OHIO HEALTH PLANS MEDICAID – ODJFS Online

Text Preview:
Provider
       Detailed IVR User Guide

      OHIO HEALTH PLANS
           MEDICAID
INTERACTIVE VOICE RESPONSE SYSTEM




               1-800-686-1516
           http://jfs.ohio.gov/ohp




                                     April 19, 2007
                                                     TABLE OF CONTENTS


IVR OVERVIEW............................................................................................................................................ 3
PROVIDER PIN RESPONSIBILITY ............................................................................................................. 3
LOGIN MENU ............................................................................................................................................... 4
    CHANGE TEMPORARY PIN........................................................................................................................... 5
    HOW TO RESET YOUR PIN .......................................................................................................................... 5
MAIN MENU ................................................................................................................................................. 6
    CONSUMER ELIGIBILITY ( OPTION 1 ) ............................................................................................................ 6
    CLAIM STATUS ( OPTION 2 ) ......................................................................................................................... 7
    PAYMENT STATUS ( OPTION 3 ) .................................................................................................................... 8
    PRIOR AUTHORIZATION ( OPTION 4 )............................................................................................................. 8
    PROVIDER INFORMATION ( OPTION 5 ) .......................................................................................................... 8
    DRUG AND PROCEDURE PLAN COVERAGE, REIMBURSEMENT INFORMATION, ASSISTANCE WITH PLAN POLICY,
    OR BILLING QUESTIONS ( OPTION 6 ) ............................................................................................................ 9
    FOR PIN ADMINISTRATION  PROVIDERS ONLY ( OPTION 7 ) .......................................................................... 9
HOSPICE SERVICE SPAN ENTRY COMPONENT (HOSPICE PROVIDER OPTION ONLY)................. 11




                                                                         Page 2
IVR Overview

The Ohio Medicaid Interactive Voice Response System ( IVR ) provides 24-hour, 7-day a week
access to information regarding client eligibility, claim status, payment status, prior
authorization, drug and procedure code, and provider information.

A Personal Identification Number ( PIN ) is now required to access client eligibility, claim status,
payment status, prior authorization, and provider information. PINs are 4 digits numeric ( 0-9 ),
and do not include the * or # symbols. The first time a Medicaid Provider calls the IVR, the
system will require the caller to enter a temporary PIN which is the last 4 digits of their
state reported Social Security Number ( SSN ) or Employer Identification Number ( EIN ).

Billing Entities or Trading Partners, who are not Medicaid Providers, must be authorized to
access IVR protected information. Ohio Medicaid Providers are responsible for authorizing each
Billing Entity or Trading Partner's access. A Billing Entity or Trading Partner is defined as "those
business partners contracted with Providers to access protected health information". Once the
Provider has authorized the Billing Entity or Trading Partner's access, the Billing Entity
or Trading Partner will be required to enter a temporary PIN, which is the last 4 digits of
their EIN/SSN.

Each Provider and each Billing Entity or Trading Partner will have a unique PIN. All staff within
each respective organization can use the PIN.

When you call the IVR, you will be asked if you are a Provider, a Billing Entity or Trading
Partner. Providers will be required to logon to the IVR using their Provider number and their
PIN. Once the Provider has authorized the Billing Entity or Trading Partner's access, they will be
required to log on to the IVR using their entire Billing Entity or Trading Partner's Employee
Identification Number ( EIN ) or Social Security Number ( SSN ) and PIN.

All callers will have access to the following information without entering a PIN:
          Drug and procedure plan coverage
          Reimbursement information
          Plan policy or billing questions
          Requesting new or status on a Medicaid application
          Verify EIN on record
          Provider training information


Provider PIN Responsibility

Providers are responsible for granting and maintaining IVR access for their Billing Entities or
Trading Partners. Before a Billing Entity or Trading Partner can use the IVR, you must set up
their access. Providers are responsible for resetting a PIN for a Billing Entity or Trading Partner
and deleting their access (if/when you change your Billing Entity or Trading Partner).




                                              Page 3
Billing Entities or Trading Partners will access the IVR system with their EIN or SSN and their
PIN. You are responsible to obtain the Billing Entity or Trading Partner's EIN/SSN in order to set
up their access. Once you have set up a Billing Entity or Trading Partner, you need to provide
them with the temporary PIN that the system will assign.

Remember, you are responsible for the integrity of your Provider PIN and that the Billing Entities
or Trading Partners you have contracted to protect the integrity of the access you have granted
them.

Providers must login to the IVR system using the pay to Provider number (and corresponding
PIN) submitted on their claim.


Login Menu

If you are familiar with the menu options, you may enter your selection at anytime. At each
menu, you may press the # key to return to the previous menu or press 9 to end the call. When
the IVR is directing the Provider to make a selection, it will be shown in italics.

 For instructions in English:                   Select option 1

 For instructions in Spanish:                   Select option 2

 If you are a Provider:                         Select option 1

 If you are a Billing Entity or Trading
 Partner and need to access information on      Select option 2
 multiple Providers:

 To login with your PIN or establish a PIN:     Select option 1

                                                Select option 2 (if this is your first time
 If you do not know your PIN or to reset a
                                                calling the IVR, please see the selection
 PIN:
                                                entitled : Change Temporary PIN)

 For drug and procedure plan coverage,
 reimbursement information or assistance        Select option 3
 with plan policy or billing questions:

 To request a Provider enrollment
 application, check the status of an existing
 application, or to update or verify your       Select option 4
 Provider information, including your state-
 reported EIN and enrollment status:

 For Provider Training information:             Select option 5


 If you are a Provider and selected option 1    Enter your 7 digit Ohio Medicaid Provider
 from the Login menu:                           Number. You will then be prompted to enter
                                                your 4 digit PIN.

You will be taken to the Main Menu.




                                                Page 4
Change Temporary PIN


 For instructions in English:                 Select option 1

 For instructions in Spanish:                 Select option 2

 If you are a Provider:                       Select option 1

 If you are a Billing Entity or Trading
 Partner and need to access information on    Select option 2
 multiple Providers:

 To login with your PIN or establish a PIN:   Select option 1


      Enter your 7 digit Ohio Medicaid Provider Number.
      Enter your temporary PIN (the last 4 digits of your state reported EIN/SSN on
       record).
      Enter a new 4 digit numeric PIN (must be 0-9, no * or #).
      Enter the new 4 digit PIN that you selected for confirmation.

You will be taken to the Main Menu.

How to Reset Your PIN

Providers must reset their PIN by calling the IVR. The PIN will be reset to a temporary PIN,
which is the last 4 digits of the Provider's State reported EIN/SSN.

 After you have selected option 1 for         Select option 2 to reset your PIN.
 Providers from the login menu:


      Enter your 7 digit Provider number.
      Enter your 9 digit EIN/SSN.

 If the IVR repeats the correct number
                                              Select option 1
 entered:
 To re-enter the EIN/SSN:                     Select option 2

      The IVR will say, "The PIN has been reset for Provider ID (speak the Provider ID you
       entered). The temporary PIN for this Provider has been set to the last 4 digits of the
       Provider's EIN/SSN. When the Provider logs into the system for the first time, they will
       be forced to change their PIN."

You will be taken to the Main Menu.




                                              Page 5
Download Link:
Share Link: Forum Link:

More on Health

  • Picture: English Language Arts and Mathematics Tests Preliminary

    English Language Arts and Mathematics Tests Preliminary

    File Size: 387.45 KB, Pages: 6, Views: 40,760 views

    English Language Arts and Mathematics Tests Preliminary Results Spring 2015 Administration Highlights The new Ohio State Tests in English language arts and mathematics were administered for the first time during the 2014-2015 school year. These tests were produced by the Partnership for Assessment of Readiness …
  • Picture: Medicare & Reimbursement Advisor Weekly - HCPro

    Medicare & Reimbursement Advisor Weekly – HCPro

    File Size: 292.11 KB, Pages: 6, Views: 46,767 views

    Medicare & Critical insight for Reimbursement managed markets Advisor Weekly professionals 1 2 3 Contents | Survey snapshot | Reporter's notebook | Contact us 4 5 6 Infusion reimbursement drop would shift Medicare July 15th, 2009 Vol. 5 No. 23 patients to hospitals In this …
  • Picture: Employment Application - Cummins

    Employment Application – Cummins

    File Size: 206.80 KB, Pages: 6, Views: 3,863 views

    Employment Application Cummins Location: Today's Date: Reviewed By: Date available to start work: Print name in full: LAST FIRST MIDDLE Social Security No.: Salary expected: Present address: City: State & Zip Code: Previous addresses over the past 10 years: Email address: Phone No. & Area …
  • Picture: Live your life, enjoy your life

    Live your life, enjoy your life

    File Size: 9,988.82 KB, Pages: 9, Views: 2,279 views

    Live your life, enjoy your life A guide to using your health plan In a hurry? Pages 45 shows where to find your medical plan information online quickly at myuhc.com. Welcome We're glad you're here. While no one can predict t the future, , you …
  • Picture: Fetal Pig Dissection Lab - Quia

    Fetal Pig Dissection Lab – Quia

    File Size: 807.23 KB, Pages: 11, Views: 5,561 views

    Fetal Pig Dissection Labs Dr. J. Lim Objective: In this exercise you will examine the organization of the many body systems studied this semester in the context of a single specimen, the fetal pig. Be sure to identify the major organs as you explore the …

Leave a Reply

Your email address will not be published. Required fields are marked *