page 18 of 30 Primary Payer Payment Information Line Level BlueCross BlueShield US of Alabama About Us Contact Us Careers Help Seach Home gt Providers gt ProviderAccess gt eClaims Primary Payer Payment Information Line Level Line 2 Contract XAA1 234567389 Date of Birth 01 28 1972 Required fields are de
16. ProviderAccess www bcbsal com User Manual For Professional and Dental Providers eClaims And Audit Report Retrieval BlueCross BlueShield of Alabama Professional eClaims User Manual Rev June 2008 Page 1 of 30 CONTACT NAMES AND NUMBERS l For connectivity or communication problems call or e mail the Corporate Support Center at 205 220 6134 6 00 a m 5 30 p m SupportCenter bcbsal org 2 For other questions or problems e System Status is available as a streamer on the website www bcbsal com e Contact your Electronic Data Interchange EDI Services Representative at 205 220 6899 HARDWARE REQUIREMENTS Minimum Browser Requirements Netscape or Internet Explorer 4 0 or higher Minimum Hardware Requirements for best results Screen Resolution 640 x 480 Internet connection with at least 28 800 bps HELPFUL HINTS l If you leave the PC for a long period of time the application will time out You will need to close and restart your browser or if you have previously bookmarked your ProviderAccess sign in page you may use your Favorites or Bookmark to access the Sign In page directly If you were keying a claim any information not previously saved will be lost Zi Use the tab key not the Enter key when navigating through a screen however don t forget to select the Next button to save your data prior to leaving the screen 3 Do not use the back button o
17. Y Home gt Providers gt ProviderAccess gt eClaims You are signed in as webuser Insured Patient Information gt ProviderAccess Menu gt Claims Administration Contract AA1 23456769 Date of Birth 01 28 1975 Patient Name Jane Doe Required fields are denoted by an asterisk C Payer ok Insured Information Insurance inc Name Last Doe First Jane Middle Address e Street 1 23 Park Place City Anywherw State ALABAMA Zip 35004 Click on the revious Other p Date of Birth 01251972 Gender Female Section Heading to Patient Information move Name backward or to Last Doe First Jane Middle correct any f i Address information Street 123 Park Place City Anywhere State ALABAMA Zip 35004 Other Ao A Date of Birth 01251972 Gender Female SS Patient s Account Number Release of Information Code Do you have on file a signed statement by the patient authorizing the release of medical billing information for this Yes i claim Next Tip Don t forget to add the Patient Account Number Verify the Insured Patient Information on this page to make sure all questions are answered and pre populate fields are accurate If the information is correct press the Next key If the information is not correct select the ProviderAccess link and re key your information If the information is still incor
18. e Adobe Read Download the latest version of Adobe Reader EE EAE Find out how to distribute Adobe Reader software on an intranet CD or other media or place an Includes Adobe Reader logo on your printed material Step 1 of 2 Select your version of Windows Choose a different version Select a Windows 2000 version More info Adobe Reader Adobe Reader for Symbian OS Adobe Reader for Pocket PC Adobe Reader for Palm OSB Whatis Adobe PDF continue Select the version of Windows that you are currently utilizing LUnanges COMMUNITIES COMPANY DOWNLOADS STORE SEARCH Adobe Reader updates Get the latest updates available for your version of Adobe Reader Distribute Adobe Reader Find out how to distribute Adobe Reader software on an intranet CD or other media or place an Includes Adobe Reader logo on your printed material More info Adobe Reader Adobe Reader for Symbian OS Adobe Reader for Pocket PC Adobe Reader for Palm OS What is Adobe PDF Also download V Adobe Yahoo Toolbar Learn more Download information File size 16 4mMB System requiremen ts Update adwisory It is recommended that version 6 0 1 be updated to version 6 0 2 from within Adobe d k Click Download Follow instructions elies on Adobe Reader when converting or transforming PDF files into other file formats Adobe Reader license agreement Adobe Photoshop Starter Edition licen
19. ick on the Audit Report link BlueCross BlueShield About Us Contact Us Careers Help UAV of Alabama Home gt Providers gt ProviderAccess gt Location Menu You are signed in as webuser ProviderAccess Menu E Man Meni k Provider4ccess User Manuals PHYSICIAN HAME HERE k Provider Publications NPE 1234567090 k Change Location Location ID 51012345 k Payee Menu 123 GET WELL DRIVE Tip Please BIRMINGHAM AL 35244 See page 3 to Change Location access this page transactions please return to this page to select your next function Please select the e Practice Management application you would like to perform from the list below To perform additional Patient Information t Eligibility and Benefits t Summary Plan Description Claim Information t Claim Entry eClaims Audit Reports K t Claim Status Fee Schedules t PMD Fee Schedule t April 1 2008 PMD Fee Changes Special Bulletin BS 200805 October 1 2007 PMD Fee Changes Injectable Drugs t January 2007 PMD Fee Changes Special Bulletin BS 2006 22 IMPORTANT NOTE Audit Reports are now available electronically for 60 business days An Audit Report should be retrieved for every date of claims submission Professional eClaims User Manual Rev June 2008 Page 27 of 30 To view Audit Reports enter your Submitter ID Click Submit to continue Or click View Audit Report only to view only the audit report without batch messages
20. ient Medical Information gt Top 100 Procedure Codes HIPAA Information gt More services Guidelines and Policies gt Medical policies gt Blue Advantage Terms and Conditions Uniform Provider Application gt Blue Advantage medical policies Dental Provider Application gt Fragmented coding edits gt DME Policies Fraud and Abuse Professional eClaims User Manual Rev June 2008 Page 3 of 30 Click on Provider Functions to go to eClaims BlueCross BlueShield About Us Contact Us Careers Help UAV of Alabama Home gt Providers gt ProviderAccess gt Main Menu You are signed in as weobuser ProviderAccess Please select the e Practice Management application you would like to perform from the list below To perform additional transactions under another grouping please return to this page to select your next function gt Provider Functions Functions that require the need to identify a specific provider number or NPI must be accessed through Provider Functions This section is referred to as the Location Based application and allows a provider to request eligibility and benefits information retrieve audit reports and error descriptions and enter claims via eClaims You can also view guidelines policies fragmented coding edits and use the NPI search to find NPs for the PCN network Payee Functions Functions that are related to a group or provider s payment information must be
21. mat should be utilized Printing in HTML format is not recommended Audit Reports are available for retrieval 60 days after the submission of a claims batch Professional eClaims User Manual Rev June 2008 Page 28 of 30 Note It is necessary to have the Acrobat Reader software installed on your computer in order to view print the audit trail reports If you have trouble viewing the report or do not have the software installed on your computer download the free version of the Acrobat Reader software Clicking the download link will open a browser window taking you directly to the download page Follow the download instructions and install the software Once install return the Online Audit Trail Retrieval Page and repeat steps above ANI Adobe Adobe Reader Download the latest version of Adobe Reader Step 1 of 2 i of Windows Choose a different version 2000 continue Step 2 of 2 Adobe Reader 6 0 1 for windows 2000 English Latest version By downloading software from the Adobe web site you agree to the terms of our license agreements including that you agree notto use Adobe Reader sofhware with any other software plug in or enhancement which uses or r SOLUTIONS PRODUCTS SUPPORT ya Adobe SOLUTIONS PRODUCTS SUPPORT COMMUNITIES COMPANY DOWNLOADS STORE SEARCH Adobe Reader updates Get the latest updates available for your version of Adobe Reader Adobe Reader j Distribut
22. n your PC while accessing ProviderAccess 4 To select a field using a mouse e Move the mouse pointer to the information to be selected e Depress or click the left mouse button once e The item is selected if the information you choose is highlighted by color shading 5 To select a field without using a mouse e Use the Tab key to move the cursor to the item you would like to select e The item is selected if the information you choose is highlighted by color shading 6 To select a button choose one of the following e Move the mouse pointer to the button and depress the left mouse button once or e Press the Tab key until the dotted line appears around the word and then press the Enter button Professional eClaims User Manual Rev June 2008 Page 2 of 30 Easy Steps to eClaims www bcbsal com Click on fam a Provider on the Blue Cross and Blue Shield of Alabama home page myBlueCross Plans amp Services Health amp Wellness Pharmacy Find a Doctor individual B ye Register LEARN MORE REGISTER NOW Forgot your Username Forgot your Password Looking for Insurance Oa SIGNIN BeHealthy com ind a Health Provi Employers amp Prov I am an Employer Health Care Provider or Resources for employers to Facility maintain their group s benefits Find a hospital doctor dentist I am a Provider or other medical professional Resources for
23. nformation gt Claims Administration Contract XAA1 23450789 Date of Birth 01 25 Patient Name Required fields are denoted by an asterisk Gass Bi Diagnosis Codes geie required Insurance ok 1 73330 2 73393 3 73349 4 Claim Info ok Line Info inc 5 7 Dates of Service Facility Type Oe en ene A A f Emergency Days or From To mmddyyyy Code POSY Diagnosis Code Fointens i dicator Charger Units CPT HCPCS Modifiers 10312006 file fjoeso eT No froo o0 fr Delete 10312006 Toy IE IE 0312006 Mele p9212 Hill No 75 00 M Delete 0312006 r OC z L No o Delete Tf E I z OL No O Delete 1 i EW A Tip Place your mouse over the question mark on the screen for a help window to appear Help Windows provide a description of the chosen field You may key up to 10 lines items on this screen After completion click the Next button If there are no errors the claim will be accepted and you will be forwarded to the Claims Administration screen If you have more than 10 line items you must add a new claim to enter the additional line items Professional eClaims User Manual Rev June 2008 Page 16 of 30 Line Level Information Click here if you do not have line level payment information ar BlueCross BlueShield Abougpls Contact Us Careers Help US of Alabama SF Search H
24. noted by an asterisk C You are signed in as webuser gt ProviderAccess Menu gt Claims Administration Patient Name JANE DOE Insurance ok i Procedures Services or Supplies Claim info ok Dates of Service Facility Type Be Di Code Point Emergency Ch Days or Anesth Line Info ok From To mmddyy Code POS N Dean Cono eiii Indicator arges Units Minutes Primary Payer CPTSHCPCS Modifiers 1 No 75 00 1 Line 1 ok 10312006 races 10312006 Enter the payment information for LINE 2 from the Primary payer Line Level ee Line 2 Primary Payer Name ABC INSURANCE Primary Payer Contract Number ABC123456789 Payment Details Allowed Amount 75 00 Paid Amount 50 00 Payment Date fi1012006 Each line item is pre populated in the top portion of this page This option makes it easy for the user to key secondary information on this claim Professional eClaims User Manual Rev June 2008 Page 19 of 30 Submit your completed claim Claims Administration At BlueCross BlueShield About Us Contact Us Careers Help VAY of Alabama fs Search Home gt Providers gt ProviderAccess gt eClaims You are signed in as webuser Claims Administration New Claim Submit All Pending Claims incomplete and Pending Claims Date Crested Claim Type Cortract Number Epi a Patient Name Claim Amount 20 2008 10 59 00 Professional 0123456789 12345678
25. ome gt Providers gt ProviderAccess gt eClaims You are signed in as wehnser Primary Payer Payment Information Line Level gt ProviderAccess Menu gt Claims Administration Line 1 Contract XAA1 23456789 Date of Birth 01 28 1972 biont Name JANE DOE Required fields are denoted by an asterisk Click here ifyou do not have line level payment information Payer ok ine 1 Insurance ok i Procedures Services or Supplies eer ei ue Dates of Service Facility Type PP F P Emergency ar Days or Anesth Line Info ok From To mmddyy Code POS lagnosis Code Pointers Indicator ans Units Minutes Primary Payer CPT HCPCS Modifiers Linet ine 10312006 11 2 No 100 00 1 0 10312006 Enter the payment information for LINE 1 from the Primary payer Primary Payer Name ABC INSURANCE Primary Payer Contract Number ABC123456789 Line Level Adjustments Line 1 Payment Details Allowed Amount 0 00 Paid Amount 0 00 Payment Date fi1032006 Num Group 1 PR a 2 D 41141 3 uli TTT uhh uli sluh slal F ul Click on the question mark to pull up a help window Tip This page provides a user with the ability to key in other insurance information per line item Professional eClaims User Manual Rev June 2008 Page 17 of 30 Primary Payer Payment Information Claim
26. or Other Source From To Last Name of Referring Physician or Other Source NPI of Referring Physician Hospitalization dates related to current services From f Prior authorization number To Accept Assignment Corrected Claim Original Claim Number Review this screen and answer any questions that are valid for this claim Once complete click the Next button to save your information and to advance to the next step Professional eClaims User Manual Rev June 2008 Page 9 of 30 Line Item Information PE BlueCross BlueShield Vy of Alabama Home gt Providers gt ProviderAccess gt eClaims You can add up to amp diagnoses per claim Also the diagnosis does not need a period between the third and fourth digit Use the diagnosis code pointer to Line Item Information indicate which diagnosis applies to your claim Required fields are denoted by an asterisk Payor ok Diagnosis Codes a5 t one required PELER 1 73330 2 73393 3 73349 4 Claim Info ok Line Info inc s 6 7 8 Dates of Serice Facility Type OONN OA Sa ad s Emergency Days or Tip Place your From To mmddyyyy Code POSY eer ae Diag ree ae aia ioaten ena Units mouse over the ho312006 ile ae No fono ff Delete 10312006 uestion mark m the screen for 10312006 Mee agzi2 Him No 75 00 fr _Delete 103
27. rect contact your EDI Services Representative for assistance Professional eClaims User Manual Rev June 2008 Page 14 of 30 Claim Information Contract AA123456789 Date of Birth 0125 1972 PatientName jane Doe Payer ok Insurance ok Is claim accident related Date of current illness Claim Info ok Line Info ok Date of Accident Onset date of current illness Type of Accident Auto Accident State Dates Patient unable to work in current occupation First Name of Referring Physician or Other Source From To Last Name of Referring Physician or Other Source NPI of Referring Physician Hospitalization dates related to current services Prior authorization number From To Accept Assignment Corrected Claim Original Claim Number Review this screen and answer any questions that are valid for this claim Once complete click the Next button to save your information and to advance to the next step Professional eClaims User Manual Rev June 2008 Page 15 of 30 Line Item Information You can add up to amp diagnoses per claim Also the diagnosis does not need a peg betes period between the third and fourth digit om Use the diagnosis code pointer to indicate which diagnosis applies to your claim Home gt Providers gt ProviderAccess gt eClaims Line Item I
28. se agreement Once you have selected Submit the next screen will show that your request is being processed my Ria AUDIT REPORT We are processing your request This may take several minutes depending on the size of the audit report Professional eClaims User Manual Rev June 2008 Page 29 of 30 The accepted portion of the audit report contains a list of all claims that were accepted for processing Each claim is assigned a claim number The claim number can be used to track the claim throughout processing This claim number confirms receipt of your claim but does not guarantee payment Printing Tip The Acrobat print function must be used to print the complete Audit Trail Report Click on the printer icon in the Acrobat Reader toolbar Fl Save a Copy a P Search Tr Select i Q K 4 90 DOI 7 i A mn Yn J d Options X gt x gt 2 HA Location ID an BlueCross BlueShield J FS 51012345 WAY of Alabama ae py 51012345 Been AUDIT REPORT a P A 51012345 P 8 Batch Total 02 14 2008 2 PROVIDER 1234567890 ANY HOSPITAL ACCEPTED CLAIMS se T BLUE CROSS CLAIMS E 2 CONT MED REC PAT CNTL PATIENT NAME FROM DOS THRU DOS CLAIM CHARGES p 7 BLU123456789 Doe John 02 05 08 02 05 08 69 00 a CLAIM NBR 0450925763 i 250438 o E CONT MED REC PAT CNTL PATIENT NAME FROM DOS THRU DOS CLAIM CHARGES 8 BLLI123456789 Doe John 0
29. t Submit Delete Submitted and Processed Claims Select all submitted claims or processed claims by date Submitted Claims gt Go Date Created Claim Type Contract Number te Patient Name Claim Amount 1625 2006 02 09 33 9725200 02 03 33 professional MAALI3 5 6789 50 00 Submitted w E E 10192006 09 31 12 eor PPAL23 5 789 Account Number DOF JOHN 200 00 Submitted View Tip The Claims Administration screen shows all claims that are in a pending status and all claims that have been submitted or processed The claim that you just entered should now appear in the Incomplete and Pending Claims list along with the total claim amount You may now choose to edit submit or delete the claim After the batch is received by Blue Cross and Blue Shield of Alabama the claim will appear in the Submitted and Processed Claims list Note Claims located in the Incomplete and Pending Claims list have not yet been received by Blue Cross and Blue Shield of Alabama for processing Professional eClaims User Manual Rev June 2008 Page 11 of 30 Choose the option secondary to key a secondary claim Secondary Claims Member Information Required fields are denoted by an asterisk Home gt Providers gt ProviderAccess gt eClaims Member Information Choosing the correct claim type will allow the appropriate screen to appear Required fields are denoted by an asterisk C
30. those who provide Pharmacy health care for patients Find a pharmacy near you Enter your Individual User ID and Password then click Sign In ey BlueCross BlueShield Contact Us Careers About Us my WY Of Alabama a Find a doctor dentist or hospital Find a pharmacy Home gt Providers Individual User Sign In Providers Register to access essential resources for those who provide health care to patients Essential resources for those who provide health care to patients For the most current provider information be sure to check Hot Topics last updated 06 03 2008 REGISTER HOW Software Vendors Obtain helpful resources and information regarding our electronic information network Already registered ProviderAccess Services Pharmacy Resources User ID fs Posen gt Physician Profile Reports gt Prescription Drug Guide l gt Check Patient Eligibility and Benefits gt Pharmacy Prior Authorization Forms Ew gt Check Claims Status gt Drug Coverage Guidelines gt File Claims Online eClaims gt Pharmacy Policies E ante aaa a gt View Physician Remittances Drug Information on your PDA i gt View Fee Schedules gt Medicare Part D Participating Pharmacy 8 Security at Sign In gt View Hospital Remittances Manual Your login is secured using Secure gt View Pharmacy Remittances Sockets Layer SSL technology gt Review Payment History gt Pat
31. une 2008 Page 23 of 30 Payer Line Info ok Insurance ok ok Contract AA12345679 Claim Information Date of Birth Patient Name Jane Doe ls claim accident related Date of Accident Type of Accident Auto Accident State Date of current illness Onset date of current illness From To Dates Patient unable to work in current occupation First Name of Referring Physician or Other Source Last Name of Referring Physician or Other Source NPI of Referring Physician Hospitalization dates related to current services From To Prior authorization number Accept Assignment Corrected Claim Original Claim Number Review this screen and answer any questions that are valid for this claim Once complete click the Next button to save your information and to advance to the next step Professional eClaims User Manual Rev June 2008 Page 24 of 30 You can add up to amp diagnoses per claim Also Line Item Information the diagnosis does not need a period between the third ry ores and fourth digit Use the diagnosis code pointer to Home gt Providers gt ProviderAccess gt eClaims ind C at e wh iC h d ia g nos LS Line Item Information applies to your claim Contract XAA1 23456789 Date of Birth 01 28 1975 Patient e JANE DOE Diagnosis Codes at Ig one required Payer ok Insurance ok 1 73390 2 7339
32. ws of Alabama Ea Home gt Providers gt ProviderAccess gt eClaims You are signed in as webuser Payer Information gt ProviderAccess Menu gt Claims Administration Contract XAA1 23456789 Date of Birth 01 25 1972 Patient Name Jane Doe Required fields are denoted by an asterisk Payer inc Primary Payer BCBS gt Payer Name Member ID f HICN BCBS of Alabama Kaa 23456789 Patient Relationship to Insured gt Professional eClaims User Manual Rev June 2008 Page 7 of 30 Insured Patient Information Verify that all information returned on this screen is correct BlueCross BlueShield About Us Contact Us Careers Help tet V of Alabama e Home gt Providers gt ProviderAccess gt eClaims You are signed in as webs er Insured Patient Information gt ProviderAccess Menu gt Claims Administration Contract XAA1 23456789 Date of Birth 01 28 1975 Patient Name Jane Doe Required fields are denoted by an asterisk Payer ab Insured Information Insurance inc Name Last Doe First Jane Middle Address e Street 1 23 Park Place City Anywherw State ALABAMA Zip 35004 Click on the revious Other p Date of Birth 01251972 Gender Female Section Heading to Patient Information move Name backward or to Last Doe First Jane Middle correct any
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