EZ Net User Manual - Touchstone Health
Contents
1. Type Service Description Mod Qty Diag Ref zl x Prof B7141 ABDOMINAL fi x Prof 75765 ABDOMINAL SELECTIVE fi Click in Mod edit box to select a masa List of Procedure Codes To delete a specified Procedure Code from the list click on the x delete button on the very left side of the row to remove that line from the list Enter Service Type Click on the dropdown list to select from one of the two following values Professional or Hospital Enter Modifier if applicable Click on the dropdown list to select modifier If Procedure Code has already been added to line click in the Modifier box to display lookup window Enter the number of times the procedure was rendered into this required field Enter Diagnosis Reference number that this Procedure Code corresponds to Valid values are 1 2 3 or 4 Example Diagnosis Reference number 2 would correspond to Diagnosis Code line 2 in the Diagnosis Code section in the middle Authorization Inquiry and Submission EZ NET 5 2 User Manual Claim Notes Section Field Name Field Description Auth Notes Enter Notes To increase window size dick on the Click to Enlarge Notes link that is in blue text Review data entered into the Authorization Submission Entry form Submit the form by clicking the Submit Request button at the bottom of the page The notification dialog box will display the submission status Request succeeded there2. Contains Search Clear Close Search Diagnosis Code dialog box Enter search parameters in the fields provided and click Search Authorization Inquiry and Submission EZ NET 5 2 User Manual Diagnosis Section Field Name Field Description 3 Diagnosis Search Web Page Dialog Diagnosis List Diagnosis Code Diagnosis Description 441 4 ABDOM AORTIC ANEURYSM 789 3 ABDOM PEL IC SWELLNG NEC ABDOM PELY IS ESSEL INJ ABDOMEN PEL IS SYMP NEC ABDOMINAL ACTINOMYCOSIS ABDOMINAL PAIN ABDOMINAL PREGNANCY ABDOMINAL RIGIDITY ABDOMINAL WALL ANOMALIES Last Page First 1 Prev Next C co D B B F Oo B 0 i Back to Search http dell2721 menet45 DiagCodeSearch asp Company REYLEXKATV amp SY Ez Local intranet Search Diagnosis Results window Once the code is found select the code by clicking in the checkbox and then clicking on the Add Selection button Up to 4 Diagnosis Codes can be entered Diagnosis Diagnosis Code da Add Only 4 diagnosis codes allowed Number Code Description K l 789 0 ABDOMINAL PAIN List of Diagnosis Codes To delete a specified Diagnosis Code from the list click on the x delete button on the very left side of the row to remove that line from the list Services Requested Section Field Name Field Description Procedure code Enter the required Procedure Code The code number must be exact including the decimal point and number s Once the code is
3. Enter the required Member s ID Click on the binoculars icon to search for Member ID Once Member ID is entered the Name Sex and DOB fields will be populated Enter the required Provider s ID Click on the binoculars icon to search for Provider ID Once Provider ID is entered the Name field will be populated Enter Place of Service which is the type of facility or environment the services were performed Click on dropdown list to select Place of Service Enter the patient s care outcome from the drop down list box Enter the Provider s claim number which is a unique system number Enter the authorization number secured prior to the rendering of the service attached to this claim Click on the binoculars icon to search for Authorization NOTE A valid HP Member ID must be entered before entering or searching for Authorization Auto populated by system Diagnosis Section Field Name Diagnosis Code Page 30 of 33 Field Description Enter the required Diagnosis Code The code number must be exact including the decimal point and number s Once the code is manually entered in the field click the Add button If the code is unknown or only a partial code is known click on the binoculars icon to search for the code Diagnosis List Enter your search criteria below Any combination may be selected Diagnosis Code Diagnosis Description Begins With Contains Search Clear Close Searc
4. MZI HealthCare EZ NET 5 2 USER GUIDE FOR EZ CAP April 2007 MZI HealthCare 2007 MZI HealthCare All rights reserved The information in this document is subject to change without notice No part of it may be reproduced or transmitted in any form or by any means without the express written consent of MZI HealthCare Copyright October 2006 MZI HealthCare LLC all rights reserved MZI HealthCare Proprietary This material constitutes proprietary and trade secret information of MZI HealthCare and shall not be disclosed to any third party nor used by the recipient except under the terms and conditions prescribed by MZI HealthCare This material is also protected by Federal Copyright Law and is not to be copied or reproduced in any form using any medium without the prior written authorization of MZI HealthCare However MZI HealthCare allows the printing of Adobe Acrobat PDF files included on the software installation disc for the purposes of client training and references MZI HealthCare the MZI HealthCare logo EZ CAP and the EZ CAP logo are trademarks of MZI HealthCare LLC EZ NET 5 2 User Manual Oro ge Geer re ne eee re er ee CC er Tre re rr TT rrerrr cr rect rr re cre A System OVElVICW inicceanasicnvcrccrederecencssirnnrseserecsicinsercisesscrstiny A EZ NE FUNC HOMEY anaanet econ senuiaeteeerraayscsess nenecain ae sreetaanannnew eq asaanenpaemanensesenieusana ces 4 EZ NE T Solution Advantage Sisasaattcevessccrasto
5. Qty fi Diag Ref ns g Date Service From 05707 2004 Time Service From aoz for 10 30 AM Date Service To 05 07 2004 Time Service To asz for 3 20 PM Billed Charge fo FETE EB bb Claim Notes Click to enlarge Notes i Submit Request Clear Form Fields marked with are required fields Bros Sl ee pee Bh gy Deere Byte ee el hy Ee i a pee De ee phy de Be poke yeh Peterasce and p fees Talay provided by MSI Hee Ph eee AD Pajil tel This Site Best Viewed with Explor Claim Submission Entry window Claims Inquiry and Submission Page 29 of 33 Master Record Section Field Name Company ID Request Date Units HP Member ID Provider ID Place of Service Outcome Provider Claim Authorization Date Received Field Description Select Company ID Click on arrow to select from drop down list The listing contains multiple company identifications usually with its acronym followed by its full name Auto populated by system This field may be used to identify any useful count of items such as the number of visits reflected on this claim If the authorization covering this claim specifies an authorized number of units the system will check against the number on this claim plus all other claims referencing the same authorization EZ CAP issues a warning message if the number of authorized units exceeds this number and it changes the claim status to 2 System Hold
6. 2 User Manual Home providers Eligibility Member Search Results Member Eligibility Authorizations Hambar embar Name Jeendar prh Data Wealth Plan Nema Wealth Pan Option From Data tru Date Inau TEE E BLUE SHELOOFCALmORNE foan fries 5 FHC oa e passa BLUE cRose pLUs cAcaREROR Peram rau Erc submission oT CaUFORNwcaRE fimen sas japianes E Claims Processing a e ETWA romt OF GERVCEGROG asus a Access Batches 745052101 smmHarmam E _ many PACIFICAR E OF CALIFORNIA HMO GWF haras Oooo e Report Batches C smmrmatveea _ roma aie oc e fnaowe Jasoanes EE Submitter Services r eee Sewnsis gt __ awrnanorew W oranaone BLUECRORS PLUS CACARE OS PERSE rams ferwc Eee jess mrmanorews A PACIFICAREOF CALIFORNIA HHO ona fwiaow orc Response 271 oonzicca owrrmanprews wore AEWA HEALTH PLAN a rao Jorn Enrollment Status First Page 834 upload 834 download 12345678910 11 12 13 14 15 16171819 20 21 22 23 24 25 GN ya EZ Link Elig Upld Claim Inquiry Inquiry 276 Response 277 Member Search Result window If the system does not locate any records that meet your search criteria a message stating that No records found will display Click on the browser s Back button to redisplay the search criteria window Either replace adjust selection criteria or click Clear and re enter criteria Member Detail To display specific member detail click on the selected Member in red text in the Sea
7. 8 15 2003 5 00 NICE ROCCASECCA VENUS 11 01 1971 HEALTH NET COMMERCIAL 001 4 1 1938 6 30 2002 5 00 NICE VOGHEL LYNN 09 04 1956 HEALTH NET COMMERCIAL YTD TEST 1 4 2005 0 00 NICE Last Page 1 Assigned Members window Health Plan Affiliations For COLEMAN M D MARCK F 2850 Health Plan Name Eff Date Term Date AETNA HEALTHPLAN Last Page Health Plan Affiliations window Office Locations For COLEMAN M D MARCK F 2850 Street City State Zip Country Phone Fax Office Type ADDRESS1 CITY CA 91304 888 888 8888 OFFICE 1 Last Page Back to Provider Detail Office Locations window To return to the main Provider Detail window click the Back to Provider Detail button at the bottom of each of the above windows Provider Inquiry Page 13 of 33 EZ CAP Chapter 4 Member Eligibility Inquiry This chapter describes the procedures necessary to verify eligibility through EZ NET Accurate eligibility verification by the provider s office ensures the legitimacy of all encounters avoiding lost time and effort on the part of patient provider and EZ CAP client Member Eligibility Click on the Member Eligibility link in the function menu list to display the Member Eligibility Search window Home p r T Eligibility Member Eligibility Search Authorizations Enter your search criteria below Any combination may be used Lie Claims Processing Sarean dealt Company ID All Companies Ref
8. Sex M DOB 06 03 1974 Age 32 9288 ys Action Date Perf Prov Name Company ILLIC H DAVID Last Page 1 Back to Member Detail Authorization History window To view additional provider information click on the Provider s Name in red text to open the Provider Detail window see the Provider Detail section Member Eligibility Inquiry Page 17 of 33 EZ CAP Chapter 5 Authorization Inquiry and Submission This chapter describes the steps by which a EZ NET user can make both an authorization status inquiry display and view an authorization history and submit a routine referral authorization request Authorization Status Inquiry An EZ NET user can inquire about an authorization status and view an authorization history Whether originally submitted via EZ NET phone or facsimile EZ NET enables a user to view all authorizations submitted Authorization Inquiry Click Authorizations gt Inquiry link in the function menu The Authorization Referral Search window will be displayed Home Providers or Clinihilitw Authorization Referral Search Inquiry ve Enter your search criteria below Any combination may be selected Submission Company ID All Companies Submitter Services Member ID References Log Off 7 Site Disclaimer Auth Status NONE SELECTED Administration Request Date From To Auth Date From To Exp Date From To Patient Name Last First Ref Prov Last
9. and Password Click Login For a forgotten password click the I Forgot My Password button your default email program opens with a pre addressed and pre written message requesting the password Log Out To log off the EZ NET system click on the Log Off link in the function menu list to log out For security purposes it is very important to log off the system when you are finished with your work Requesting Access to the System If you need additional EZ NET user accounts established for other members of your organization please contact the Provider Services department system administrator or person responsible for adding users to the system The new user is added at the EZ CAP client organization end The following information is necessary for each new user account Medical group or physician name Full name of user requesting access Phone number of user requesting access Fax number E Mail ID Optional Preferred method of receiving notifications Phone Fax or E mail Physicians in your medical group this individual should be allowed to access Any restrictions to be placed on the user such as limited views of eligibility data enabled authorization requests but not inquiries etc A unique user account and password will then be established and communicated to you by the Provider Services staff Page 6 of 33 System Overview EZ NET 5 2 User Manual Contacting Us Contact information for a
10. are some warning pend conditions The authoriztion was successfully entered into EZ CAP Your authoriztion number is 20020724T0300001 The authorization has been requested Submit Another Authorization Request succeeded notification dialog box To enter another authorization click the Submit Another Authorization button To review details of the authorization click the authorization number link underlined in the Request Succeeded window above to display the Authorization Referral Details window Authorization Referral Details Status Information Authorization 2005043054200035 Company ID CFHC Status MODIFIED Request Date 1 1 2001 Processed By Auth Action Date 1 1 2001 Place of Service 12 HOME Expiration Date 4 1 2001 LOS 0 Units 0 Patient Information Patient SMITH MV ANDREW G Sex M DOB 1 17 1967 Age 40 3 yrs HP Memb ID RO2707453MM1 PCP OV Co Pay 0 00 Health Plan HEALTH NET Diagnosis Referring Physician Name ZGLINIEC ROBERT P Prov ID ZGLI Specialty INTERNAL MEDICINE Phone 760 769 5160 Fax 760 789 6316 Performing Physician Name E MEDICAL SUPPLIES Prov ID EMED Specialty DURABLE MEDICAL EQUIPMENT Phone 209 366 1918 Fax 209 366 2140 Facility Id Name E MEDICAL SUPPLIES Prov ID EMED Specialty DURABLE MEDICAL EQUIPMENT Phone 209 366 1918 Fax 209 366 2140 Services Requested Service Description Mod Oty Co Pay 99213 P OFFICE OUTPATIENT VISIT 1 0 00 Printable Version Authoriz
11. number assigned to the patient by the rendering provider and submitted by that provider with the claim or encounter An account identification number assigned to the patient by the rendering Provider and submitted by that provider with the claim or encounter Claims Inquiry and Submission Page 27 of 33 Field Name Field Description Sort By The ability to specify how the selected claim encounter records are to be displayed is provided via the Sort By pick list The default sort order is by claim identification number Click on the dropdown arrow to select one of the following sort options Claim Number Provider Claim Number Member Name Service Date From Provider Name Provider Claim Number Click on the Search button EZ NET returns the Claim Search Results window a grid displaying search results sorted in the specified order Claim Search Results Claim MEMB NAME Prov Name Prov Claim ID Date of Service Status Company 200504137503000763 1 SMITHANA ANNA L ZAKKO MARAM F 3 4 2005 3 4 2005 PAID CFHC 200505090000200139 1 SMITH ANNA L ZAGULILMARVIN 12 29 2004 12 29 2004 PAID CFHC 200507010001300088 1 SMITH ANN C POLTEROCKJERROLD 8 2 2005 6 2 2005 PAID CFHC 200507010001300088 2 SMITH ANN C POLTEROCKJERROLD 6 2 2005 6 2 2005 PAID CFHC 200507010001300038 3 SMITH ANN C POLTEROCKJERROLD 6 2 2005 6 2 2005 PAID CFHC 200507010001300088 4 SMITH ANN C POLTEROCKJERROLD 6 2 2005 6 2 2005 PAID CFHC 200
12. range of functional units such as Provider Services Referral Management Eligibility etc is available on line via the EZ NET system In addition the ability to submit a formatted e mail message directly to the department or individual most qualified to assist you with your question or issue is provided Displaying Contact Information Click References gt Contacts to display the search Contacts List dialog page Contacts List Enter your search criteria below Any combination may be selected Company ID All Companies v Type Begins with Name Contacts List window Search for contacts by entering search criteria and clicking the Search button Site Disclaimer Each site IPA EZ CAP client organization PHO specifies its own disclaimer The site disclaimer statement can be viewed by clicking on Site Disclaimer in the function menu list Know Your Data Simplifying the search for providers in EZ NET is accomplished by applying sound logic and common sense to the search Unless absolutely necessary avoid entering any data of which you are not sure For instance do not enter more data in any field than has been confirmed it is more productive to enter less known information than to guess at an extra piece of data and experience no search results System Overview Page 7 of 33 EZ CAP Chapter 2 System References System references enable a user to look up a variety of reference codes including Service procedur
13. 507 190004 100585 1 SMITH ANN C POLTEROCKWJERROLD 7 6 2005 7 6 2005 PAID CFHC 200507 190001 100535 2 SMITH ANN C POLTEROCK JERROLD 7 6 2005 7 6 2005 PAID CFHC 200507 190001 100585 3 SMITH ANN C POLTEROCKJERROLD 7 6 2005 7 6 2005 PAID CFHC 200507 190001 100595 4 SMITH ANN C POLTEROCKJERROLD 7 6 2005 7 6 2005 PAID CFHC First Page 12345678 Claim Search Results window The Search Results list can be printed by clicking on the browser s Print button Claims Detail To display a claim s detail click on the selected Claim number link in red text to display the Claim Encounter Detail window Claim Encounter Detail Status Information Claim 200504137503000763 1 Company ID CFHC Auth 2 Status PAID Date Recd 4 11 2005 Prov Claim 2 Date Paid 3 4 2005 Check 99 9999999 Payment Status Claim Type Professional Vendor CEN Payee Patient Information Name SMITHANA ANNA L Sex F DOB 3 10 1926 Age 61 16 yrs Health Plan SECURE HORIZONS Mbr Id 486585701 Benefit Plan 5SP Prov Pat Id Diagnosis 787 2 DYSPHAGIA Provider Information Name ZAKKO MARAM F Provider Id ZAKK Specialty GASTROENTEROLOGY Place of Service 24 AMBULATORY SURG CENTER Services Sve Svc CPT Billed Cntc Co pay WH Adj Net Adj Adj Date Code Description Mod Qty Amt Amt Amt Amt Amt Paid Code Desc Detail 3 42005 43249 ESOPH ENDOSCOPY DILATION 51 1 650 00 0 00 0 00 0 00 0 00 0 00 01 DUPLICATE
14. 9 018 WCENTRIF SER SEP OUT LAB i NICE 99021 020 WICENTRIF amp SERUM NICE 99018 1 VENOUS OR CAPIL PUNCTURE NICE 93274 12 THRU 24 HR RCRDNG NICE 20650 2ND OR 3RD OPINION NICE 20651 2ND OR 3RD OPINION NICE 20652 2ND OR 3RD OPINION NICE 90853 2ND OR 3RD OPINION NICE re 123456789 10 111213 1415 16 17 18 19 20 21 22 23 24 25 QED Search Results window The following subsections provide descriptions of each reference code Page 8 of 33 System References EZ NET 5 2 User Manual Procedure Reference Codes The Procedure Reference table contains a list of professional and hospital service codes and associated descriptions Code and or description can key searches See preceding window image Procedures Reference Enter your search criteria below Any combination may be selected Company ID All Companies Code Begins with Description Search Clear Diagnosis Reference Codes The Diagnosis Reference table contains a list of ICD 9 Diagnosis codes and their associated descriptions Code and or description can key searches Diagnosis Reference Enter your search criteria below Any combination may be selected Company ID All Companies Code Begins with Description Search Clear Place of Service Reference Codes This reference contains the Place of Service codes for use in authorizations and claims These codes are typically the HCFA standard codes but can be customized by the IP
15. 9213 OFFICE OUTPATIENT VISIT fe Oty Co Pay 1 0 00 Authorization Detail window Printable Version To print the page click on the Printable Version button To view detail for the Member Referring Physician and or Performing Physician or Facility ID click on their links in red text to display their individual information detail windows Page 20 of 33 Authorization Inquiry and Submission EZ NET 5 2 User Manual Authorization Submission Authorization requests can be submitted by the user directly through the EZ NET system Authorization Submission Click Authorizations gt Submission link in the function menu The Authorization Submission Entry window will be displayed Home Providers Authorization Submission Entry Marahavr Climibilites Authorizations Inquiry Submission Company ID CFHC CENTRE FOR HEALTH CARE x Master Record Inquiry Submission Claims Processing Access Batches Report Batches Submitter Services Eligibility Inquiry Request Date 5 3 2007 Los 0 Units 0 HP Member ID he Hp Name Sex DOB E Referring Physician ID g Name Inquiry 270 Response 271 Enrollment Status 834 upload 834 download EZ Link Elig Upld Claim Inquiry Performing Physician ID g Name Facility ID 4 Name Place of Service 837 download a Code aiption EZ Link Claim Upld 997 download Professional Cl
16. A EZ CAP client organization PHO Place of Service Reference Enter your search criteria below Any combination may be selected Company ID AN Companies Code Begins with Description Search Clear CPT Modifier Reference Codes This reference contains CPT Modifier codes that can be used to provide additional descriptions for requested or provided services These standard codes are provided with the CPT Procedure codes but can be customized by the IPA EZ CAP client organization PHO CPT Modifiers Reference Enter your search criteria below Any combination may be selected Code Begins with Description Search Clear System References Page 9 of 33 EZ CAP Contacts Reference This reference contains a list of IPA EZ CAP client organization PHO contacts including contact phone numbers fax numbers and email addresses Clicking on a contact s email address retrieves a form into which the message can be input then submitted to the contact Contacts List Enter your search criteria below Any combination may be selected Company ID All Companies Type Begins with Name Search Clear Page 10 of 33 System References EZ NET 5 2 User Manual Chapter 3 Provider Inquiry The Provider search function enables the EZ NET user to search Provider directories Search Providers Click on the Providers link in the function menu to display the Provider Directory Search wind
17. CLAIM MANUAL DETERM Totals 650 00 0 00 0 00 0 00 0 00 0 00 Claim Encounter Detail window To view detail for the Member or Provider click on the link in red text to display the individual information and detail windows Click on the Detail link in red text to view the line item detail of the Services rendered Page 28 of 33 Claims Inquiry and Submission Claim Submission EZ NET 5 2 User Manual Claim requests can be submitted by the user directly through the EZ NET system Claim Submission Click Claims gt Submission link in the function menu to display the Claim Submission Entry window EZ NET Home Providers Phim enbhmiedan Eniro Member Eligibility i CAMS UBMISMON EMEN fauthoasicatinnc i Company ID REYLEXKATV JUSE MEDICAL GROUP z Inquiry a Master Record aisre NMunnnrrinsa Submitter Services Request Date 05 07 2004 References Log Off HP Member 1D oa Hp Site Disclaimer Same Sen DOD Administration Provider w o 4 Name Place of Service None Selected gt Qutcome 1 HOME y Provider Claim aooo Authorization a Date Received 05 07 2004 Diagnosis Diagnosis Code Add Only 4 diagnosis codes allowed Number Code Description Services Requested Procedure Code f Service Type Prof Modifier 1 None Selected X Modifier 2 None Selected X Modifier 3 None Selected X Modifier 4 None Selected X
18. First Perf Prov Last First Search Clear Sort by Auth z 2005 MZI Healthcare All Rights Reserved System Availability transaction execution and response times may vary due to volume syst performance and other factors Technology provided by MZI Healthcare All Rights reserved Authorization Inquiry window Field Name Field Description Company ID Select Company ID Click on arrow to select from drop down list The listing contains multiple company identifications usually with its acronym followed by its full name Auth Enter Authorization number a partial number may be entered Up to 6 digits must be entered NOTE If all other fields are blank then this field is required to have a minimum of 6 digits entered Status Status of the authorization Value defaults to None Selected which means that the search will not be restricted to a specific authorization status Searches can be limited to a specific authorization status by selecting it from the drop down list Page 18 of 33 Authorization Inquiry and Submission EZ NET 5 2 User Manual Field Description Enter From and or To dates for these period parameters Enter date s in mm dd yyyy format Field Name Request Date Auth Date Exp Expiration Date Referring Provider Enter Last and or First names for the Requesting Provider Perf Prov Enter Last and or First names for the Performing Provider that is the provider actually p
19. ID LESI Company ID REVYLEAKATY Name MANUEL ALESIS R Class PRIMARY CARE PHYSICIAN Practice Group JUSE MEDICAL GROUP Group ID 222272 Street 15444 WOODLAND AVE Specialty PAIN MANAGEMENT Street City State Zip WARNER CITY CA 91111 Contract Effective 1 1 2000 Phone Contract Term Fax Contact Assigned Members Health Plan Affiliations Office Locations Provider Details window The buttons at the bottom of the above window will appear only if the user s system is configured for displaying the indicated information If EZ NET is configured in Administration Tools to view additional provider information click on the Assigned Members Health Plan Affiliations and Office Locations buttons as described in the following section Page 12 of 33 Provider Inquiry EZ NET 5 2 User Manual Displaying Additional Provider Information If EZ NET is configured in Administration Tools to view additional provider information click on the Assigned Members Health Plan Affiliations and Office Locations buttons to display the following windows as shown below Eligibility List Date 5 24 2006 4 50 06 PM For COLEMAN M D MARCK F 2850 Member Name Birth Date Sex Health Plan Option Eff Date Term Date PCP Company O Co Pay BROOKS BEVERLY A 06 01 1942 HEALTH NET COMMERCIAL 001 4 1 1998 6 30 2002 5 00 NICE CORNER POOH 04 23 1970 HEALTH NET COMMERCIAL 001 8 15 2003 5 00 NICE MORENO TIGER 03 02 1973 HEALTH NET COMMERCIAL 001
20. RPOSE AND THE WARRANTY OF NON INFRINGEMENT WITHOUT LIMITING THE FOREGOING SOPMG MAKES NO WARRANTY THAT i THE SITE AND INFORMATION WILL TAE MEET YOUR REQUIREMENTS ii THE SITE AND INFORMATION WILL BE UNINTERRUPTED TIMELY SECURE OR ERROR FREE iii THE RESULTS THAT MAY BE OBTAINED FROM THE USE OF THE SITE AND 297 download INFORMATION WILL BE EFFECTIVE ACCURATE OR RELIABLE AND iw THE QUALITY OF ANY INFORMATION OBTAINED BY YOU FROM THE SITE WILL MEET YOUR EXPECTATIONS THIS SITE COULD INCLUDE Professional ciate ECHNICAL OTHER MISTAKES INACCURACIES OR TYPOGRAPHICAL ERRORS 7 uploa 837 download E2Z Link Claim Upld 997 download Remittances 835 Auth Referrals 278 Req Review 278 Download References Procedures Diagnosis Place of Services CPT Modifiers Site Disclaimer Administration Connection Editor performance and other factors Technology provided by MZI Healthcare All Rights reserved This Site Best Viewed with RO Pre login window In the pre login window a disclaimer is displayed that you must agree to before the system allows you to enter the system Click the I Agree button at the center of the window System Overview Page 5 of 33 EZ CAP Thyequest a new User ld or changes to an existing Id please contact Client Services at 950 824 7177 or Client_sericesiscpmes arg Login User ID Enter your UserID Password Enter your Password Forgot My Password Login window Enter User ID
21. ZONS SECURE HORIZONS SECURE HORIZONS PRESANT LARRY A CFHC DURE SMITH BELINDA A PRESANT LARRY A CFHC CFHC First Page 1234 Authorization Referral Search Results window The Search Results list can be printed by clicking on the browser s Print button Authorization Inquiry and Submission Page 19 of 33 Authorization Detail EZ CAP To display an authorization s detail click on the selected Authorization number link in red text to display the Auth Status Information window Authorization 2 Status Processed By Place of Service LOS Patient HP Memb ID Health Plan Diagnosis Name Prov ID Phone Name Prov ID Phone Name Prov ID Phone Authorization Referral Details Status Information 2005043054200035 Company ID CFHC MODIFIED Request Date 1 1 2001 Auth Action Date 1 1 2001 Expiration Date 4 1 2001 Units 0 12 HOME 0 Patient Information SMITH IV ANDREW G Sex M DOB 1 17 1967 Age 40 3 yrs RO2707483MM1 PCP OV Co Pay 0 00 HEALTH NET Referring Physician ZGLINIEC ROBERT P ZGLI 760 789 5160 Specialty INTERNAL MEDICINE Fax 760 789 6316 Performing Physician E MEDICAL SUPPLIES EMED 209 366 1918 Specialty DURABLE MEDICAL EQUIPMENT Fax 209 366 2140 Facility Id E MEDICAL SUPPLIES EMED 209 366 1918 Specialty DURABLE MEDICAL EQUIPMENT Fax 209 366 2140 Services Requested Service Description 9
22. aims 837 upload 837 download EZ Link Claim Upld 997 download Remittances 835 Auth Referrals 278 Req Review Services Requested 278 Download References Procedures Diagnosis Place of Services CPT Modifiers Procedure Code i Bh Service Type Prof iw Modifier Qty Diag Ref Site Disclaimer Administration Connection Editor Inquiry 276 Diagnosis Response 277 Institutional Claims 837 upload Diagnosis Code oh Only 4 diagnosis codes allowed Auth Notes Chol w euhige Nows Fields marked with ave required fields Authorization Submission Entry window Authorization Inquiry and Submission Page 21 of 33 Field Name Company ID Request Date LOS Units HP Member ID Referring Physician ID Performing Physician ID Facility ID Place of Service Master Record Section Field Description Select Company ID Click on arrow to select from drop down list The listing contains multiple company identifications usually with its acronym followed by its full name Auto populated by system Length Of Stay related to a hospital claim This field may be used to identify any useful count of items such as the number of visits reflected on this claim If the authorization covering this claim specifies an authorized number of units the system will check against the number on this claim plus all other claims referencing the same authorization EZ CAP issues a warning m
23. ation Referral Details window To print the page click on the Printable Version button To view detail for the Member Referring Physician and or Performing Physician click on their links in red text to display their individual information detail windows Authorization Inquiry and Submission Page 25 of 33 EZ CAP Chapter 6 Claims Inquiry and Submission This chapter discusses the searching functionality of the Claim Search page Claims Status Inquiry To inquire on the status of a submitted claim follow these steps Claim Inquiry Click Claims gt Inquiry link in the function menu The Claim Search window will be displayed Member Eligibility n futharizatians Claim Search cam Enter your search criteria below Any combination may be selected nquiry Submission a Company ID All Companies x References Member ID 4 Log Off i p i Site Disclaimer Claim Status NONE SELECTED Administration Provider Name Last first Patient Name Last First D Service Date From ess To as Prov Patient Id Hosp Patient Id naa Medical Record Provider Claim Search Clear Sort by Claim 2005 MZI Healthcare All Rights Reserved System Availability transaction execution and response times may vary due to volume system performance and other factors Technology provided by MZI Healthcare All Rights reserved w ic This Site Best Viewed with Explore
24. d termination dates of service into these required fields Time Service From To Enter times for both for the start and termination of service Billed Charge Enter the total billed charge for the service into this required field Claim Notes Enter Notes To increase window size dick on the Click to Enlarge Notes link that is in blue text Review data entered into the Claim Submission Entry form Submit the form by clicking the Submit Request button at the bottom of the page The notification dialog box will display the submission status Request succeeded there are some warning pend conditions The claim was successfully entered into EZ CAP Your claim number is 20060524T0300001 The claim has been received PEND Auth not approved Submit Another Claim Request succeeded notification dialog box To enter another claim click the Submit Another Claim button To review details of the claim click the claim number link underlined in the Request Succeeded window above to display the Claim Details window Claims Inquiry and Submission Page 33 of 33
25. e The code number must be exact including the decimal point and number s Once the code is manually entered in the field click the Add button If the code is unknown or only a partial code is known click on the binoculars icon to search for the code Service List Enter your search criteria below Any combination may be selected Service Code Service Description Search Clear Close Search Procedure Code dialog box Enter search parameters in the fields provided and click Search Claims Inquiry and Submission Page 31 of 33 Field Name Service Type Modifier 1 2 3 4 Qty Diag Ref Page 32 of 33 Services Requested Section Field Description 2 Service Search Web Page Dialog Service List Procedure Procedure P rofessional Code Description Hospital 40070 AMB 02 amp SUPPLS LIFE SUSTAIN 40308 AMB ADY ER NO SPEC SERY ALL 40310 AMB ADY ER SPEC SERY ALL 40344 AMB ADY NON ER NO SERY MILE 40304 AMB ADY NON ER NO SERY ALL 40346 AMB ADY NON ER SERY MILE 40306 AMB ADY NON ER SPEC SERY ALL 40220 AMB ADY SUPPORT INCL SER ICE 40221 AMB ADY SUPPORT ONE WAY 40223 AMB ADY SUPPORT SEP SUPPLIES First Page First Prev Next Last imm m m CL CL CI eS EI kI EIo El Add Selection Back to Search http idell2721 menet45 ServiceCodeSearch asp Company REYLEXKATV amp S fox Local intranet Search Procedure Code Results window Once the code is found select the code by clicki
26. e codes Diagnosis ICD 9 International Classification of Diseases 9th Edition codes Place of Service codes CPT Current Procedural Terminology Modifier codes IPA EZ CAP client organization PHO contacts To access EZ NET system references from the function link menu click References gt Procedures Diagnosis Place of Services CPT Modifiers or Contacts A search criteria dialog box will be displayed Member Eligibility Authorizations Procedures Reference Claims Enter your search criteria below Any combination may be selected Claims Processing DUVHHNLLCI DUI VILUD gt References Company ID All Companies Procedures Diagnosis Code Begins with Description Place of Services CPT Modifiers Contacts Search Clear Log Off Mibe A m E T 2005 MZI Healthcare All Rights Reserved System Availability transaction execution and response times may vary due to volume system performance and other factors Technology provided by MZI Healthcare All Rights reserved icr nternet eene jaca This Site Best Viewed with Procedures Reference search dialog box Enter requested search information in the reference code dialog box such as abd in the Description field above and click the Search button Procedures Reference Search Results eo O Code Procedure Description CP rofessional Hjospital ee ID 5935 0 H OR F REFLEX STUDY NICE s 99014 010 WiCENTRIF SERM SEP OUT LAB NICE jaa01
27. erences a m N5 Log Off Last Name Site Disclaimer 3 al Administration First poai Member ID _ i Health Plan None Selected v 2005 MZI Healthcare All Rights Reserved System Availability transaction execution and response times may vary due to volume system performance and other factors Technology provided by MZI Healthcare All Rights reserved T Microsoft Internet u This Site Best Viewed vith mexploree Member Eligibility window Company ID Select Company ID Click on arrow to select from drop down list The listing contains multiple company identifications usually with its acronym followed by its full name Last Name Last name of the member First Name First name of the member MemberID Member ID which could be in alpha numeric or alphanumeric format Health Plan Health plan of which the member is associated with Value defaults to None Selected which means that the search will not be restricted to a specific health plan Searches can be limited to a specific health plan by selecting it from the dropdown list Sort By To specify the presentation order of the search results click on the Sort By pick list and select one of the following available sort options Member Name Member ID HP Member Name Click on the Search button EZ NET returns the Member Search Result window a grid displaying search results sorted in the specified order Page 14 of 33 Member Eligibility Inquiry EZ NET 5
28. erforming the service Member ID Member s ID which could be in alpha numeric or alphanumeric format Sort By To specify the presentation order of your search results click on dropdown list and select one of the following available sort options Auth Member Name Mbr Name Req Date Mbr Name Auth Date Mbr Name Expr Date Referring Provider Ref Prov Req Date Ref Prov Expr Date Performing Provider Perf Prov Reg Date Perf Prov Expr Date Click on the Search button EZ NET returns the Member Search Results window a grid displaying search results sorted in the specified order Authorization Referral Search Results Auth Memb ID Mem Name Health Plan Ref Prov Company 2005043054200035 RO2Z707483MM1 SMITH IVANDREW G HEALTH NET ZGLINIEC ROBERT P CFHC 2005043054200036 SMITH IMV ANDREW G HEALTH NET Z LINIEC ROBERT P CFHC 2005043054200037 2005043054200038 SMITH MV ANDREW amp SMITH IVANDREW G HEALTH NET HEALTH NET ZGLINIEC ROBERT P ZGLINIEC ROBERT P CFHC CFHC 200504308700007 1 2005043089200006 2005043089200007 SMITHANALANNA L SMITH ANN C SMITH ANN C IE n SECURE HORIZONS SECURE HORIZONS SECURE HORIZONS DURE SMITH BELINDA A PRESANT LARRY A PRESANT LARRY A CFHC CFHC CFHC 2005043089200008 2005050134100096 2005050517400095 SMITH ANN C SMITHANA ANNA L Injinia SMITH ANN C SECURE HORI
29. essage if the number of authorized units exceeds this number and it changes the claim status to 2 System Hold Enter the required Member s ID Click on the binoculars icon to search for Member ID Once Member ID is entered selected the Name Sex and DOB fields will be populated Enter the required Referring Provider s ID Click on the binoculars icon to search for Provider ID Once Provider ID is entered the Name field will be populated Enter required Performing Provider s ID Click on the binoculars icon to search for Provider ID Once Provider ID is entered the Name field will be populated Enter the required Facility ID Click on the binoculars icon to search for Provider ID Once Facility ID is entered the Name field will be populated Enter Place of Service which is the type of facility or environment the requested services is to be performed Click on dropdown list to select Place of Service Diagnosis Section Field Name Diagnosis Code Page 22 of 33 Field Description Enter the required Diagnosis Code The code number must be exact including the decimal point and number s Once the code is manually entered in the field click the Add button If the code is unknown or only a partial code is known click on the binoculars icon to search for the code Diagnosis List Enter your search criteria below Any combination may be selected Diagnosis Code Diagnosis Description adbo Begins With
30. from multiple databases and companies into a single collection point both for inquiry and submission Delivers a fast accurate and controlled method that enables physicians to access healthcare information including claims eligibility benefits authorization and provider directories EZ NET Solution Advantages EZ NET provides many advantages to users Healthcare entities of the EZ CAP product as those users provide sensitive information to their business providers physicians hospitals lab facilities etc including Reduce the cost of sharing information reduced faxes voicemail and telephone tag Improve the accuracy of information presentation eliminate the incidence of human error Provide secure controlled access to information 24 hours a day 7 days a week Enhance communication between your organization network providers and health plans Compatible with the popular Microsoft Internet Explorer 6 browser note that the EZ NET Server requires the same Uses strict user authentication layered application security and 128 bit data encryption technologies EZ NET Benefits to Business Partners EZ NET users provide many benefits to their business risk sharing partners Examples of these benefits are 1 Search provider directories 2 Submit authorizations requests and claims into the EZ CAP system 3 Inquire on authorization status A Verify health plan eligibility Page 4 of 33 System O
31. h Diagnosis Code dialog box Enter search parameters in the fields provided and click Search Claims Inquiry and Submission EZ NET 5 2 User Manual Diagnosis Section Field Name Field Description 3 Diagnosis Search Web Page Dialog i Diagnosis List Diagnosis Code Diagnosis Description 176 0 SKIN KAPOSI S SARCOMA 757 39 SKIN ANOMALY NEC 709 9 SKIN DISORDER NOS 709 8 SKIN DISORDERS NEC 59 1 SKIN DONOR 701 8 SKIN H PERTRO ATROPH NEC 701 9 SKIN H PERTRO ATROPH NOS 782 0 SKIN SENSATION DISTURB On 42 3 SKIN TRANSPLANT STATUS 782 SKIN OTH INTEGUMENT SYMP First Page First Prev Next Last F a Add Selection Back to Search http dell2721 mcnet45 DiagCodeSearch asp Company REYLEXKATY amp SY L fax Local intranet Search Diagnosis Results window Once the code is found select the code by clicking in the checkbox and then clicking on the Add Selection button Up to 4 Diagnosis Codes can be entered Diagnosis Diagnosis Code g Add Only 4 diagnosis codes allowed Number Code Description xhi 6953 ALLERGY UNSPECIFIED Xe 099 BKINDISORDERNOS xB 4939 ASTHMA NOS O List of Diagnosis Codes To delete a specified Diagnosis Code from the list click on the x delete button on the very left side of the row to remove that line from the list Services Requested Section Field Name Field Description Procedure Code Enter the required Procedure Cod
32. ions Office Locations Provider Details window To view additional provider information click on the Assigned Members Health Plan Affiliations and Office Locations buttons See Displaying Additional Provider Information to view these windows Viewing a Member s Authorization History Using the Member Information window view a particular member s auth history Eligibility Member Information Member Information Company I0 CFHC Member Hame SMITHAAROW A Sex ht DOB 060319794 Age 32 9255 yrs Member ID JOO S91420000 Relation ta Sub Address PO BOM 2391 City Steip ILOILO CA 925943 Member Benefit Information Health Plan BLUE SHIELD OF CALIFORNIA Benefit Plan OO AH Benefits Termed Benefits Effective 09 07 2006 Benefit Category MrA Co Pay MA Co Insurance WA Additional Benefit Search Category H A Co Pay Co Insurance Primary Care Provider Information PCP Name SMITH DAID bel Prowider ID SMID Specialty INTERNAL MEDICINE Phone 64943 8273 Fax a OS 36S9 87H4 PCP Effective OM 2006 PCP Ter mination Authorization History Member Details window Page 16 of 33 Member Eligibility Inquiry EZ NET 5 2 User Manual From the Member Information window above view the member s auth history by clicking on the Authorization History button to display the Authorization History for Member window Authorization History for Member Member ID JOO7391420000 Member Name SMITHAARON R
33. manually entered in the field click the Add button If the code is unknown or only a partial code is known click on the binoculars icon to search for the code Service List Enter your search criteria below Any combination may be selected Service Code 3 Service Description search Clear Close Search Procedure Code dialog box Enter search parameters in the fields provided and click Search Authorization Inquiry and Submission Page 23 of 33 Field Name Service Type Modifier Qty Diag Ref Page 24 of 33 Services Requested Section Field Description Service List gt Procedure Procedure P rofessional Code Description H ospital O 37440 ABDOMEN P 37540 ABDOMEN P id 37141 ABDOMINAL P Pi 35340 ABDOMINAL AORTA P O 35070 ABDOMINAL AORTIC ANEURYSM P m 33260 ABLATE HEART DYSRHYTHM FOCU P C3333250 ABLATE HEART DYSRHYTHM FOCUS P O 33251 ABLATE HEART DYSRHYTHM FOCUS P 0 33261 ABLATE HEART DYSRHYTHM FOCUS P 38794 ACCESS THORACIC LYMPH DUCT P First Page First Prev Next Last Add Selection Back to Search http fdell2721 menet45 ServiceCodeSearch asp Company REYLEXKATV amp 5 e Local intranet Search Procedure Code Results window Once the code is found select the code by clicking in the checkbox and then clicking on the Add Selection button Services Requested Procedure Code j Service Type Prof Modifier None Selected gty 1 Diag Ref Add
34. mited to a specific Provider specialty by selecting it from the dropdown list City Name of the city in which the Provider s office is located Zip Zip code in which the Provider s office is located Provider Inquiry Page 11 of 33 EZ CAP Field Name Field Description Sort By To specify the presentation order of the search results click on the Sort By pick list and select one of the following available sort options Provider Name Specialty City Name City Specialty Zip Name Click on the Search button EZ NET returns the Provider Search Result window a grid displaying search results sorted in the specified order Provider Search Result Provider Name Specialty Group Phone Fax City State Company DERMATOLOGY ASSOCIATES DERMATOLOGY DERMATOLOGY ASSOCIATES 18 857 0934 NORTHRIDGE CA E22003 DATA46 NICE DONAHUE ANECITA T ALLERGY BAY AREA PRIMARY CARE k E22003 DATA46 NICE Last Page Provider Search Results window If the system does not locate any records that meet your search criteria a message stating that No records found will display Click on the browser s Back button to redisplay the search criteria window Either replace adjust selection criteria or click Clear and re enter criteria Provider Detail To display specific provider detail click on the selected Provider in red text in the Search Results window as shown above Provider Details Provider
35. ng in the checkbox and then clicking on the Add Selection button Services Requested Procedure Code 351 05 f Service Type Prof z Modifier 1 None Selected m Modifier 2 None Selected Modifier 3 None Selected m Modifier 4 None Selected Qty i Diag Ref fi s Date Service From 05 07 2004 Time Service From 1030 for 10 30 AM Date Service To 05 07 2004 Time Service To asz for 3 20 PM Billed Charge fo Add x por b i fromrcom frre K por bo P O O O ear er Click in Mod edit box to select a masa List of Procedure Codes To delete a specified Procedure Code from the list click on the x delete button on the very left side of the row to remove that line from the list Enter Service Type Click on the dropdown list to select from one of the two following values Professional or Hospital Either leave as None Entered or select a modifier from the drop down list Enter the number of times the procedure was rendered into this required field Enter Diagnosis Reference number that this Procedure Code corresponds to Valid values are 1 2 3 or 4 Example Diagnosis Reference number 2 would correspond to Diagnosis Code line 2 in the Diagnosis Code section in the middle Claims Inquiry and Submission EZ NET 5 2 User Manual Services Requested Section Field Name Field Description Date Service From To Enter dates for both for the start an
36. nnnsnnnnnsnnnnnnnnsnnnnnnnnnnnnnnnn 16 oa ee err rr er ry err EE 18 Authorization Inquiry and Submission cccsssssceenneseseenesssees LS AUTHOFIZalION Status INGUICY ssiscaonesessecnasndosentananiwantasetentiansinct ceqetaniaindeneneestenterssias 18 PUG OMIZaAvOl SUNS SION ea E EEE 21 Chapter ivsaesivinsessndensectuceunsenssanendesunsensesensertetenweneninnvarnecusaesaueinweveneucvessncimes 26 Claims Inquiry and SubmiSSiOn csssccecccceennneeeeeccecesnnnsesessesss DO CHIME o eUS MOUN eer eee E A EE A E 26 EE a EES e E E E E A S 29 Contents Page 3 of 33 EZ CAP Chapter 1 System Overview This chapter discusses instructions for logging in and out site disclaimer and accessing requests and contact information in the EZ NET system EZ NET is a secured web based application for exchanging information between physicians health plans independent physician association IPAs managed care organizations MCOs and management service organizations EZ CAP client organizations EZ NET s secure nature enables your organization to make important data accessible to your business providers via the Internet or Intranet without compromising EZ CAP system security This chapter is intended as an introductory overview of EZ NET EZ NET Functionality EZ NET s functionality was designed to provide the following advantages Reduces the manual capture of patient authorization and referral data Consolidates information
37. ow nume C PNE Member Eligibili uunercauons Provider Directory Search A Claims Enter your search criteria below Any combinations may be selected Claims Processing Submitter Services References Company ID All Companies z Log Off R Site Disclaimer Provider ID Administration Last Group Name SS First Name Specialty NONE SELECTED City Zip Search Clear Sort by Provider Name z a 2005 MZI Healthcare All Rights Reserved System Availability transaction execution and response times may vary due to volume system performance and other factors Technology provided by MZI Healthcare All Rights reserved w This Site Best Viewed with la Provider Directory Search window Field Name Field Description Company ID Select Company ID Click on arrow to select from drop down list The listing contains multiple company identifications usually with its acronym followed by its full name Provider ID Provider ID in alpha numeric or alphanumeric format Last Group Name Last name of the Physician or the full name of a provider organization First Name First name of the Physician Note that provider organizations such as Tower Radiology will not have first names Specialty Primary specialty of the physician or provider organization Value defaults to None Selected which means that the search will not be restricted to a Provider specialty Searches can be li
38. r Claim Inquiry window Field Name Field Description Company ID Select Company ID Click on arrow to select from drop down list The listing contains multiple company identifications usually with its acronym followed by its full name Patient Name Last First Patient associated with the claim or encounter Note that all of the name field components do not have to be filled out Partial values can be entered For example a Last Name field containing Smith and a First Name field containing J will return all records the user is authorized to view whose ast name starts with Smith and whose first name starts with a J Page 26 of 33 Claims Inquiry and Submission EZ NET 5 2 User Manual Field Name Provider Name Last First Claim Claim Number Status Service Date From To Provider Patient ID Hospital Patient ID Medical Record Provider Claim Field Description Unless the user has special access privileges this field will be a pick list containing an alphabetized list of all providers for whom the user has access privileges If the user does have special privileges the Provider Name field will consist of three fields open to user entry Last Group Name First Name and Middle Name NOTE If a pick list is displayed it defaults to All Allowed which does NOT mean all physicians and providers in the system All Allowed extends the search to all user accessible phy
39. rch Results window as shown above Eligibility Member Information Member Information Company ID CFHE Member Hame SMITHAARON A Sex hd DOB 06031974 Age 32 9255 yrs Member ID J00F 597420000 Relation ta Sub Address PO BOM 2391 CityiStZip IDYLLWILD CA 92549 Member Benefit Information Health Plan BLUE SHIELD OF CALIFORNIA Benefit Plan D0AH Benefits Ter med Benefits Effective 0901 2006 Benefit Category WA Co Pay iA Co Insurance WA Additional Benefit Search Category WA Primary Care Provider Information PCP Name SMITH DAWID wi Prowider ID Shc Specialty INTERNAL MEDICINE Phone 64943 9273 Fax a 89899 8794 PCP Effective 9 2006 PCP Termination Authorization History Member Details window The Member Details can be printed by clicking on the browser s Print button Member Eligibility Inquiry Page 15 of 33 EZ CAP From the Member Information window above view detail of the member s PCP by clicking on the PCP Name in red text in the Primary Care Provider Information section The Provider Detail window displays Provider Details Provider ID SMID Company ID CFHC Name SMITH DAVID i Class SPECIALIST Practice Group UCSD MEDICAL GROUP Group ID UC12 Street 200 WEST ARBOR DR Specialty INTERNAL MEDICINE Street 2 City State Zip SAN DIEGO CA 92103 Contract Effective 1 1 2004 Phone 6193543 8273 Contract Term Fax 88336539 8731 Contact Assigned Members Health Plan Affiliat
40. sicians and providers Unique identification number assigned to a claim encounter by the payer not the rendering provider The Claim Number has a format of YYYYMMDDNNNSSSSS the breakdown of which iS YYYY Year of entry MM Month of entry DD Day of entry NNN Number identifying source of entry SSSSS Sequence number entered by source for entry date A minimum of 6 digits must be entered Partial identification numbers can be entered For example specifying a value of 200403 will return all claims and encounters having identification numbers starting with that value Processing status of the claim or encounter Value defaults to None Selected which means that the search will not be restricted to a specific claim status Searches can be limited to a specific claim status by selecting it from the dropdown list Earliest and latest dates of service for which to include transactions in the search results Dates must be entered in MM DD YY or MM DD YYYY format NOTE Entering a date in the From field and leaving the To field blank will include all claims from the specified date to the current date Patient identification number assigned to the patient by the rendering Provider and submitted by that provider with the claim or encounter Patient identification number assigned to the patient by an Institutional provider and submitted by that provider with the claim or encounter Medical record identification
41. unesstccscceusaceaselegaieess ENEA a 4 EZ NET Benefits to Business PartnerS s sssssssssrrssrrssrrrnnrrrrrrnnrrenrrsnnrnnnnrnennrnnnrnnnae 4 VSO NGV Ga UO orrn O E A 5 LOG D enearo E EEEE O E E RST 5 EOT O ar E E E E EE 6 Requesting Access to the System sssssssssssrsnsrrunnnsrenrnnsnenenrrnsnennunrnsnsnnrnenennenrnne 6 CONGACTING US eee E EEEE E E 7 EDECANES 7 KNOW VOU Data cscsigontecceassapcsaauntessubsaeamiasine pin ugedsamameas anes eE a EE 7 SOL ol ee eer ree eee oT eer tT Ce err TT TT TT TT Terr er TT rrr errr rrr ree rr rrr 8 System R f rent S cicnsscescancisrcsuecinvnccecienseeviecesineeearcsureucssasenss O Procedure Reference Codes ssssssnsnsrnenunnnnnnnnnrnrunnnnnnnnnnnsnnnsnnnnuunsnnnnnnnnnnnnnnnnsannnnnnnn 9 Diagnosis Reference CodeS s ssssssssssnsnnrnnrsnnsnnrenrennennrnnrsnnsnnrenrsnnernrnnrnenrennsnnrrnrrnnn 9 Place of Service Referenc COdES sursmorisiasranni onei a a ane 9 CPT Modifier Reference CodeS sssssussnrnnanssunnnnnrnnunennnsnnnnnnnnnnnnnnnnnnnrnnaunnnnnnnnnnnannnan 9 Cona ROO CE a r A E E E AEAEE EA r NE 10 CRET aR 11 Provider INGUITY siicsiintcsstdescecextviensicdersnciemnicensenionninsneinminemnen 2b Displaying Additional Provider Information sssssssesssrerrsrrerrrrerrsrrnrrnrerrerrnrerrerrerre 13 CRAP ee ain A 14 Member Eligibility TNQulry cccssscccccnnsccccccnnnsesccsncnsssccssnesesess LO Viewing a Member s Authorization HiStOry sssssssssnnnnnnnnnnn
42. verview EZ NET 5 2 User Manual View member authorization history Check status of claim encounter information PCPs can access and print assigned member lists Look up procedure codes diagnosis codes and other general reference information M 2 2 2 Provide a contact list of key office personnel for problem resolution System Navigation Basic system navigation functions such as logging into and out of the system requesting access etc are described in the following subsections Log In Depending on your set up from Internet Explorer i e URL EZ NET Server URL bring up EZ NET in Internet Explorer The pre login window is shown below Home Providers Member Eligibility Authorizations Inquiry EZ NET Inquiry VERSION 5 2 Submission Claims Processing Presented By Access Batches Report Batches Submitter Services Eligibility Inquiry Inquiry 270 y Response 271 F Submission Claims Enrollment Status 834 upload 834 download EZ Link Elig Upld sea tee MZI HealthCare Response 277 Institutional Claims DISCLAIMER OF WARRANTIES YOU EXPRESSLY AGREE THAT YOUR USE OF THE SITE IS AT YOUR SOLE RISK THE SITE AND ALL INFORMATION ON THIS SITE ARE PROVIDED AS IS ON AN AS AVAILABLE 837 upload BASIS WITHOUT WARRANTY OF ANY KIND EITHER EXPRESS OR IMPLIED ALL WARRANTIES ARE HEREBY DISCLAIMED INCLUDING BUT NOT LIMITED TO THE IMPLIED WARRANTIES OF MERCHANTABILITY 837 download AND FITNESS FOR A PARTICULAR PU
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