There is a report in TherapyMate that will make billing your Optum Medicaid claims easier when using ProviderConnect NX.
There are some Practice and Client's settings that need to be done prior to creating the report. Please follow the instruction below.
Practice Settings
1. Add "Medicaid-Optum" or equivalent as an insurance provider to your Insurance Companies and Other Provider settings if you haven't already done so. This is done by the System Administrator or Assistant System Administrator for the Practice.
2. Create a new Insurance Billing Method called "Medicaid". This must be done by the System Administrator or Assistant System Administrator for the Practice from the main settings page for the Practice.
This completes the Practice setting changes.
Client Settings
1. Configuring a Client's Insurance Billing Settings using the following instructions:
- Set their Billing Method to "Medicaid"
- Enter the client's ProviderConnect Medicaid number in the Insured's ID box
- Enter the client's Medicaid ID number in the Insured's Group or Feca Number box for reference
- The relationship to the insured should be Self
- Specify the date of birth, gender and address information
This completes the billing settings for the client.
Creating a Report
At this point, we assume that the clients have been scheduled correctly, a diagnosis assigned and a session note created. To create a report do the following:
1. Login to TherapyMate and go to the main Billing tab on the blue menu bar.
2. Click on the Billing Service Reports tab.
3. Click on the Report Type dropdown and choose Procedure Report
4. Select the Clinician or All Clinicians from the dropdown as desired
5. Select Medicaid as the Billing Method dropdown.
Your report will appear similar to the one below.
The report will list all of the Optum Medicaid claims that have not been submitted yet.
When you're satisfied with the report, click Save button. This will change the status of the invoices from Pending to Submitted. Once this occurs, these same session dates will not appear again in future reports. You can now print a copy to paper or save the Procedure Report as a PDF to your computer. You will need a saved copy of this report when you enter the claims in ProviderConnectNX.
ProviderConnect NX
Login to ProviderConnect NX and start entering your claims into the Fast Service Entry Submission screen. Type in the Insured's ID number into the highlighted box from the Procedures Report to quickly and easily locate a patient. Complete the rest of the information for the client. Make sure the Copy Data On Add is checked as Yes if you're billing for more than one client at a time. This will reduce the need to re-type a lot of the information into the window and speed up the process of entering claims.
When done with this patient add another client and keep going until all of the clients on the Procedure Report have been entered. If you have questions about entering claims refer to your Optum ProviderConnect NX training manual.
Review and Submit your claims when you have them all entered.