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MO HealthNet Internet Provider Training Program Presented by the Provider Education Unit

MO HealthNet Internet Provider Training Program Presented by the Provider Education Unit MO HealthNet Division. Proper Completion of the Online Outpatient Claim. Presented by the Provider Education Unit MO HealthNet Division.

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MO HealthNet Internet Provider Training Program Presented by the Provider Education Unit

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  1. MO HealthNet Internet Provider Training Program Presented by the Provider Education Unit MO HealthNet Division Mo HealthNet Division

  2. Proper Completion of the Online Outpatient Claim Presented by the Provider Education Unit MO HealthNet Division Mo HealthNet Division

  3. To file a claim go to the Internet Web site www.emomed.com and log on under the appropriate NPI and Taxonomy code, if applicable for the claim to be submitted. This will bring up the eProvider Home Page. At the top of each page is a “Help” button in the form of a question mark. You can print out field-by-field instructions. Mo HealthNet Division

  4. Mo HealthNet Division

  5. Mo HealthNet Division

  6. Mo HealthNet Division

  7. Participant Information 01010101 Mo HealthNet Division

  8. Participant Information PATIENT Mo HealthNet Division

  9. Participant Information IMA Mo HealthNet Division

  10. Participant Information Mo HealthNet Division

  11. Service Information M200000000 NOTE: BOXES IN GRAY ARE NOT REQUIRED FIELDS FOR THIS CLAIM Mo HealthNet Division

  12. Service Information 1-Emergency NOTE: BOXES IN GRAY ARE NOT REQUIRED FIELDS FOR THIS CLAIM Mo HealthNet Division

  13. Code Details 8820 E8490 4019 Mo HealthNet Division

  14. Code Details AJ – Payer Responsible for Co-payment NOTE: WHEN BILLING 1-EMERGENCY ADMIT TYPE A CONDITION CODE AJ MUST BE ENTERED TO EXEMPT THE PARTICIPANT FROM THE COST SHARING AMOUNT FOR THE SERVICE Mo HealthNet Division

  15. Save Claim Header Information Mo HealthNet Division

  16. Detail Line Information 11/15/2012 Mo HealthNet Division

  17. Detail Line Information NOTE: WHEN BILLING A FACILITY SUPPLY CODE (0260, 0270, AND 0274) THE PROCEDURE CODE AND MODIFIERS FIELDS ARE LEFT BLANK Mo HealthNet Division

  18. Detail Line Information 0270 Mo HealthNet Division

  19. Detail Line Information 250.00 Mo HealthNet Division

  20. Detail Line Information 1 NOTE: WHEN BILLING A FACILITY SUPPLY CODE (0260, 0270, AND 0274) THE DAY/UNITS FIELD SHOULD BE “1” Mo HealthNet Division

  21. Detail Line Information Mo HealthNet Division

  22. Detail Line Information Mo HealthNet Division

  23. Detail Line Information Mo HealthNet Division

  24. Detail Line Information Mo HealthNet Division

  25. Detail Line Information 11/15/2012 Mo HealthNet Division

  26. Detail Line Information 85025 Mo HealthNet Division

  27. Detail Line Information 0305 Mo HealthNet Division

  28. Detail Line Information 75.00 Mo HealthNet Division

  29. Detail Line Information 1 Mo HealthNet Division

  30. Detail Line Information Mo HealthNet Division

  31. Detail Line Information 11/15/2012 Mo HealthNet Division

  32. Detail Line Information 12002 Mo HealthNet Division

  33. Detail Line Information NOTE: FOR REPORTING LINE THE MODIFIERS FIELDS SHOULD BE LEFT BLANK Mo HealthNet Division

  34. Detail Line Information 0361 Mo HealthNet Division

  35. Detail Line Information 0.00 Mo HealthNet Division

  36. Detail Line Information 1 Mo HealthNet Division

  37. Detail Line Information Mo HealthNet Division

  38. Detail Line Information 11/15/2012 Mo HealthNet Division

  39. Detail Line Information NOTE: WHEN ENTERING A FACILITY REVENUE CODE (0450, 0459, 0490, AND 0510) THE PROCEDURE CODE AND MODIFERS FIELDS ARE LEFT BLANK Mo HealthNet Division

  40. Detail Line Information 0459 Mo HealthNet Division

  41. Detail Line Information 400.00 Mo HealthNet Division

  42. Detail Line Information 1 NOTE: WHEN BILLING A FACILITY REVENUE CODE (0450, 0459, 0490, AND 0510) THE DAY/UNITS FIELD SHOULD BE “1” Mo HealthNet Division

  43. Detail Line Information Mo HealthNet Division

  44. Other Payer Information Mo HealthNet Division

  45. Other Payer Information Mo HealthNet Division

  46. Other Payer Information 1 Mo HealthNet Division

  47. Other Payer Information ABC INSURANCE CO Mo HealthNet Division

  48. Other Payer Information 11/26/2012 Mo HealthNet Division

  49. Other Payer Information 325.00 Mo HealthNet Division

  50. Other Payer Information 0.00 Mo HealthNet Division

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