Professional eClaims User Manual - Blue Cross and Blue Shield of
Contents
1. Go Click on New Claim if the original claim was submitted electronically using a vendor clearinghouse Corrected Claims Member Information BlueCross BlueShield j of Alabama Home gt Providers gt ProviderAccess gt eClaims Member Information Choose the Claim Type and indicate whether the claim being submitted is Primary Secondary or Informational Cisim Type 1 Anesthesia C Dentali Home Health Professional institutional This cisim is being submited as amp Primary Secondary _ leformational Contract Number First Name Mikko inaa Last Name Date of Birth Gender Last date of service for this cluim Next Click Next Required fields are denoted by an asterisk Note Once you click the Next button you will not be able to return to this page If while keying the claim you realize you have entered incorrect information on this page you will have to delete the claim and start a New Claim Corrected Claims Payer Information Payer Information cannot be modified once initially saved If you need to make changes delete this claim and create a new one Sere Nee ee Click the Next button once you verify that all information is correct Magdusia an daat by an name gt Primary Payers BCBS Payer Name BCBS OF ALABAMA Rev 11 2014 AlabamaBlue com providers Corrected Claims Ins2. provideraccess SOAS your secure link to Blue Cross Professional eClaims User Manual BlueCross HueShiekl of Alabama Go to Find a doctor dentist or hospital Find a pharmacy AlabamaBlue com providers Home gt Providers Providers Essential resources for those who provide healthcare to patients Last updated Thursday October 16 2014 Register for 2014 Fall Winter Town Mootings motes Posted 10102 Additional Articles ProviderAccess Ifyou do not have a ProviderAccess User ID and Password please click Register Now or contact the ProviderAccess administrator at your practice BlueCross BlueShield j of Alabari Home gt Providers ProviderAccess gt Main Menu ProviderAccess Click on lansections under another grouping please rebum to this page to select your mext function 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 MPI search to find NPls for the PCN network Payee Functions Functions that are related to a group or provider s payment information must be accessed through Paye
3. 04 26 1956 Patient Name JANE SMITH Requred Sere sre Cencted by an seterce Cik here if you do not have fine leval paymon information Insurance ok Chaim info ok E o Neram ee ee Click here if you do not have Uei ic ssa a el y Era line level payment information It will take you to the claim level apn g KO Tip Click on the help icon view additional information Required fields are denoted by an asterisk Note Line Level Adjustments plus Payer Paid Amount should equal Total Charges Rev 11 2014 AlabamaBlue com providers Secondary Claims Claim Level Information Note This page is returned ONLY if you do not have line level payment information D Y A a ae aa r a aaae Click the Next button You will be forwarded to ee memen ma apenan primey Payor Correct Numar XAA123466700 the Claims Administration screen to submit pending claims Required fields are denoted by an asterisk Note Claim Level Adjustments plus Payer Paid Amount should equal Total Charges Rev 11 2014 AlabamaBlue com providers Corrected Claims Corrected Claims Claims Administration If the original claim was submitted through eClaims locate the claim in the Submitted Claims list and Resubmit You will then be able to edit the claim Select al submited claims or processed claims by dale Subenined Caimi
4. 640 x 480 e Internet Explorer 6 0 or higher e Internet connection with at least 28 800 bps Software Requirements Adobe Acrobat Reader It is necessary to have Adobe Acrobat Reader installed on your computer in order to view or print the remittances using the online application If you do not have Adobe Acrobat installed on your computer you may install it for free from the Adobe website at http www adobe com products acrobat readstep html Helpful Hints 1 If you leave the PC for a long period of time the application may time out You will need to close and restart your browser IF you have previously bookmarked the ProviderAccess sign in page you may use your Favorites or Bookmark to access the sign in page directly Refer to Page 1 of this manual for further instructions on how to reach ProviderAccess 2 Use the Tab key not the Enter key when navigating through a screen 3 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 4 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 5 To select a button choose one of the following e Move the mouse pointer
5. Cross Contracts BlueCross BlueShield of Alabama Home gt Providers gt ProviserAccess gt Claims Member Information Repsred Seige orn Garatu by m oA C Choose the Claim Type and indicate whether the claim being submitted is Prirmary Secondary or Informational Claim Type J Aneshesia Dental Home Health Professionali institutional This cisim is being submited as Primary Secondary _ leformational Contract Number First Name Mikio initiat OO Click Next Gender Last date of service for this daim Required fields are denoted by an asterisk Note Once you click the Next button you will not be able to return to this page If while keying the claim you realize you have entered incorrect information on this page you will have to delete the claim and start a New Claim Rev 11 2014 AlabamaBlue com providers a BlueCross BlueShield About Us Contact Us Careers Help of Alabama Home gt Providers gt ProwiderAccess gt eCiaims Member Information ProviderAcomes Mons Carns Admneteation Number you entered Goes not appear to be a Blue Cross and Due Seis of Alabama contact The Contract We are unable to verify ebgiility for contracts You may bypass the elgtlty vantemon paras by dung the Sip Verficaten button below You will then be required to enter af insurance information iret fukia ave Cervctend by arr ostera f Cin
6. cessed daina by dana Submited Chins Go To submit your claim for processing you must click T oe d E Ee Submit or Submit All Pending Claims The Claims Administration screen shows all claims that are in a pending status and all claims that have been submitted or processed on the current day To view claims submitted on a previous day select the date you submitted the claim and click Go After a claim is submitted and received by Blue Cross it will appear on the Submitted and Processed Claims list Submitted and Processed Claims s Select al submitied clams or processed ciais by date Submittes Claim Go St ee ee ed mana OOOO aea ee a a XAAIZMASITIS SAITH JANE 30 Suemanes Yon Rev 11 2014 AlabamaBlue com providers Secondary Claims Secondary Claims Member Information a rham Choose the Claim Type Member Information Requred tds ace Gencied Sy an pacer j Claire Type Gop D Anewthesig O Denai O Home Heath Professional O Insttutional This claim is being submited a O Primam Secondary linfonmational Contract Nucber First hame Micki iritis Lost Parca Dala of Binte Choose Secondary Required fields are denoted by an asterisk Note Once you click the Next button you will not be able to return to this page If while keying the claim you realize you have entered incorrect information on this pag
7. e you will have to delete the claim and start a New Claim Secondary Claims Payer Information D Y pogo BlueShield Choose the Primary Payer Key the Primary Payer information Key the Primary Subscriber information Choose the correct option for Patient Relationship to Insured Click the Next button once you Required fields are denoted by an asterisk verify that all information is correct Rev 11 2014 AlabamaBlue com providers Secondary Claims Insured Patient Information BlueCross BlueShield About Us Contact Us Carsers Help of Alabama m Home gt Providers gt ProviderAccess gt eCiaims insured Patient Information ProwkderAcoess Menu Cams Agere Contract XAA 123456789 Date of Birth 4 26 1966 Patient Name JANE SMITH Required tide are Sarated by an exterteh Payer ox SUE Information oma Name Street Cty Zor 123 PARK PLACE SOMEWHERE 35244 Other 7 Date of Birth MUDOYYYY 0426 1956 Female Patert Informaton gt Name Last SMITH First JANE Middle Address Se Cay State Dp 123 PARK PLACE SOMEWHERE ALABAMA 3524 Other Date of Birth MUDOYYYY ONIN ratte Panert s Account Number Release of information Code Recase of inkemason Yes t ew Required fields are denoted by an asterisk Secondary Claims Claim Information Bl
8. e Functions This section is rafared ta 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 Bloc ross BucShield j of Abeban Home gt Providers gt ProviderAccass gt Location List Choose Location NPI Click on the provider location for you which you are submitting claims Provider Mam 123466783 BLUE JOHN 123456789 BLUE SARAH ETEM 321 MAIN STREET SOMEWHERE December 2014 Blut ross MucsShiehd s af Alabama Home gt Providers gt ProviderAccess gt Location Manu ProviderAccess Menu Dr JOHN OQ BLUE MD NPI 123456789 LOCATION ID 24681012 123 MAIN STREET Change Location Click on Claim Entry eClaims Piease 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 Pationt Information Eligibility and Benefits Rx History Claim Information Claim Entry eClaims Audit Reports oClaims Only ICD 10 CM Diagnosis Code Mapping Tool Medical Records Requests Claims Administration Philos Bloc Shield Click on New Claim to create a new claim Select al submited claims or processed claima by dala Submitted Caimi Go 1 Aiia i S Sa Harntar Peete Ca Ane Member Information For In State Blue
9. im Type Contract Number First Name eaa Miso Irai Last Name Srah Dato of Bann 04261956 Gender Last date of service for this claim 06172014 Went Payer Information For out of state Blue Cross members the Skip Verification button will bypass the eligibility verification process You will then be required to enter all insurance information Click Next Payer Information cannot be modified once initially saved If you need to make changes delete this claim and create a new one Contract XAA123456789 Date of Birth 04 26 1956 Patient Name JANE SMITH Pacpdves tih an Guant by an emma A Payer Name Patient Relationship to Insured Patient Information BlueCross BlueShield About Us Contact Us Careers gt Help J of Mabama Ae E insured Patient Information ProwkderAccess Menu gt Clams AgmneTetor Contract XAA 123456783 Date of Birth 04 26 1956 Patient Name JANE SMITH Requred toida are Gercted by an anterea iegured iniormaton Payer ox pe M Name Lest SMITH Adress Stroot Cty V23PARKPLACE Other Date of Birth MUDOYYYY C4269 Date of Birth MMDOYYYY Release of Information Code Release of information T Click the Next button once you verify that all information is correct Click on the section heading to return to a previo
10. ne items you must create a new claim to enter the additional line items Rev 11 2014 AlabamaBlue com providers Claims Administration Edit submit or delete any pending claims The claim that you just entered should now appear in the Incomplete and Pending Claims list These claims have not yet been submitted to Blue Cross for processing To submit your claim for processing you must click Submit or Submit All Pending Claims The Claims Administration screen shows all claims that are in a pending status and all claims that have been submitted or processed on the current day To view claims submitted on a previous day select the date you submitted the claim and click Go A After the claim is submitted and received by Blue Cross it will appear on the Submitted and Processed Claims list Select al submitied clams cr processed cians by date Submittes Claims Go ee a ced saa OOOO aea KAATZESETED SMITH JANE 125 00 sommes vee Rev 11 2014 AlabamaBlue com providers Contact Information If you need further assistance with an audit report rejection contact your vendor clearinghouse or EDI Services at 205 220 6899 or email Ask EDI bcbsal org Please include in your email the provider s NPI Tax ID and a detailed description of your question Hardware Requirements Minimum Hardware Requirements for best results Minimum Browser Requirements e Screen resolution
11. to the button and depress the left mouse button once or e Press the Tab key until a dotted line appears around the word and then press the Enter button BlueCross BlueShield of Alabama An Independent Licensee of the Blue Cross and Blue Shield Association Rev 11 2014 AlabamaBlue com providers
12. ueCross BlueShield of Alabama First Name of Referring Physician or ther Source Last Mame of Referring Physician or Other Sarea NA of Reteering Physician Click on the section heading to return to a previous screen Verify the Insured Patient Information on this page If the information is not correct press the Next button Review this screen and provide all information applicable to this claim Once complete click the Next button to save your information and advance to the next screen Rev 11 2014 AlabamaBlue com providers Secondary Claims Line Item Information BlueCross BlueShield 3 Ker oranana You can enter up to 12 diagnosis codes Use the diagnosis code pointer to indicate which diagnosis applies to each line item apn g Tip Click on the help icon to view additional information Required fields are denoted by an asterisk Note You may key up to 10 line items on this screen After entering all line items click the Next button If you have more than 10 line items you must create a new claim to enter the additional line items Secondary Claims Line Level Information D Y BlueCross BlueShield About Ls Contact Us Careers Hele Home gt Providers gt ProwiderAccess gt eCiaims Primary Payor Payment Information Line Level Provo tecess Meru Cains Adventuratios Contract XAA123456789 Date of Birth
13. ured Patient Information G Y BlueCross BlueShield PEE Cintas da EA l i Click on the section heading ae eT to return to a previous screen Contrat XAA 123456780 Date ot Bi 047261968 Paton Nama ANESTH coon Bs l E a Last SMITH First JANE mose 1 123 PARK PLACE SOMEWHERE 35244 Verify the Insured Patient Information on this page If the information is not correct press the Next button To indicate this is a corrected claim select Yes from the drop down menu Enter the Original Claim Number Review this screen and provide all information applicable to this claim Once complete click the Next button to save your information and advance to the next screen Rev 11 2014 AlabamaBlue com providers Corrected Claims Line Item Information BlueCross BlueShield About Us Contact Us Cansers Hele Ker oranana You can enter up to 12 diagnosis codes Contract XAA123456769 Date of Birth 04726 1955 Patient Namo JANE SMITH Roqured Satis are dpactec by an asierak Use the diagnosis code pointer to indicate which diagnosis applies to each line item apn KO Tip Click on the help icon view additional information Required fields are denoted by an asterisk Note You may key up to 10 line items on this screen After entering all line items click the Next button If you have more than 10 li
14. us screen Verify the Insured Patient Information on this page If the information is correct press the Next button Rev 11 2014 AlabamaBlue com providers Claim Information Bluctiross BlueShield of Alabama E a e Review this screen and provide all information applicable to this claim Once complete click the Next button to save your information and advance to the next screen Line Item Information BlueCross BlueShield About Lis Contact Us Careers Hele Ker oranana eS You can enter up to 12 diagnosis codes Contract XAA123456789 Osto of Birth 04 26 1956 Patient Namo JANE SMITH Mequred faite are Sencted by an asierak 7 Use the diagnosis code pointer to indicate which diagnosis applies to each line item apn g to Tip Click on the help icon view additional information Required fields are denoted by an asterisk Note You may key up to 10 line items on this screen After entering all line items click the Next button Ifyou have more than 10 line items you must create a new claim to enter the additional line items Rev 11 2014 AlabamaBlue com providers Claims Administration The claim that you just entered should now appear in the Incomplete and Pending Claims list These claims have not yet been submitted to Blue Cross for processing Sei a wns cme or pro
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