Home

Louisiana Medicaid Management Information System (LMMIS)

1. special or consequential damages Exercise caution to ensure the use of this information and or software material complies with the laws rules and regulations of the jurisdictions with the respect to which it is used The information contained herein is subject to change without notice upon DHH approval Revisions may be issued to advise of such changes and or additions Molina Medicaid Solutions is a registered trademark of Molina Healthcare Inc Copyright 2011 Molina Medicaid Solutions All rights reserved Date Revised 10 17 2010 i eCSI Application User Manual PROJECT INFORMATION Document Title Louisiana Medicaid Management Information System LMMIS XXX Application User Manual Technical Communications Group Molina Medicaid Solutions LMMIS QA Revision History 6 01 04 Section 1 0 2 0 3 0 Attachment A and Attachment B Section 3 1 3 Section 3 4 1 Section 3 4 2 B B Vazquez lt 6 29 04 B Vazquez and Attachment B 9 13 04 Sections 2 0 and 3 0 Replaced all screens 11 29 04 Sections 3 2 2 Data Fields and Section 3 4 Response Screens 01 10 05 Replaced all screens containing PHI Information 02 04 05 Replaced screens on pages 5 7 10 and 12 Blacked out the provider last name in the screens on pages 5 10 and 12 Blacked out the date of birth on the Response Screen on page 14 Section 3 2 2 and 3 3 2 Removed Org Name from Table Section 3 1 3 Added last line to first parag
2. 29 DEPARTMENT OF e HEALTH anal MOLINA Medicaid Solutions AND HOSPITALS Medicaid Louisiana Medicaid Management Information System LMMIS Electronic Claims Status Inquiry eCSI Application User Manual Date Created 06 01 2004 Date Revised 10 17 2011 Prepared By Technical Communications Group eCSI Application User Manual Molina Medicaid Solutions and the Louisiana Department of Health and Hospitals Proprietary Data Notice The information contained in this document is proprietary to Molina Medicaid Solutions and the Louisiana Department of Health and Hospitals The information in this document shall not be reproduced shown or disclosed outside Molina Medicaid Solutions or Louisiana DHH BHSF without written permission Information contained in this document is highly sensitive and of a competitive nature NO WARRANTIES OF ANY NATURE ARE EXTENDED BY THIS DOCUMENT Any product and related material disclosed herein are only furnished pursuant and subject to the terms and conditions of a duly executed license or agreement to purchase services or equipment The only warranties made by Molina Medicaid Solutions if any with respect to the products programs or services described in this document are set forth in such license or agreement Molina Medicaid Solutions cannot accept any financial or other responsibility that may be the result of your use of the information in this document including but not limited to direct indirect
3. 3 ICN 13 Digit Number Your Trace Hote Required fields are inred Submit A e Select the Search link to perform a Claims Status Inquiry search by ICN or General Method e Select the Response link to view the claims status response screen e Select the Print Friendly link to view a print friendly version of the response screen e Select the eMEVS link to access the electronic Medicaid Eligibility Verification System e Select the Main Menu link to discontinue current processing at any page and return to the Provider Applications Area Main Menu e Select the Help link to obtain field specific help information e Select the Clear Screen link to clear a page and reset the page data fields to their default values There is a selection processing button that appears in the lower right hand corner of the web screen e Select the Submit button to process the data entered on a screen Date Revised 10 17 2011 5 eCSI Application User Manual 3 1 2 Submission Error Messages The eCSI application provides logical user friendly error messages during the submitting process to inform the user that an error has occurred and corrective action is needed When an error is detected a user is informed via a message box that an error has occurred The error message identifies the corrective action needed to fix the error If a required field is blank when the user selects the Submit button an error message dialog box is displayed indi
4. EM DEPARTMENT OF HEALTH AND HOSPITALE BUREAU OF HEALTH SERVICES FINANCING SHORT DESCRIPTION HIPAA LA MEDICAID ERROR CODE CROSSWALK i SCRIPTION AVAILABLE AVAILABLE if AVAILABLE ROT US AVATLABLE AVAILABLE NOT AVAILABLE NOT AVAILABLE SE AVAILABLE AVAILABLE CLAIM BYPASSED THE PAM EDITS CLAIMCHECK E BYPASSED THE CLAIMCHECK EDITS USED AVAILABLE NOT AVAILABLE HOT AVAILABLE NOT US AVAILABLE HOT AVAILABLE NOT Ui AVAILABLE NOT US AVAILABLE HOT AVAILABLE DENIED DER SURS GUIDELINES CUTEACEK PER SURS GUIDELINES DENIED PER THE TPL BOR INFORMATION INDICATOR 3 INVALID WITH CPT CODES PCP REFERRAL REQ HOT PAID BY MEDICARE HURRICAN KATRINA EVACUEE AID CAT 11 HURRICANE KATRINA EVACUEE PARTSH UNITS PAID BETWEEN 33 AND 47 KELOID TREATMENT ONLY FIRST DIAGNOSTIC VISIT IS PAID THERAPEUTIC DUPLICATION DENIAL LIMITED TO SPECIFIC CLAS PREGNANCY PRECAUTION DENIAL FDA CATEGORY X HEW RZ WILL REQUIRE PA CUTHACK REPAIR MUST YIELD DENTURE SERVICEABLE FOR 1 YR PROBLEM ORIENTED CODE PAID WITHIN 2 YEARS USAGE OF SAME RX NUMBER CREATER THAN SYSTEM LIMIT MAX EXCEEDED FOR ADDED CLAIM LINES RESUBMIT CLAIMCHECK PROVIDER NOT ELIGIBLE ON DATES OF SERVICE PROVIDER NOT CERTIFIED FOR SERVICE CLIA DOES NOT COVER DATE OF SERVICE PROVIDER NOT COVERED FOR SERVICES RENDERED BY MEDICAID BILLING PROVIDER INELIGIBLE ON DATE OF SERW PROVIDER FILE DOES HOT CONTAIN VALID RATE FOR DOS HOT PAYABLE WITH CLIA CERT TYPE PROVIDER CERTIFICATION EXPIRED AS OF DOE CERV
5. ENDIX A INTERNET EXPLORER WEB BROWSER SET UP Prior to initial use of the eCSI Web User Screens the web browser setup must be implemented This will ensure that the latest change information is displayed to the user Using a Web Browser compatible with Internet Explorer v4 0 or higher Select the Tools menu selection Select the Internet Options selection At the General Tab page under the Temporary Internet Files section select the Settings button At the Settings page select the Every visit to the page radio button Select the OK button on the Settings page Select the OK button on the Internet Options page Date Revised 10 17 2011 17 eCSI Application User Manual 5 0 APPENDIX B SAMPLE OF ERROR CODE CROSSWALK REPORT LAM5M113 RUN 08 01 11 12 09 30 AVATLABLE AVAILABLE AVAILABLE AVATLABLE AVATLABLE AVATLABLE AVATLABLE AVATLABLE AVATLABLE PAM EDITS CC EDITS AVAILABLE AVATLABLE AVATLABLE AVATLABLE AVAILABLE AVAILABLE AVAILABLE AVAILABLE DENIED PER TEL EOB INDICTR CPT CONFLICT HOT PAID BY MEDICARE KATRINA EVACUE CAT11 EATRINA EVACU PARISH aie 33 47 NEW RI REQUIRES PA CUTEACK SERV 1 YEAR PROBLEM CODE PD 2YRS RENO USE GR THAN LIM MAX CLM LINES EXC PROVIDER NOT ELIG PROV NOT CERTIFIED CLIA NOT CERT DOS PROVIDER NOT COVERED BILL PROV NOT ELIG PROV RATE NOF HOT PAY W CLIA CERT PROV CERT DATE ERROR CEV DTE LT PROV LIC NON HOSPICE PROVIDER LOUISIANA MEDICAID INFORMATION SYST
6. ICE DATE IS PRIOR TO PROW LICENSING EFFECTIVE DATE SUBMIT JUSTIFICATION FOR SERVICES REPORT NO RF 0 77 R AGE 1 Date Revised 10 17 2011 18
7. Provider Last Name and Provider ID fields based on the authentication process that occurs when a provider logs into the application The provider is required to enter the Recipient ID number only however there are other search elements available for inquiry purposes Required fields are denoted in red on the web screen When a General Search inquiry is initiated the eCSI application always checks the database against the following match criteria e Provider Billing or Servicing e Recipient ID eCSI returns all claims where there is a match on provider and recipient ID If the provider has entered incorrect information in a field the correct data echoes back Date Revised 10 17 2011 7 eCSI Application User Manual 3 2 1 Screen Samples The following is an example of a General Search Home Screen eCSI General Search Change Password Change Account info Provider Logout Help Medicaid Claims Status Inquiry Web Application Navigation Menu Search Response Print Friendy eMEVS Mam Menu Help IMPORTANT DO HOT use the BACK browser button please use the navigation menu For Technical Support please contact 877 598 8753 For Eligibility Yerification Support please choose the eMEVS Navigation Menu Option above or call 800 776 6323 or 225 216 7387 to access REVS For Other Types of Assistance please contact Molina Medicaid Solutions Provider Relations at 800 473 2783 or 225 924 5040 To view the Medicaid HIPAA Error Code C
8. ate Revised 10 17 2011 eCSI Application User Manual 3 3 1 Screen Samples The following is an example of an ICN Search Home Screen eCSI Search by ICN Change Password Change Account Info Provider Logout Help Medicaid Claims Status Inquiry Web Application Navigation Menu Search Response Print Friendly eMEVS Mam Menu Help IMPORTANT DO HOT use the BACK browser button please use the navigation menu For Technical Support please contact 877 598 8753 For Eligibility Verification Support please choose the eMEVS Navigation Menu Option above or call 800 776 6323 or 225 216 7387 to access REVS For Other Types of Assistance please contact Molina Medicaid Solutions Provider Relations at 800 473 2783 or 225 924 5040 To view the Medicaid HIPAA Error Code Crosswalk table click here Search Type ICN Search Clear Screen Provider Name JOHN DOE 23 13 Digit Number Your Trace _ Hote Required fields are in red Submit 3 3 2 Data Fields Required fields are denoted in red on the web screen All required data fields must contain valid entries before processing continues The following table designates which fields are required Field Name Required Data Validation Search Type Yes Use the dropdown box to select General Search or ICN Search Provider Last Name Yes Maximum length 13 characters alohanumeric This field is automatically populated based on the provider log in authentication informatio
9. ation Original Charge Amount Claim Payment Amount Remittance or Check Number Status Effective Date Check or EFT Date Date of service Procedure Code Procedure Code Modifier s ICH Bill Type General Search Finalized Denial The claimiine has been denied HIPAA Adj Rsn Code 252 Authorization certification number 343 00 DU DODOOO00 120 7 2010 03 01 2009 thru 03401 009 99233 Finalized Denial The claimiine has been denied HIPAA Adj Rsn Code 252 Authorization certification number 655 00 DU 00000000 12 4 7 2010 02 27 2009 thru 02 27 2009 99223 Transaction run on 1043 2011 at 01 56 55 CT by LAMedicaid Louisiana Medicaid The following is an example of an ICN Response Screen This response includes one claim because only the ICN number was entered for the inquiry Date Revised 10 17 2011 12 eCSI Application User Manual eCSI ICN Search Response Screen Change Password Change Account info Provider Logout Help Medicaid Claims Status Inquiry Web Application Navigation Menu Search Response PrintFriendly eMEVS Mam Menu Help IMPORTANT DO HOT use the BACK browser button please use the navigation menu For Technical Support please contact 877 598 8753 For Eligibility Yerification Support please choose the eMEVS Navigation Menu Option above or call 800 776 6323 or 225 216 7387 to access REYS For Other Types of Assistance please contact Molina Medicaid Solutions Provider Relations a
10. ation validates selected fields to ensure that data is entered in an acceptable format and range criterion Many data fields require information to be entered in a specific format If the data entered is not in the proper format a message and an example of the required format are displayed Processing continues after all data on the page is entered in the correct format Character fields accept alphabetic numeric and special character data Character fields are NOT case sensitive for alohabetic characters Numeric fields accept only numeric values Monetary amounts must be a number with 2 decimal places No dollar signs and positive negative signs are accepted 3 3 ICN Search Screen The eCSI ICN Search methodology is discussed in this subsection This search methodology can uniquely identify a claim within the system by matching the ICN eCSI automatically populates the Provider Last Name and Provider ID fields based on the authentication process that occurs when a provider logs into the application The provider is required to enter the ICN only Required fields are denoted in red on the web screen When an ICN search inquiry is initiated the eCSI application checks the database against the following match criteria e Provider Billing or Servicing ICN The eCSI application returns all claims where there is a match on provider and ICN If the provider has entered incorrect information in a field eCSI will echo back the correct data D
11. cating that the required field s is blank Most text fields require a certain number of characters to be entered If fewer than the required number of characters is entered a message will inform the user that a minimum number of characters must be entered This sequence continues until the user has entered the appropriate information in all required fields If data entered in a specific field is in an incorrect format i e alphabetic instead of numeric data in a numeric field then a message is returned identifying the error All data must be entered in the correct format before processing continues The following is an example of an error message eCSl Error Message The pace at http 192 60 37 68 Says E t The following emos ourred Chango Paeeword Chango Acchumtinia Provider Lag Medicaid Claims Statu Navigation Menu Kent ID must be a 13 digit number Search Response Print Fri Y IMPORTANT PO MOT use tli LE For Technical Support ple For Eligihiity Verilication Support pled ine PML GS ode Pepin Seye of call ROO TT6 6323 or 225 216 7307 to access REYS For Other Types of Assistance please contact Molina Medicaid Salut App provider Relations at 800 473 2783 of 225 924 5040 To view the Medicaid HIPAA Error Code Crosswalk table click here i Search Type General Search Provider Name wl Recipient ID 1245678910 13 Dagit Number Claim Charge Amount E o Dates of ae BES vepdd irren Water Req
12. e provider logs in using their NPI then the NPI is displayed If the provider logs in using their Medicaid Provider ID and has an NPI the NPI is displayed If the provider is an atypical provider and does not have an NPI the Medicaid Provider ID is displayed Medicaid Claims Status Inquiry Web Applicat Navigation Menu Search Response PrintFriendyy eMEVS MainMgmu Help IMPORTANT DO HOT use the BACK browser butin please use the navigation menu For Technical Support please contact 877 W8 For Eligibility Yerification Support please cfose the eMEYS Navigation Menu Option above or call 800 776 6323 or 225 216 7387 to access REYS For Other Types of Assistance please copMact Molina Medicaid Solutions Provider Relations at 800 473 2783 or 225 924 5040 To view the Medicaid HIPAA Error Cde Crosswalk table click here DEE Provider Name JOHN DOE Recipient ID 123456789123 13 Digit Number Claim Charge Amount t Dates of Service E thru gi rmmfdd y yyy Your Tracet ____ The eCSI page will display a functioning link to the HIPAA LA MEDICAID ERROR CODE CROSSWALK report Date Revised 10 17 2011 3 eCSI Application User Manual 3 0 USING THE eCSI APPLICATION This section of the User Manual presents information on navigating through the application general search inquiry ICN search inquiry and the response transaction Providers are able to inquire on the status of a claim by performing a general search
13. enseenecessonseoaseenseenesenes 4 3 1 Navigating Through the Application ccccccsesseeeeeeseeeeeeeeseneeeeseeeeees 5 KG Es Screen BUHONS inoin E tetera 5 3 1 2 Submission Error Messages 1scccecccsecsensccsenscnsesenssnensennenensseensensssenses 6 3 1 3 Informational MCSSAGES cc1scccseccensscsecsnscneenscnessenssnsensensesensseensensesenses 7 32 G neral Search Sereia a aa aaa aa 7 32 1 Sereen E e 8 322 DUI E EE 8 3 3 Led Re E E H 3 31 E e EN 10 332 IAA E 10 34 Jee OH 11 3 4 1 Screen SAMDICS E 12 3 4 2 Data E E 15 4 0 APPENDIX A INTERNET EXPLORER WEB BROWSER SET UP 17 5 0 APPENDIX B SAMPLE OF ERROR CODE CROSSWALK REPORT 18 Date Revised 10 17 2010 IV eCSI Application User Manual 1 0 OVERVIEW 1 1 Objectives The Electronic Claims Status Inquiry eCSI Web Application provides a secure web based tool for providers to inquire on the status of a claim within the adjudication process This application is accessible to all providers who have a computer with Internet access using a recent version of either Netscape Navigator or Internet Explorer browser software Providers must establish a valid online account with Louisiana Medicaid complete with a valid login ID and password in order to access the web based application The eCSI application enables providers to inquire on the status of claims i e paid denied voided etc using the HIPAA compliant Transaction Se
14. hange Password Ct For Technical Support call Provider Applications Area toll free Lage The application s listed below are for authorized use only Cli application n an application link to access the Provider Applications LAMEDICAID COM Fact Sheet Restricted Provider Applications Administrative Tools Administrative Tools PBM Submitter Contact Information Submitter Linked Provider Submitter Claims Denied All 9 Batch Eligibility Verification Sem Batch 270 Submission Moi Batch Eligibility Verificaugyi System Pilo Electronic Clinical D Claim Status Inquiry Prescriber Practices and Diabetes Management Admin Electronic Prior Authorization Provider Ownership Enrollment Electronic Referral Authorization Medicaid Eligibility Verification System Provider Logout National Provider identifier Immunization Pay For Performance P4P PACE 820 Report System Provider Locator Information Electronic Referral Authorization Pilot PA Requests for Case na S Uncompensated Care Costs EDI Submission Application EDI ts for Case Managers Document Provider Appliostons Ares Note The list of applications shown here is comprehensive you options on the Provider Applications page may not see as many Date Revised 10 17 2011 If you do eCSI Application User Manual 4 The Medicaid Claims Status Inquiry Web Application screen is displayed If th
15. ication returns a response providing the following information about a claim Field Name Data Validation Search Criteria Search Type Denotes whether search mechanism was General or ICN ICN lf ICN search methodology was entered denotes the ICN number Provider Information Name Provides the name of the servicing provider Provider ID or NPI Denotes the ID number for the servicing provider If the user logs in using NPI instead of Louisiana Medicaid Provider ID then NPI is displayed Telephone Provides the area code and telephone number for the servicing provider Claim Status Denotes whether a claim has been paid denied or pended Provides any corrective action that is needed Claims Status Explains in further detail the status of the claim Clarification Original Charge Provides the original charge amount submitted by the Amount provider Claim Payment Provides the amount paid by the payer Amount Remittance or The Remittance or Check number Check Number Procedure Code Provides the procedure code modifier s if Modifier s applicable Date Revised 10 17 2011 eCSI Application User Manual Field Name Data Validation ICN 13 digit numeric Internal Control Number Bill Type Code designation that is returned if the claim was associated with a UB04 claim Timestamp The date and time that the eCSI response was generated Date Revised 10 17 2011 eCSI Application User Manual 4 0 APP
16. ider Date Revised 10 17 2011 4 eCSI Application User Manual 3 1 Navigating Through the Application This subsection provides information on navigating through the eCSI application 3 1 1 Screen Buttons The selection processing functions that appear on the eCSI web user screen pages assist the user in navigating through the application There are six navigational links that appear across the top of the web screen These links are disabled if the function is not available from a particular screen In addition the Clear Screen link appears in the middle of the screen If the users mouse hovers i e remains stationary for a period of time over one of these links a message appears to identify the purpose of the link Change Password Change Account info Provider Logout Help Medicaid Claims Status Inquiry Web Application Navigation Menu Search Response Print Friendy eMEVS Mam Menu Help n IMPORTANT DO HOT use the BACK browser button please use the navigation menu For Technical Support please contact 877 598 8753 For Eligibility Verification Support please choose the eMEVS Navigation Menu Option above or call 800 776 6323 or 225 216 7387 to access REVS For Other Types of Assistance please contact Molina Medicaid Solutions Provider Relations at 800 473 2783 or 225 924 5040 To view the Medicaid HIPAA Error Code Crosswalk table click here Search Type ICN Search Clear Screen be Provider Name BUJARD NPI J1
17. n Provider ID or NPI Yes 7 or 10 digits numeric This field is automatically populated based on the provider log in authentication information ICN 13 digits numeric Your Trace No The provider s unique code to link a wf transaction to a recipient Search Type Yes Use the dropdown box to select General Search or ICN Search Date Revised 10 17 2011 10 eCSI Application User Manual 3 4 Response Screen When all required fields of the inquiry page have been entered and the Submit button is selected the message is sent to the eCSI system The application returns a response providing information about a claim once a match has been established using the search criteria All Original search data that has been entered on the inquiry page will be displayed on the response screen Related data is grouped together by subject matter An ICN Search uniquely identifies a claim thus the response is an exact match For inquiries by ICN it is possible to return status information about the claim history starting with the ICN that is input Adjustments will appear if the original claim was paid For example if the original claim were adjusted twice and the original ICN is input there would be chronologically three ICNs associated with the claim the original and two adjustments The response will contain information regarding the ICN on the inquiry plus all subsequent adjustments If the provider does not supply unique ide
18. ntifying elements and initiates a General Search the response includes multiple claims that meet the parameters supplied by the provider Date Revised 10 17 2011 14 eCSI Application User Manual 3 4 1 Screen Samples The following is an example of a General Response Screen This response includes multiple claims because only the Recipient ID was entered for the inquiry eCSI General Response Screen Medicaid Claims Status Inquiry Web Application Navigation Menu Search Response Print Friendy eMEVS Mam Menu Help IMPORTANT DO HOT use the BACK browser button please use the navigation menu For Technical Support please contact 877 598 8753 For Eligibility Verification Support please choose the eMEVS Navigation Menu Option above or call 800 776 6323 or 225 216 7387 to acces For Other Types of Assistance please contact Molina Medicaid Solutions Provider Relations at 800 473 2783 or 225 924 5040 To view the Medicaid HIPAA Error Code Crosswalk table click here Search Criteria Search Type Recipient ID Provider Information Hame HPI Telephone Subscriber Information Hame Member ID Humber Claims Information Claim Status Claims Status Clarification Original Charge Amount Claim Payment Amount Remittance or Check Humber Status Effective Date Check or EFT Date Date of service Procedure Code Procedure Code Modifier s ICH Bill Type Claims Information Claim Status Claims Status Clarific
19. or an ICN specific search These two different search methods are provided in a pull down menu in the Search Type field eCSI Search Type Methods Change Password Change Account info Provider Logout Help Medicaid Claims Status Inquiry Web Application Navigation Menu Search Response Print Friendly eMEVS Mam Menu Help IMPORTANT DO HOT use the BACK browser button please use the navigation menu For Technical Support please contact 877 598 8753 For Eligibility Verification Support please choose the eMEVS Navigation Menu Option above or call 800 776 6323 or 225 216 7387 to access REVS For Other Types of Assistance please contact Molina Medicaid Solutions Provider Relations at 800 473 2783 or 225 924 5040 To view the Medicaid HIPAA Error Code Crosswalk table click here Search Type General Search Clear Screen 3 General Search Provider Har ICN Search MELI 386740959 Recipient ID E 13 Digit Number Claim Charge Amount CH t Dates of Service BS thru El mim dd y yyy Your Trace Hote Required fields are in red Submit A provider is able to utilize the billing provider number or the servicing provider number whichever the provider used to log into the application If a billing provider number is used ez returns all claims for that billing provider regardless of the servicing provider If a servicing provider number is used eCSI will return only claims where that provider is the servicing prov
20. pes of Assistance please contact Molina Medicaid Solutions Provider Relations at 800 473 2783 or 225 924 5040 To view the Medicaid HIPAA Error Code Crosswalk table click here Search Criteria Search Type ICH Provider Information Hame HFI Telephone Subscriber Information Hame Member ID Humber Claims Information Claim Status Claims Status Clarification Original Charge Amount Claim Payment Amount Remittance or Check Humber Status Effective Date Check or EFT Date Date of service Procedure Code Procedure Code Modifier s ICH Bill Type Claims Information Claim Status Claims Status Clarification Original Charge Amount Claim Payment Amount Remittance or Check Humber Status Effective Date Check or EFT Date Date of service Procedure Code Procedure Code Modifier s ICH Bill Type ICM Search 225 644 5307 FinalizecdPayment The claimine has been paid HIPAA Adj Ran Code 65 Claimdine has been paid 20 00 1 29 00000051 O2 08 201 4 02 09 20 4 0141 2014 thru 0141 2014 A0425 PH FinalizedRevised Adjudication information has been changed HIFAA Adj Ren Code 65 Claimdine has been paid 20 00 1 15 oo0000052 0308201 4 O309 201 4 014172011 thru 0141 2014 A0425 FH Transaction run on 1043 2011 at 01 56 55 CT by LAMedicaid Louisiana Medicaid Date Revised 10 17 2011 eCSI Application User Manual 3 4 2 Data Fields The Electronic Claim Status Inquiry appl
21. raph regarding error message 0005 Restored document from 2005 pdf original and updated screen shots that contain left hand menu bar updated Section 2 0 05 05 06 Added Approval names and titles 08 08 08 Removed Approval page updated 2 0 and 5 0 for NPI 08 14 08 Reformatted pp 5 6 of 2 0 updated 3 1 1 3 1 2 3 2 2 and 5 0 in accordance with changes requested by PCT B Vazquez B Vazquez B Vazquez B Vazquez 03 18 05 B Vazquez 04 27 06 H Eyster Kearney S Triggs R Sheehan R Sheehan S Triggs R Sheehan R Sheehan 12 02 08 The application displays NPI if user logs in using 2278 R Sheehan NPI if user logs in using LA Medicaid ID LA Medicaid ID is displayed Following sections updated 2 0 Item 6 3 2 2 3 3 2 3 4 1 second screenshot 3 4 2 12 17 08 Formatted per approved user manual template n a R Sheehan and streamlined application access information Replaced Appendix B with a link in 1 0 Date Revised 10 17 2010 ji eCSI Application User Manual 07 12 10 Logos updated Unisys gt Molina R Sheehan 10 17 11 Replaced screen shots on pages 3 13 Added 6729 T Tate Appendix B and removed data fields from chart on pages 15 and 16 Date Revised 10 17 2010 II eCSI Application User Manual TABLE OF CONTENTS LO OVERVIEW E 1 EE ODJECU ME 1 2 0 ACCESSING THE APPLICA HON eseu sees eseu seess 2 3 0 USING THE ECSI APPLICATION 00 cece eeeeeeeeeeneeense
22. rosswalk table click here Search Type General Search sl Clear Screen Provider Name JOHN DOE Recipient ID 3 3 13 Digit Number Claim Charge Amount O HHH Dates of Service Be thru El mmfdd yyyy YourTrace Hote Required fields are in red Submit 3 2 2 Data Fields Required fields are denoted in red on the web screen All required data fields must contain valid entries before processing continues The following table designates which fields are required Field Name Required Data Validation Search Type Yes Use the dropdown box to select General Search or ICN Search Provider Last Name Yes Maximum length 13 characters alphanumeric This field is automatically populated based on the provider log in authentication information Provider ID or NPI Yes 7 or 10 digits numeric This field is automatically populated based on the provider log in authentication information Recipient ID Yes 13 digits numeric Claim Charge Amount Numeric with 2 decimal places Dates of Service No Type in dates of service or click on popup calendar and select calendar options If only a beginning date of service is entered the ending date of service will auto populate with the same date of service Date Revised 10 17 2011 8 eCSI Application User Manual Field Name Required Data Validation Your Trace No The provider s unique code to link a transaction to a recipient The eCSI applic
23. t 800 473 2783 or 225 924 5040 To view the Medicaid HIPAA Error Code Crosswalk table click here Search Criteria Search Type ICN Search ICH Provider Information Name HPI Telephone Member ID Number lt E SS Name BS Claims Information Claim Status Finalized Denial The claimiine has been denied Claims Status Clarification HIPAA Adj Rsn Code 252 Authorization certification number Original Charge Amount 655 00 Claim Payment Amount 00 Remittance or Check Humber ooo000000 Status Effective Date 124 7 2010 Check or EFT Date Date of service 02 27 2009 thru 02 27 2009 Procedure Code 99223 Procedure Code Modfifier s ICH eer Bill Type Transaction run on 1043 2011 at 02 07 21 CT by LAMedicaid Louisiana Medicaid Date Revised 10 17 2011 13 eCSI Application User Manual The following is an example of an ICN Search Response Screen where the original claim and an adjustment are displayed eCSI ICN Search Response Screen Adjustment Change Password Change Account info Provider Logout Medicaid Claims Status Inquiry Web Application Navigation Menu Search Response Print Friendy eMEVS Main Menu Help IMPORTANT OO HOT use the BACK browser button please use the navigation menu For Technical Support please contact 8677 598 8753 For Eligibility Verification Support please choose the eMEWS Navigation Menu Option above or call 600 776 6323 or 225 216 7387 to access REVS For Other Ty
24. t 276 277 It is a real time application that processes in accordance with the Health Care Claim Status Request and Response 276 277 Implementation Guide ANSI X12N 276 277 005010212 The database for the application maintains two years of claim information based on the claim s date of receipt On a daily basis claim activity including new claims adjustments voids and pended claims is extracted and passed to the UNIX ORACLE Database and is processed as new activity Claim status inquiry and response processes are supported for all LMMIS claim types Providers can inquire on the status of a claim by executing a search via a generic general method or by specific ICN Date Revised 10 17 2011 eCSI Application User Manual 2 0 ACCESSING THE APPLICATION 1 Open your web browser and enter the URL for the Louisiana Medicaid main menu http Awww lamedicaid com the Provider Web Account Registration Instructions link at htto www lamedicaid com provweb1 Provweb_ Enroll website enrollment htm Login in to the Provider Applications area in accordance with the instructions located on not already have a web account this guide will explain how you get a web account to access provider applications If you do already have an account the guide explains how to login to the provider application area Claim Status Inquiry link Once you login the Provider Applications Area screen is displayed Select the ee E a C
25. uired foto ane in red Submit Date Revised 10 17 2011 eCSI Application User Manual 3 1 3 Informational Messages During eCSI web screens processing the user is kept aware of the processing status through the use of informational messages If an informational message is received the user does not have to initiate a corrective action The message is for informational purposes solely and the processing continues The following is an example of an informational message that is executed when the server is down and the user needs to try again later Medicaid Claims Status Inquiry Web Application Navigation Menu Search Response Print Friendly eMEVS MainMenu Help Fee Elgedity Verification Support please choose the NES Wavigation Many Gulam above or call B00 776 6323 e 225 216 7387 to access REVS For Other Types of Agsettance pleate contact Noung Medicaid Solutions Frores Relations af 800 473 278 ce 225 924 5040 To view the Medicaid HIPAA Error Code Crosswalk table click here Error Message 0005 Unable to Respond within required time limits 3 2 General Search Screen The eCSI General Search methodology is discussed in this subsection This search methodology can return multiple claims that meet the parameters supplied by the provider when the inquiry does not uniquely identify a claim within the system The provider may enter unique identifying elements to obtain an exact match The system automatically populates the

Louisiana Medicaid Management Information System (LMMIS)

Contents

Download Pdf Manuals

Related Search

Related Contents