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Frequently Asked Questions
WebPortal FAQ's  

1.  Will we be able to transmit claims using the web portal, i.e., create a file, open web site, attach file, and send rather than using a modem?
     EDI exchange features on the web portal are coming soon, including EDI Upload and EDI Retrieval. Users can upload files in HIPAA-compliant X12 EDI format. Files are then communicated to Envision for processing. Users can also retrieve response files in EDI format from the web site using the EDI Retrieval feature.

2.  Will denial codes appear on the claim status screen?
     Web portal claim status response information includes HIPAA-compliant claim status category codes and claim status codes. These codes indicate the status of the claim (including denied statuses) and include text descriptions explaining the codes.

3.  Can the Master Administrator be edited?
     Yes. The Master Administrator can be edited by the portal administrator for Conduent.

4.  Will a billing company that bills for different providers have to register for web portal use for each provider? Can one ID be used for all providers?
     The billing company will have to be given web portal rights through the provider's web portal administrator. The user will have one login ID; however, as part of the login process the user will be required to select the provider for which provider he or she wishes to log in.

5.  Do you have to be a registered user to access provider enrollment status?
     No. Provider enrollment status can be obtained by entering the application tracking number or the social security number/tax identification number used on the application.

6.  Is web portal password the same as provider password?
     No. You must register yourself with the web portal using the site's Account Registration feature. During registration, you will select your User ID. A password is randomly generated and e-mailed to you. During your first login, you will be forced to change the password to one of your choosing.

7.  Will we be able to inquire as to eligibility of a patient for eye exams and glasses over using the web portal? If not, is this a possibility in the future?
     You can inquire about eligibility using the web portal. You will still need to call Conduent Provider and Beneficiary Services for information regarding service limits on eye exams and eyeglasses.

8.  Is the Master Administrator the same as the User Administrator?
     No. The Master Administrator is the primary person responsible for managing the users for his or her organization. An organization can have up to three Master Administrators. The Master Administrator may, in turn, designate other users with User Administration privileges. Although privileges are similar between a Master Administrator and a User Administrator, the Master Administrator for an organization cannot be deleted, except by an Conduent Administrator.

9.  How many users can a Master Administrator/User Administrator have?
     Each Web portal provider or organization can have up to three Master Administrators; however, when a Master Administrator creates a user, he or she can assign User Administration privileges to that user. The User Administrator may, in turn, create another user and assign that user to have User Administration privileges.

10.  In a group practice with multiple provider numbers, how will we set up the user IDs? We need users to access claim status or eligibility for multiple providers. Will the users have to set up under multiple provider numbers?
     If the group bills using the group provider ID number, only an account for that group provider ID number would need to be created. If the group bills using each provider's individual provider ID as the claim pay-to-provider, an account for each pay-to-provider must be created. The user would need to associated him/herself with each of these provider ID's. During the login process, the user will be required to select which provider he or she wishes to log in for. You may only inquire on claims for which the pay-to-provider ID matches the provider ID associated with your login. Eligibility inquiries are not-provider specific. Any provider may inquire on any beneficiary's eligibility provider he or she is properly logged in and can provide sufficient information to uniquely identify the beneficiary.

11.  On EDI Exchange, what format should be used to upload files?
     All files must be in HIPAA-compliant X12 EDI format. Users should have the ability to generate and process EDI files using a practice management system, electronic claims submission software, etc.

12.  Can the EDI Exchange feature be used for beneficiary eligibility and claims status inquiry?
     Yes. The web portal supports any transaction supported by EDI. The web portal acts solely as a pass-through mechanism for EDI transactions.

13.  On Beneficiary Eligibility response page, what is 'lock-in information'?
     Lock-in indicates that the beneficiary can receive services only from certain providers or only with authorization from that provider.

14.  Will beneficiary information through the web portal show that the beneficiary has Medicare as well as Medicaid?
     Yes. The web portal beneficiary eligibility inquiry response includes information on Medicare Part A and Part B eligibility and third party insurance.

15.  Can patient treatment history or specific codes be checked to see if they have been paid or paid to another provider?
     At this time the web portal does not provide service limit information when eligibility is checked. Please contact Conduent Provider and Beneficiary Services for this information.

16.  If a specific date or date range is entered, will the web portal give a list all claims that have been submitted for that date or date range?
     Yes, if the claim has been entered into the claims processing system. If it is a paper claim, it will not be included if it has not been keyed.

17.  How far back does the web portal go for checking claim status?
     Three years of claims information is available through the web portal.

18.  How are attachments handled in the Web Portal?
     At the bottom of most windows there is an upload attachment function. Once the user browses down on their PC and selects the file to attach, they hit the upload button. The file is then uploaded using the key of the window you are on. For example: if you upload an attachment from a claims window then it will use the TCN for the claim as the key to that document.

19.  How can I inquire upon the status of my Prior Authorization?
     On the Provider Drop Down Menu there is an Inquiry menu. One of the options is PA inquiry. You enter your PA number and then submit and the status of your PA will return.

20.  What type of batch files are we submitting for EDI Exchange?
     The web portal will support the 270, 276, 837I, 837P and 837I transaction sets. The web portal acts solely as a pass-through mechanism for EDI transactions.

21.  Can you enter the group number to get an inquiry transaction for all providers?
     No. The web portal inquiry for claim status will only report claims for the provider number used to submit the claim. If the group number was used, you will get all claims submitted with that group number. If individual provider numbers were used, you will need to enter each provider's individual number. Please note that you may inquire only for the provider ID for which you are logged in.

22.  Is it possible to do a Medicare/Medicaid crossover form on the web portal?
     Yes. When doing claims entry on the Web if you are wanting to do a Medicare Part A claim then select the UB04 option and the first question will ask if this is a Part A claim. If it is then select the 'yes' radio button and continue with entering the claim. However, if you prefer not to enter this information over the web then the crossover forms are on the web site for the Division of Medicaid, and you can enter the information, print and submit the form with the Medicare EOB. The crossover forms can be found at: Go to provider information, select forms for providers, and then click on the form you need to use.

23.  Can we file corrected claims on the web portal when we check claim status and find a denial.
     Yes. You can resubmit the claim via the web portal under the claims options on the Provider drop down menu.