Provider Portal User Manual

Transcription

1 1 Provider Portal User Manual To gain access to the MNS Provider Portal, you must contact your Account Representative. If you are unsure of your assigned Account Representative, please call x 5. Once you are granted access to the portal, you will receive a link to register and once you register, you will save to your favorites. The login screen will look like the below: If your organization is an individual entity, you will see the below screen: 1

2 2 If your organization has multiple facilities, you will see the below screen: 2

3 3 You can click on an individual facility to the data for each facility. 3

4 4 Tabs The tabs located at the top will navigate you through the system: Home Screen The home screen will provide a plethora of information. Current Census: o Products with Charges: This indicates the census for products in which MNS knows the charges prior to receipt of the facility claim. o Products without charges: These will show the census days in which MNS is not aware of the actual charges until a facility claim is received. Claim Summary: o Awaiting Facility Claim: The claims in this category represent claims where MNS will need a copy of the facility claim before the claim can be submitted to the payer. o Awaiting Facility Verification: The claims in this category represent claims where the facility can verify online that they agree to the charges and covered days listed. These claims can be validated online and our system will automatically bill the payer. o Awaiting Payor Payment: These claims have been billed to the payer and are awaiting receipt of the payer s payment. o Reviewing Facility Claim: These claims are being reviewed for possible issues with the facility claim. o Processing Facility Payment: These claims are in the process of being vouchered and paid to the provider. Any of these items can be clicked on and the claims for each category will be listed. 4

5 5 Messages: o This area will contain pertinent messages to your organization, as well as the claim verification section. (You may also verify these claims in the services tab). Click on the check mark next to the patient s name and date of service to get the verification box: 5

6 6 Fill out the approved area with a YES or NO. o If yes, fill in your total charges. Claims indicated yes, will be automatically billed to the payer electronically. o If No, please provide a comment in the reason section. Claims indicated with a no will be submitted to an Account Representative for proper handling. o Once complete, click Save & Next or Save. Membership: o This are show the membership information MNS has on file for your facility: 6

7 7 Cases Screen This area shows current census and post discharge patients. Case Profile Screen This section will give you the ability to do a global case search for any patient that has ever gone through Management and Network Services, LLC. Services Screen This screen is the second place you can go to verify claims. 7

8 8 Payments Screen This section will show all payments made. You are able to click on the payment number and view the EOB for each payment. A sample of the EOB is below: JIM STACK (Self) 07/01/ /31/2012 Reference No: Claim ID: A Received: 08/02/12 Member W Member: JOHN STACK ID: Group USA Group Number: Name: Product: Aetna Diagnosis: ; 72887; 4019 SUBMITTED NEGOTIATED PATIENT OTHER CHARGES CHARGES RESP ADJUST PRIOR PAID AMOUNT 6, , (250.00) $2, Remarks: 1 - Partial payment, balance outstanding 8

9 9 Profile Screen The profile screen houses all pertinent information for the provider such as the contact information, addresses, credentials, survey items, compliance information, and last survey information. If you need to make changes to any of the items on the profile, click on the notify MNS of updates. This will open your preferred editor and you can send an of the changes needed. Additionally, the facility profile indicates what contracts are held by the provider as well as the levels of care and specialties the facilities offer along with any accreditations. 9

10 10 If you click on a contracted payer, you will see the services associated with this service along with the rates and effective dates. 10

11 11 Status of Claims To see the status of a claim, either search for a patient on the case profile tab, or from the cases tab. This will show you the patient s demographic, admission and discharge, insurance information and benefits. To see claim details, click on the paper icon next to the patient s name: Once you click on the claims icon, you will see the below screen: 11

12 12 This will give you pertinent information regarding claims for this patient such as paid date, received date, charges, patient responsibility, adjustments, payments, and the current balance. If you have questions regarding your claim(s), you can reach your assigned Account Representative from the home screen: If you click on the blue link, this will bring up your preferred editor and you can proceed to send an to your assigned Account Representative, or you may call the number beneath their name and reach them via telephone. EFT Enrollment Once logged into the portal as an administrator, go to the profile tab, and click actions: 12

13 13 Here you will either set up an enrollment, update enrollment, or cancel enrollment. Enrollment will be reviewed and approved within 24 hours. The bank verification process will take up to 7 days. All payments will continue to come via manual check until verification is complete. MNS will be listed in the description details from the bank along with a unique identifier. The unique check number can be searched on the provider portal for its associated explanation of payment. 837 and PDF claim uploads Once logged into the portal, you will go to the tab named, claim uploads. To submit a file, simply click on upload 837 or upload PDF. Once a file is chosen from your desktop or network drive, click upload. Once the file has been submitted, you will be able to view the date, filename, and status of the documents in the portal under the claim upload section: 13

14 14 Should any issues arise, please contact your assigned account representative for assistance. 14

15 15 Forms Tab Overview Under the forms tab, you will find a variety of forms MNS uses for patient placement, updates, payor notifications, and more. You can click on the hyperlinks to download a copy to your computer. 15