Web Portal Fundamentals

Welcome to the Web Portal Fundamentals course.

Table of Contents

Welcome
Submit a Provider Enrollment Application
Modify Provider Demographic Information
Verify Recipient Eligibility
Submit a Prior Authorization Request
Search for a Prior Authorization
Void a Prior Authorization
Assign Agent Roles
Modify Agent Role Assignments
Remove an Agent and Associated Role Assignments
Set a Default Provider
Switch from One Provider to Another
Submit a Trading Partner Enrollment Application
Modify Trading Partner Demographic Information
Conclusion

Welcome

Overview

The goal of this course is to provide you with the skills and knowledge necessary to use the Ohio MITS (Medicaid Information Technology System) public Portal and secure Portal for your role as a provider, agent, or trading partner.

Prerequisites

Before taking this training, you must have completed these courses:

  • MITS Overview for Providers
  • Navigating the MITS Web Portal

Objectives

After completing this course, you should be able to:

  • Submit a provider enrollment application
  • Modify provider demographic information
  • Verify recipient eligibility
  • Submit a prior authorization request
  • Search for a prior authorization
  • Void a prior authorization
  • Assign agent roles
  • Modify agent role assignments
  • Remove an agent and associated role assignments
  • Set a default provider
  • Switch from one provider to another
  • Submit a trading partner enrollment application
  • Modify trading partner demographic information

Note: Some of the practice exercises for the secure Portal show the super user header instead of the header designed for your role as a provider, agent, or trading partner. When you log on to the Portal to perform your own tasks, the header will reflect the appropriate options for your role. The super user header contains more menu items than you will see for your role.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Submit a Provider Enrollment Application

Overview

In this topic, you learn how to submit a provider enrollment application. A provider enrollment application is the first step in being able to manage claims through Ohio MITS.

Who

Only providers can submit provider enrollment applications.

When

You must submit a provider enrollment application to obtain a logon ID and password to access the secure Ohio MITS Portal for providers.

Relevance

When you enroll as an Ohio MITS provider, you can use self-service tools to perform activities such as:

  • Processing claims and prior authorizations
  • Updating demographic information
  • Assigning agent roles

Requirements

To submit a provider enrollment application, you must have this information:

  • NPI (National Provider Identification) number
  • SSN or FEIN (Federal Employer Identification Number)
  • License number
  • Tax ID
  • Other items as needed based on the type of enrollment

Required fields are marked with an asterisk in the online enrollment wizard.

Guidelines

When you submit a provider enrollment application, these guidelines can help:

  • Follow the instructions in the Enrolling Provider Checklists by Request Type document before and after you submit your online enrollment application. You can access this document from the first page of the enrollment wizard.
  • Write down the ATN (Application Tracking Number) when the number displays. It is helpful to use this number as a reference if you contact ODJFS with any questions about your application.
  • If you have more than one address, you can add up to four addresses.
  • Use the bread-crumb links at the top of the wizard pages to go to previous pages instead of clicking Previous multiple times.
  • Click Next to save information as you proceed through the wizard—there is no Save button on the pages.
  • If you are an individual provider, you do not need to enter group information.
  • You do not need to use parentheses or dashes for phone numbers; when you tab off a field, the system completes the punctuation.
  • Click the Help question mark at the upper-right corner of the wizard pages to obtain more information about the pages.

How To

Follow these steps from the ODJFS Home page to submit a provider enrollment application:

Step

Action

1

Click Ohio Medicaid.

Note: The Welcome to Ohio Medicaid page displays.

2

Click anywhere in the Providers section. (There are no individual links.)

Note: The Welcome Providers page displays.

3

Click Provider Enrollment in the Enrollment and Support section.

Note: The provider-enrollment wizard displays.

4

Click Checklist in the second paragraph.

Note: The Enrolling Provider Checklists by Request Type document displays.

5

Follow the instructions in the Enrolling Provider Checklists by Request Typedocument to prepare for using the provider-enrollment wizard.

6

Click New Application at the bottom-right of the provider-enrollment wizard.

7

Follow the steps in the wizard until you have submitted your enrollment application successfully.

8

Follow the instructions in the Enrolling Provider Checklists by Request Typedocument for the next steps in the enrollment process.

Success

You have successfully completed this task when the wizard Confirmation of Receipt page displays with the ATN for your enrollment application and you have followed the instructions in the Enrolling Provider Checklists by Request Type document for the next steps in the enrollment process.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to submit a provider enrollment application.

Ohio Department of Job and Family Services Home page

Welcome to Ohio Medicaid page with the Provider section link highlighted

Welcome Providers page with the Provider Enrollment link highlighted

First page of the enrollment wizard with the new application button highlighted

In this example, the 20 - Physician/Osteopath Individual provider type automatically displays after you click the drop-down arrow. 

When you perform your own enrollment application, you will choose the applicable options on this page that reflect your situation. Depending on what you select here, the following pages of the wizard adjust accordingly. Some provider types have more pages to complete than others. In this example, there are 16 pages in the wizard for an individual practitionerinitial enrollment, and 20 - Physician/Osteopath Individual provider type.

Second page of the enrollment wizard

Request Type page of enrollment wizard with next button highlighted

Identifying Information page of the enrollment wizard

Identifying Information page of the enrollment wizard

Identifying Information page of the enrollment wizard

Identifying Information page of the enrollment wizard

Identifying Information page of the enrollment wizard

Important - The Application Tracking Number (ATN) is necessary for accessing the status of submitted applications and for continuing an application that was not finished. Please write the number down and keep it for your records PRIOR TO EXITING.

In this demonstration, the ATN is 401425. You would click OK to continue with page 4 of the wizard.

Identifying Information page of the enrollment wizard

Tax ID page of the enrollment wizard

Tax ID page of the enrollment wizard with the Name field highlighted

Tax ID page of the enrollment wizard with the Address 1 field highlighted

Tax ID page of the enrollment wizard

Tax ID page of the enrollment wizard with the State drop-down arrow highlighted

Tax ID page of the enrollment wizard with the Phone field highlighted

Tax ID page of the enrollment wizard

Address Information page of the enrollment wizard

Address Information page of the enrollment wizard

Address Information page of the enrollment wizard

Address Information page of the enrollment wizard

Address Information page of the enrollment wizard

Address Information page of the enrollment wizard

Address Information page of the enrollment wizard

Address Information page of the enrollment wizard

Type and Specialty page of the enrollment wizard

Type and Specialty page of the enrollment wizard

Type and Specialty page of the enrollment wizard

Type and Specialty page of the enrollment wizard

Language page of the enrollment wizard with the next button highlighted

Group Affiliations page of the enrollment wizard

Criminal Offense I page of the enrollment wizard

Criminal Offense I page of the enrollment wizard

Criminal Offense II page of the enrollment wizard

Criminal Offense II page of the enrollment wizard

Violations of State or Federal Law page of the enrollment wizard

Violations of State or Federal Law page of the enrollment wizard

Previously Participated page of the enrollment wizard

Previously Participated page of the enrollment wizard

Medicare Sanctions page of the enrollment wizard

Medicare Sanctions page of the enrollment wizard

Certification page of the enrollment wizard

Certification page of the enrollment wizard

Certification page of the enrollment wizard

Certification page of the enrollment wizard

Certification page of the enrollment wizard

Notes page of the enrollment wizard with the submit button highlighted

Confirmation of Receipt page of the enrollment wizard

Confirmation of Receipt page of the enrollment wizard

  1. You would click Ohio Medicaid to go to the Welcome to Ohio Medicaid page to access the enrollment wizard which leads you through the steps to complete and submit a provider enrollment application.
  2. You then click anywhere in the Providers section to go to the Welcome Providers page. (There are no individual links.)
  3. You next click Provider Enrollment.
  4. This is the first page of the enrollment wizard. These instructions describe what you must do to enroll as a provider in MITS. To continue, you would click new application to begin the enrollment process.
  5. For this demonstration, you are an individual practitioner filing for an initial enrollment. Your provider type is 20 - Physician/Osteopath Individual. You would click the Provider Type drop-down arrow to select the provider type.
  6. You would click next to continue the enrollment.
  7. Here you would type your last name in the Individual Last Name field. For thisdemonstration, your last name is Kirk and you own Kirk Family Practice. All other information in the demonstration is based on this fictitious persona.
  8. You would type Barry in the First Name field.

    Identifying Information page of the enrollment wizard

  9. And then type T in the MI field.

    Identifying Information page of the enrollment wizard

  10. You would then click the Ownership Type drop-down arrow to select the type of ownership.
  11. You would continue by typing MD in the Title/Degree field.

    Identifying Information page of the enrollment wizard

  12. Then you would click the Type drop-down arrow to select your ID type--SSN or FEIN.
  13. Now you would type 192419540 in the SSN/FEIN field.

    Identifying Information page of the enrollment wizard

  14. Next, you would click the Gender drop-down arrow to select your gender.
  15. Next, type 11/04/1950 in the Date of Birth field.

    Identifying Information page of the enrollment wizard

  16. Then you would type 1964192400 in the NPI field.

    Identifying Information page of the enrollment wizard

  17. Next, you would type 1954196422 in the License Number field.

    Identifying Information page of the enrollment wizard

  18. For the next entry, you would click the License Type drop-down arrow to select your type of license.
  19. You would type 01/02/1990 in the License Issue Date field.

    Identifying Information page of the enrollment wizard

  20. Finally, you would type 12/31/2055 in the License Expiration Date field.

    Identifying Information page of the enrollment wizard

  21. At this point, you will have finished the first main step in the enrollment wizard. A pop-up window describes the importance of your ATN (Application Tracking Number) as follows:
  22. Then you would click the IRS Tax Type drop-down arrow to select your tax type.
  23. To continue you would type 192419540 in the IRS Tax ID field.

    Tax ID page of the enrollment wizard with the IRS Tax ID field highlighted

  24. Next, you would type Kirk Family Practice in the Name field. This is the name associated with your IRS tax ID.
  25. Next, type 1900 Danner Road in the Address 1 field.
  26. And then type Akron in the City field.

    Tax ID page of the enrollment wizard with the City field highlighted

  27. You would keep going by typing 44301 in the Zip field.

    Tax ID page of the enrollment wizard with the Zip field highlighted

  28. Then you would type 01/02/1990 in the IRS Effective Date field.

    Tax ID page of the enrollment wizard

  29. Next, you would click the W9 Form drop-down arrow to indicate that you have completed a W9 form.
  30. Then you would click the State drop-down arrow to select the state.
  31. Finally, you would type 3055551900 in the Phone field. The system automatically formats the number.
  32. At this point you have completed page 4 of the enrollment wizard. You would click next to proceed to page 5.
  33. Now you would click the Address Type drop-down arrow to select the type of address.
  34. You would now type 1900 Danner Road in the Address 1 field.
  35. You would then type Akron in the City field.

    Address Information page of the enrollment wizard

  36. Next, you would click the County drop-down list to select the county.
  37. The next step would be to click the State drop-down list to select the state.
  38. Now you would type 44301 in the Zip field.

    Address Information page of the enrollment wizard with the Zip field highlighted

  39. You would type barry.kirk@kfp.com in the E-Mail Address field.

    Address Information page of the enrollment wizard

  40. And then you would type Sally Smith in the Contact Name field. This is the main contact name for your location.
  41. Next, type 3055551200 in the Phone 1 field.

    Address Information page of the enrollment wizard

  42. Then you would type 2030 in the Extension field.

    Address Information page of the enrollment wizard

  43. Next you would click the Phone Type drop-down arrow to select the type of phone.
  44. The next step would be to type 3055551245 in the Phone 2 field.

    Address Information page of the enrollment wizard

  45. You would then click the Phone Type drop-down arrow to select the type of phone.
  46. At this phase, you have completed page 5 of the enrollment wizard. When you perform your own enrollment application, you may also click add to display fields in which to provide one or more additional addresses. You would then click next to proceed to page 6.
  47. You would click the Specialty drop-down arrow to select your provider specialty.
  48. You would select the Primary Specialty checkbox to indicate that 215-Pediatric is your primary specialty. When you perform your own enrollment application, you may leave this checkbox deselected as applicable.
  49. Then you would type 203BA0003X in the Primary Taxonomy Code field. When you perform your own enrollment application, you may click Search to search by keywords to find the appropriate taxonomy code for your specialty.
  50. When you reach this panel, you have completed page 6 of the enrollment wizard. For the remaining steps in this demonstration, you are going to accept most of the default settings. You would click next to proceed.
  51. In this demonstration, you are not going to add any languages. When you submit your own enrollment application, you may click add to display fields in which to indicate the language(s) spoken in your office; however, this is not required information to proceed.You would click next to continue.
  52. Here again you are not going to add any group affiliations. When you submit your own enrollment application, you may click add to display fields in which to indicate your group affiliation(s); however, this is not required information to proceed. You would click next to continue.
  53. On this page and the next, you must read questions related to criminal offenses and answer Yes or No as applicable. You would select No for this demonstration. If you answerYes when you perform your own enrollment application, you must complete all of the fields. You may also click add to display fields in which to provide information aboutadditional criminal offenses.
  54. You would then click next to proceed to page 10.
  55. Here you would select No for this demonstration.
  56. To continue, you would click next to proceed to page 11.
  57. On this page, you must read the question related to violations of state or federal law and answer Yes or No as applicable. You would select No for this demonstration. If you answerYes when you perform your own enrollment application, you must complete all of the fields on this page. You may also click add to display fields in which to provide information aboutadditional violations of state or federal law.
  58. Here you would click next to go to page 12.
  59. On this page, you must indicate whether you have ever been issued an Ohio Medicaid provider ID or NPI ID. You would select No for this demonstration. If you answer Yes when you perform your own enrollment application, you must enter your previous ID in the Previous Provider ID field.
  60. You would then click next to proceed to page 13.
  61. On this page, you must read the question related to Medicare sanctions and answer Yes orNo as applicable. You would select No for this demonstration. If you answer Yes when you perform your own enrollment application, you must complete all of the fields on this page. You may also click add to display fields in which to provide information about additionalMedicare sanctions.
  62. Here again, you would click next to go to page 14.
  63. This is the top portion of the Certification page of the enrollment wizard. When you perform your own enrollment application, you must add and edit information as applicable. You would scroll to see the next part of this page.
  64. You would then read the Executive Order Agreement and select the Accept radio button.
  65. On this page, you would read the False Statement Agreement and select the Accept radio button.
  66. When you perform your own enrollment application, you must scroll to read the Ohio Medicaid Provider agreement before you can select the Accept radio button. You would then select the Accept radio button.
  67. Next, you would type Barry Troy Kirk as your full name.

    Certification page of the enrollment wizard

  68. You would then click next to go to page 15.
  69. When you perform your own enrollment application, you may type additional notes in the Notes field; however, the information is not required. Next, you would click submit to submit the enrollment application.
  70. This is the Confirmation of Receipt page. These instructions describe what you must do next when you submit your own provider enrollment application. You would scroll to see the next part of this page.
  71. You would then follow the instructions in the What's Next? section and print two copies of this agreement--one to send by mail to ODJFS and one to keep for your records. Finally, you would click exit at the lower-right of the page.

Summary

In this topic, you learned how to submit a provider enrollment application.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Modify Provider Demographic Information

Overview

In this topic, you learn how to modify provider demographic information. This information includes:

  • Accepting new patients or not (displays in the public Portal)
  • Visible or not in the public directory search
  • Home, mail to, pay to, and service location addresses
  • Phone numbers and email addresses
  • Service languages

Who

Only providers and their designated agents can update provider demographic information.

When

You can update your provider demographic information any time your information changes.

Relevance

By keeping your information current, recipients can obtain accurate data about your practice in the provider directory and ODJFS can have current contact information for you.

How To

Follow these steps to modify provider demographic information:

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Click demographic maintenance.

3

Modify the desired information by following these steps:

TO modify:

THEN:

Whether you are accepting new patients or if your information displays in the public directory search

  1. Click Service Location in the demographic maintenance submenu.
  2. Select either Yes or No in the Accepting New Patients? and Include in Directory Search?drop-down lists as desired.
  3. Click save.

Location addresses, phone numbers, and email addresses

  1. Click Location Name Address in thedemographic maintenance submenu.
  2. Select the appropriate address row in theLocation Name Address panel.
  3. Modify the information as desired.
  4. Click save.

Service language(s)

Note: To add a new language, click add.

  1. Click Service Language in the demographic maintenance submenu.
  2. Select the appropriate row in the Service Language panel.
  3. Modify or add information as desired.
  4. Click save.

Success

You have successfully completed this task when the modifications you made to your demographic information display in the public and secure Portals as applicable.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to modify provider demographic information.

MITS Provider home page

Provider Information panel with Service Location link highlighted

Provider Information panel

Provider Information panel

Provider Information panel with save button highlighted

Provider Information panel with Location Name Address link highlighted

Location Name Address panel with Mail To row highlighted

Location Name Address panel with Address 2 field highlighted

Location Name Address panel with Confirm E-Mail field highlighted

Location Name Address panel with save button highlighted

Location Name Address panel with Service Language link highlighted

Service Language panel with add button highlighted

Service Language panel with Language drop-down arrow highlighted

Service Language panel with the Effective Date field highlighted

Service Language panel with the save button highlighted

  1. This demonstration illustrates how to modify three types of provider demographic information in Ohio MITS. Your fictitious persona is Barry T Kirk, MD and all other information in the demonstration is based on this identity. 

    You begin at your provider Home page that displays after you log on to the secure Portal.Then you would click demographic maintenance to display the submenu options.
  2. Then you would click Service Location to display the Service Location panel in which you may indicate whether you are accepting new patients and if your information displays in the public directory search.
  3. You would click the Accepting New Patients? drop-down arrow to indicate whether you are accepting new patients.
  4. You would then click the Include in Directory Search? drop-down arrow to indicate whether you want your information to display to consumers when they perform a search using the ODJFS online directory.
  5. Next, you would click save.
  6. At this point, you would have successfully updated your service location information. To continue and modify your mailing address you would click Location Name Address.
  7. You would click anywhere in the Mail To row to display the information for editing.
  8. Next, you would type P.O. Box 1768 in the Address 2 field.
  9. And then you would type barry.kirk@kfp.com in the Confirm E-Mail field.
  10. To continue, you would click save.
  11. At this point you would have successfully updated your address information. To continue and modify your service language information you would click Service Language.
  12. Currently, you do not have any service languages in Ohio MITS. You would click add to add a service language.
  13. Next, you would click the Language drop-down arrow to select a service language.
  14. Now you would type 01/02/1990 in the Effective Date field.
  15. When you access your own provider demographic information, you may add additional service languages and modify information as applicable. To modify a service language, you would select the desired row in the Service Language panel, edit the data as applicable, and then click save.

Summary

In this topic, you learned how to modify provider demographic information.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Verify Recipient Eligibility

Overview

In this topic, you learn how to verify recipient eligibility for Ohio Medicaid.

Who

Providers and agents can verify recipient eligibility.

When

You can verify recipient eligibility whenever you want to know if a recipient is eligible for Ohio Medicaid.

Relevance

Being able to verify recipient eligibility helps to prevent you from processing claims for someone who is not eligible for Ohio Medicaid.

Requirements

To verify recipient eligibility, these are the required field combinations for the Eligibility Verification Request panel: Medicaid Billing Number and Birth Date or SSN and Birth Date. The From and To DOS (dates of service) fields default to today's date. You may enter a different date range as applicable, but these fields cannot be blank.

Data is available from the past 36 months based on today's date, and you may search in six-month increments.

Guidelines

When you verify recipient eligibility, remember that a recipient can reside in one county and have eligibility in another.

How To

Follow these steps to verify recipient eligibility:

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Click Eligibility.

3

Click eligibility search

Note: The Eligibility Verification Request panel displays.

4

Type or select information as applicable.

Note: These are the required field combinations for this panel: Medicaid Billing Number and Birth Date or SSN and Birth Date. The From and To DOS (dates of service) fields default to today's date. You may enter a different date range as applicable, but these fields cannot be blank. Data is available from the past 36 months based on today's date, and you may search in six-month increments.

Important Tip: To view information for service limitations, you must type a procedure code in the Procedure Code field.

5

Click search.

Note: The recipient information displays.

Important Tip: The Benefit/Assignment Plan panel lists plans for which the recipient is eligible, along with effective dates and end dates based on the dates of service you chose for the search criteria in the Eligibility Verification Request panel.

Success

You have successfully completed this task when a recipient's eligibility information displays.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to verify recipient eligibility.

Provider home page with Eligibility menu highlighted

Eligibility menu with eligibility search submenu highlighted

Eligibility Verification Request panel

Eligibility Verification Request panel with the Birth Date field highlighted

Eligibility Verification Request panel with the search button highlighted

Important Tip: The Benefit/Assignment Plan panel lists plans for which the recipient is eligible, along with effective dates and end dates based on the dates of service you chose for the search criteria in the Eligibility Verification Request panel.

You would scroll to see the bottom part of this page.

Eligibility Verification Request panel with the search results highlighted

  1. This demonstration illustrates how to verify recipient eligibility so you know if a recipient is eligible for Medicaid assistance. 

    In this demonstration, your fictitious persona is Smitha Patel, MD and all other information is based on this identity. 

    You begin at your provider Home page that displays after you log on to the secure Portal.You would then click Eligibility to display the Eligibility menu options.
  2. You would then click eligibility search to display the Eligibility Verification Request panel. During the next steps, you are going to search for recipient 852996122566Adam Utley.
  3. When you perform your own recipient search, you may search by other fields based on the information you have available. These are the required field combinations for this panel: Medicaid Billing Number and Birth Date or SSN and Birth Date. The From and To DOS (dates of service) fields default to today's date. You may enter a different date range as applicable, but these fields cannot be blank. 

    Data is available from the past 36 months based on today's date, and you may search in six-month increments.

    To continue, you would type 852996122566 in the Medicaid Billing Number field.
  4. Then you would type 03/18/1997 in the Birth Date field.
  5. And then you would click search.
  6. This is the recipient information for Adam Utley.

Summary

In this topic, you learned how to verify recipient eligibility.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Submit a Prior Authorization Request

Overview

In this topic, you learn how to submit a prior authorization (PA) request. You can submit three PA request types:

  • Prior Auth
  • Prior Auth--Hospital
  • Pre-Cert--Hospital

Who

Providers and their designated agents can submit a prior authorization request.

When

Based on the type of prior authorization a patient needs, the answer from ODJFS could arrive the same day or take several days--depending on how complex the case is. Thus, it is important to submit the prior authorization request in time to receive an answer when needed for the patient's condition.

Relevance

Submitting a prior authorization request directly in Ohio MITS can save time for you and the patient.

Guidelines

When you submit a prior authorization request, these guidelines can help:

  • The choice you make in the Assignment Type field determines what is available in the Authorization Type drop-down list: Prior Auth, Prior Auth--Hospital, or Pre-Cert--Hospital.
  • The amount you request to be paid for the procedure may or may not be granted by ODJFS.
  • If a message displays stating you might not need a prior authorization, and you want to proceed, you must select the Ignore checkbox and then click Continue to go to the next panel.

How To

Follow these steps to submit a prior authorization request:

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Click Prior Authorization.

3

Click new.

Note: The Base Information panel displays.

4

Type or select the desired information.

Note: To add a diagnosis code, click add.

5

Click next to proceed to the Line Item panel in which you will enter a procedure code for the PA request.

6

Type or select information as applicable.

7

Click next.

Note: If the service or supply you are requesting might not require prior-authorization approval, a message displays indicating this fact. Either select theIgnore checkbox and click Continue to indicate that you want to ignore the message and proceed with the PA request or pause here to investigate whether a PA is required for the service you are requesting.

8

If you would like to add notes for the PA request, click add and type the desired information; otherwise, proceed directly to Step 9.

9

Click next.

10

If you would like to upload attachments for the PA request, click add and upload the applicable files; otherwise, proceed directly to Step 11.

11

Click save.

Note: A message displays that lists the prior authorization number.

Success

You have successfully completed this task when a confirmation message displays with the prior authorization number.

Next Steps

Check the status of your prior authorization request by searching for the PA number in the Prior Authorization Search panel. See the Search for a Prior Authorization topic for details.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to submit a prior authorization request.

Provider home page with Prior Authorization menu highlighted

Prior Authorization menu with new submenu highlighted

Base Information panel with Assignment drop-down arrow highlighted

Base Information panel with Authorization Type drop-down arrow highlighted

Base Information panel with Medicaid Billing Number field highlighted

Base Information panel with Date of Birth field highlighted

Base Information panel with Contact Name field highlighted

Base Information panel with Contact Number field highlighted

Base Information panel with Contact Extension field highlighted

Base Information panel with the add button highlighted

Base Information panel with the Diagnosis field highlighted

Base Information panel with the next button highlighted

Line Item panel with the ICD-9 Procedure field highlighted

Line Item panel with the next button highlighted

Line Item panel and Message Description window

Line Item panel and Message Description window

Provider Notes panel with the next button highlighted

Attachments panel with the save button highlighted

  1. In this demonstration, your fictitious persona is Smitha Patel, MD and all other information in the demonstration is based on this identity. You begin at your provider Home page that displays after you log on to the secure Portal. To start you would clickPrior Authorization to display the Prior Authorization menu options.
  2. Next, you would click new to display the Base Information panel in which you can submit a prior authorization request. During the next steps, you are going to submit a hospital inpatient PA request for recipient Adam Utley.
  3. To go on, you would click the Assignment drop-down arrow to select the assignment type.
  4. Then you would click the Authorization Type drop-down arrow to select the type of authorization.
  5. Next, you would type 852996122566 in the Medicaid Billing Number field. This is the Medicaid number of the recipient for whom you are submitting a prior authorization request.
  6. Then you would type 03/18/1997 in the Date of Birth field. After you enter the recipient's date of birth, the system automatically displays the recipients's name in the name fields.
  7. Next, you would type Adam Ricci in the Contact Name field. This is the person to contact for any questions related to the PA request.
  8. Next, you would type 6145558909 in the Contact Number field. The system automatically formats the number.
  9. Then you would type 1001 in the Contact Extension field.
  10. You would click add to add a diagnosis code.
  11. Then you would type v422 in the Diagnosis field. When you submit your own prior authorization request, you may click Search to search by keywords to find the appropriate diagnosis code for the PA.
  12. To continue, you would click next to proceed to the Line Item panel in which you will enter a procedure code for the PA request.
  13. You would then type 9962 in the ICD-9 Procedure field. When you submit your own prior authorization request, you may click Search to search by keywords to find the appropriate procedure code for the PA.
  14. You would then click next. When you perform your own PA request, if the service or supply you are requesting does not require prior authorization, a message displays indicating this.
  15. Now you would select the Ignore checkbox to indicate that you want to ignore the message and continue with the PA request. When you submit your own prior authorization request, you may pause here to investigate whether a PA is required for the service you are requesting.
  16. Next, you would click Continue to proceed to the Provider Notes panel.
  17. In this demonstration, you are not going to add any provider notes. When you submit your own prior authorization request, you may click add to display fields in which to add notes related to the PA; however, this is not required information to proceed. You would clicknext to continue to the Attachments panel.
  18. In this demonstration, you are not going to add any attachments. When you submit your own prior authorization request, you may click add to upload files related to the PA; however, this is not required information to proceed. To go on, you would click save to submit the prior authorization request.

Summary

In this topic, you learned how to submit a prior authorization request.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Search for a Prior Authorization

Overview

In this topic, you learn how to search for a prior authorization (PA).

Who

Providers and their designated agents can search for prior authorizations.

When

It is helpful to search for a prior authorization when you want to view its status and other details.

Tip: In addition to viewing information about a prior authorization, you can also perform these tasks from the Base Information panel:

  • Add provider notes and attachments
  • Void the PA
  • Submit a new PA

Relevance

Searching for a prior authorization in the Portal saves you time by not having to obtain information about a PA by calling ODJFS or waiting for a reply by mail.

Guidelines

Depending on the type of search you perform, you either see a list of prior authorizations or a single PA. If a list of PAs displays, you can view an individual prior authorization by selecting the applicable row.

How To

Follow these steps to search for a prior authorization:

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Click Prior Authorization.

3

Click search.

4

Type or select the desired information.

5

Click search.

Note: If you searched by a specific prior authorization number, panels related to that PA display. If you searched by other criteria and a list of PAs displays in the search results, you can view an individual PA by selecting the appropriate row.

6

Scroll among the panels to view information about the prior authorization.

Note: The PA status displays in the Line Item panel. Possible status types are: Pending Review, Pending Additional Information, Approved, and Cancelled.

Success

You have successfully completed this task when the prior authorization search results display.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to search for a prior authorization.

Provider Home page with Prior Authorization menu highlighted

Provider Home page

Prior Authorization Search panel with Prior Authorization field highlighted

Prior Authorization Search panel with search button highlighted

Base Information panel

  1. In this demonstration your fictitious persona is Smitha Patel, MD and all other information in the exercise is based on this identity. You begin at your provider Home page that displays after you log on to the secure Portal. To start, you would click Prior Authorizationto display the Prior Authorization menu options.
  2. Then you would click search to display the Prior Authorization Search panel in which you can search for a prior authorization. During the next steps, you are going to search for PA 4010329004, which is a prior authorization request for recipient Adam Utley.
  3. You would then type 4010329004 in the Prior Authorization field. When you perform your own prior authorization search, you may search by any of the fields applicable to the information you are seeking. If a list of PAs displays in the search results, you can view an individual PA by clicking the appropriate row.
  4. Next, you would click search.
  5. This is the Base Information panel for PA 4010329004Adam Utley. When you view the results of your own PA search, you can add and edit information in this panel as applicable. In this example, the current status is Pending Review. Other possible status types areApprovedCancelled, and Pending Additional Information.

Summary

In this topic, you learned how to search for a prior authorization.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Void a Prior Authorization

Overview

In this topic, you learn how to void a prior authorization (PA).

Who

Providers and their designated agents can void prior authorizations.

When

You can void a prior authorization that is in Pending Review or Pending Additional Information status when you no longer want to pursue approval of the PA.

Relevance

Being able to void a prior authorization prevents you from having unwanted PAs in Ohio MITS and lets you focus on the desired PAs instead.

Guidelines

You can void prior authorizations in Pending Review or Pending Additional Information status only. You cannot void PAs that have other statuses.

When you void a prior authorization, its status changes to Cancelled in the PA Line Item panel and to "C" in the PA Search Results panel.

How To

Follow these steps to void a prior authorization:

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Click Prior Authorization.

3

Click search.

4

Type or select the desired information.

5

Click search.

Note: If you searched by a specific prior authorization number, panels related to that PA display. If you searched by other criteria and a list of PAs displays in the search results, you can view an individual PA by selecting the appropriate row.

6

Click void at the bottom-right of the page.

Note: A confirmation message does not display; instead, all of the fields in the panels become grayed out and unavailable for editing, indicating the void was successful. The Status column in the Line Item panel also changes to Cancelled.

Success

You have successfully completed this task when the Status column in the Line Item panel changes to Cancelled.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to void a prior authorization.

Provider Home page with Prior Authorization menu highlighted

Prior Authorization menu with search link highlighted

Prior Authorization Search panel with the Prior Authorization field highlighted

Prior Authorization Search panel with the search button highlighted

Important Tip: A confirmation message does not display; instead, all of the fields in the panels become grayed out and unavailable for editing, indicating the void was successful.

Base Information panel with the void button highlighted

  1. In this demonstration, your fictitious persona is Smitha Patel, MD and all other information is based on this identity. You begin at your provider Home page that displays after you log on to the secure Portal. To begin, you would click Prior Authorization to display the Prior Authorization menu options.
  2. Then you would click search to display the Prior Authorization Search panel in which you can search for a prior authorization. During the next steps, you are going to search for and void PA 4010329004, which is a prior authorization request for recipient Adam Utley.
  3. You would then type 4010329004 in the Prior Authorization field. When you perform your own prior authorization search, you may search by any of the fields applicable to the information you are seeking. If a list of PAs displays in the search results, you can view an individual PA by clicking the appropriate row.
  4. You would then click search.
  5. Finally, you would click void to void the prior authorization.

Summary

In this topic, you learned how to void a prior authorization.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Assign Agent Roles

Overview

In this topic, you learn how to assign agent roles. As a provider, you can assign one or more agents to perform various functions in Ohio MITS for you. Examples of agents are employees, clerks, and billing entities.

Who

Only providers can assign agent roles.

When

You can assign agent roles whenever you want an agent to perform specific Ohio MITS tasks for you.

Relevance

Being able to assign agent roles allows you to have designated users perform certain tasks for you in Ohio MITS to save you time.

Guidelines

Before you assign an agent to perform tasks for you in Ohio MITS, you must accept an online agreement that states you are obligated to ensure that information provided by the agent is true, accurate, and complete. You must also agree to PHI-related stipulations.

How To

Follow these steps to assign agent roles:

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Click Account.

3

Click agent maintenance.

4

Select the online-agreement checkbox (unlabeled).

Note: You cannot add, modify, or remove agent roles without selecting the checkbox first.

5

Click add agent .

6

Click Search to search for the agent you want to add.

Note: The agent must already be enrolled in Ohio MITS to display in the search results.

7

Select the appropriate row in the search results.

Note: The agent information displays in the User Name, Contact First Name, and Contact Last Name fields in the Agent Maintenance panel.

8

Move the appropriate agent roles from the Available Roles section to the Assigned Roles section.

9

Click submit.

Success

You have successfully completed this task when the appropriate roles have been assigned to the agent you designated.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to assign agent roles.

Provider Home page with Account menu highlighted

Provider Home page with Account menu selected

Note: You cannot add, modify, or remove agent roles without selecting the checkbox first.

Agent Maintenance panel with the agreement checkbox highlighted

Note: You already have Karen Jones as an agent, and you are going to add Fred Johnson as another agent and assign roles to him.

Agent Maintenance panel with the add agent button highlighted

Note: The agent must already be enrolled in Ohio MITS to display in the search results.

Agent Maintenance panel with the Search link highlighted

Agent Maintenance panel with the User Name window

Agent Maintenance panel with the User Name window

Agent Maintenance panel with the User Name window

Agent Maintenance panel with the User Name window and Search Results panel

Agent Maintenance panel showing the Assigned Roles and Available Roles lists

Agent Maintenance panel showing the Assigned Roles and Available Roles lists

Agent Maintenance panel showing the Assigned Roles and Available Roles lists

Agent Maintenance panel showing the Assigned Roles and Available Roles lists

Agent Maintenance panel showing the Assigned Roles and Available Roles lists

Agent Maintenance panel showing the Assigned Roles and Available Roles lists

Agent Maintenance panel showing the Assigned Roles and Available Roles lists

Agent Maintenance panel showing the Assigned Roles and Available Roles lists

Agent Maintenance panel showing the Assigned Roles and Available Roles lists

  1. In this demonstration, your fictitious persona is Anthony Hall, DDS and all other information in the demonstration is based on this identity. You begin at your provider Home page that displays after you log on to the secure Portal. To begin, you would clickAccount to display the Account menu options.
  2. Then you would click agent maintenance to display the Agent Maintenance panel.
  3. Next, you would read the agreement and select the checkbox to proceed.
  4. Then you would click add agent.
  5. You would click Search to search for the agent you want to add.
  6. Then you would type the agent's first name in the First Name field. For thisdemonstration, the agent's first name is Fred.
  7. Next, you would type the agent's last name in the Last Name field. For thisdemonstration, the agent's last name is Johnson.
  8. Next, you would click search.
  9. Then you would click anywhere in the row to add Fred Johnson to the Agent Maintenance panel.
  10. Next, you would select Prior Auth Submit. Now it is time to assign agent roles to Fred Johnson. In this demonstration, you are going to assign four roles to him.
  11. To continue, you would click the arrow to move Prior Auth Submit to the Assigned Rolessection. When you assign your own agent roles, you may click the double arrow (<<) to assign all available roles at one time. You may also move roles from the Assigned Roles section back to the Available Roles section by clicking > or >> as applicable.
  12. You would then select Prior Auth Search.
  13. You would click the arrow to move Prior Auth Search to the Assigned Roles section.
  14. Then you would select Claim Search.
  15. You would click the arrow to move Claim Search to the Assigned Roles section.
  16. Next, you would select Claim Submission.
  17. Then you would click the arrow to move Claim Submission to the Assigned Roles section.
  18. Finally, you would click submit.

Summary

In this topic, you learned how to assign agent roles.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Modify Agent Role Assignments

Overview

In this topic, you learn how to modify agent role assignments to manage the tasks an agent can perform for you as a provider.

Who

Only providers can modify agent role assignments.

When

You must modify agent role assignments when any of these situations occur for the agent:

  • Responsibilities change
  • No longer employed by your practice
  • Does not perform tasks anymore in Ohio MITS

Relevance

Being able to modify agent role assignments helps you to maintain accurate information for representatives who perform Ohio MITS tasks for you.

Requirements

To modify agent role assignments, you must know the first and last name of the agent.

How To

Follow these steps to modify agent role assignments:

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Click Account.

3

Click agent maintenance.

4

Select the online-agreement checkbox (unlabeled).

Note: You cannot modify, add, or remove agent roles without selecting the checkbox first.

5

Select the applicable agent row in the Agent Maintenance panel.

6

Add and remove agent roles as desired in the Available Roles and Assigned Rolessections.

7

Click submit.

Success

You have successfully completed this task when the appropriate roles have been modified for the agent you selected.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to modify agent role assignments.

Provider Home page with Account menu highlighted

Account menu with agent maintenance submenu highlighted

Note: You cannot modify, add, or remove agent roles without selecting the checkbox first.

Account Maintenance panel with the agreement checkbox highlighted

Account Maintenance panel with a row highlighted

Account Maintenance panel with the Assigned Roles and Available Roles lists

Account Maintenance panel with the Assigned Roles and Available Roles lists

Account Maintenance panel with the Assigned Roles and Available Roles lists

Account Maintenance panel with the Assigned Roles and Available Roles lists

Account Maintenance panel with the Assigned Roles and Available Roles lists

Account Maintenance panel with the Assigned Roles and Available Roles lists

Account Maintenance panel with the Assigned Roles and Available Roles lists

  1. In this demonstration, your fictitious persona is Anthony Hall, DDS and all other information is based on this identity. You begin at your provider Home page that displays after you log on to the secure Portal. To begin, you would click Account to display the Account menu options.
  2. Then you would click agent maintenance to display the Agent Maintenance panel.
  3. Next, you would read the agreement and select the checkbox to proceed.
  4. You would then click anywhere in the row to modify Fred Johnson's assigned agent roles.
  5. In this demonstration, you are going to remove two roles and add a new role for him. To do this, you would select Prior Auth Submit.
  6. Then you would click the arrow to remove Prior Auth Submit from the Assigned Rolessection.
  7. Next, you would select Prior Auth Search.
  8. To continue, you would click the arrow to remove Prior Auth Search from the Assigned Roles section.
  9. Then you would select Eligibility.
  10. Next, you would click the arrow to move Eligibility to the Assigned Roles section.
  11. Finally, you would click submit.

Summary

In this topic, you learned how to modify agent role assignments.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Remove an Agent and Associated Role Assignments

Overview

In this topic, you learn how to remove an agent and associated role assignments.

Who

Only providers can remove agents and associated role assignments.

When

You must remove an agent and associated role assignments when the agent no longer performs duties for you using Ohio MITS or does not work for your practice anymore.

Relevance

By removing agents and associated role assignments, you ensure that only agents who perform Ohio MITS tasks for you have access to the system. This increases security and efficiency for your practice.

How To

Follow these steps to remove an agent and associated role assignments:

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Click Account.

3

Click agent maintenance.

4

Select the online-agreement checkbox (unlabeled).

Note: You cannot remove agent roles without selecting the checkbox first.

5

Select the applicable agent row in the Agent Maintenance panel.

6

Click remove agent.

7

Click OK to mark the agent for deletion.

8

Click submit.

Success

You have successfully completed this task when the agent's name no longer displays in the Agent Maintenance panel.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to remove an agent and associated role assignments.

Provider Home page with Account menu highlighted

Account menu with the agent maintenance submenu highlighted

Note: You cannot remove an agent without selecting the checkbox first.

Agent Maintenance panel with the agreement checkbox highlighted

Agent Maintenance panel with a row highlighted

Agent Maintenance panel with the remove agent button highlighted

Agent Maintenance panel with the confirmation window

Agent Maintenance panel with the submit button highlighted

  1. In this demonstration, your fictitious persona is Anthony Hall, DDS and all other information is based on this identity. You begin at your provider Home page that displays after you log on to the secure Portal. To begin, you would click Account to display the Account menu options.
  2. Then you would click agent maintenance to display the Agent Maintenance panel.
  3. Next, you would read the agreement and select the checkbox to proceed.
  4. You would click anywhere in the row to display information for Karen Jones. She is the agent you are going to remove.
  5. Then you would click remove agent.
  6. Next, you would click OK to mark Karen Jones for deletion.
  7. Finally, you would click submit.

Summary

In this topic, you learned how to remove an agent and associated role assignments.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Set a Default Provider

Overview

What

In this topic, you learn how to set a default provider to display after you log on to Ohio MITS.

Who

Only agents can set default providers.

When

It is helpful to set a default provider if you perform tasks in Ohio MITS for multiple providers and you want to save time by having the provider for whom you work more frequently display automatically after you log on.

Relevance

Setting a default provider saves you time and effort if you work for one provider more frequently than others. This way, you do not have to choose from the list of providers that normally displays each time you log on.

How To

Follow the steps below to set a default provider.

Warning: You perform this task only if you are assigned to more than one provider.

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Select the appropriate provider row to display information for that provider.

3

Click set as default.

Note: The Default Provider ID checkboxes throughout this panel are all view-only. You cannot select the checkboxes directly.

Success

You have successfully completed this task when the default provider you selected automatically displays after you log on to Ohio MITS.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to set a default provider. This task only applies if you are assigned to more than one provider.

The purpose of setting a default provider is to cause that provider's information to display automatically the next time you log on to Ohio MITS.

Switch Provider panel with a row highlighted

Important Tip: The Default Provider ID checkboxes throughout this panel are all view-only. You cannot select the checkboxes directly.

Switch Provider panel with the set as default button highlighted

  1. In this demonstration, your fictitious persona is agent Karen Jones, and you have two providers assigned to you. 

    You begin at your agent Home page that displays after you log on to the secure Portal for the first time. If you have more than on provider assigned to you, your default Home page is the Switch Provider panel. If you have only one provider assigned to you, that provider's information displays as your Home page.

    To begin, you would click anywhere in the second row to display information for National Provider ID (NPI) 8297745718. In the next step, you are going to mark this provider as your default provider.
  2. Next, you would click set as default.

Summary

In this topic, you learned how to set a default provider.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Switch from One Provider to Another

Overview

In this topic, you learn how to switch from one provider to another by selecting from a list of providers to whom you are assigned as an agent.

Who

Only agents can switch from one provider to another.

When

It is helpful to switch to another provider when you have tasks to perform for more than one provider in a session.

Relevance

Being able to switch from one provider to another prevents you from needing to log out and back on when you perform tasks for multiple providers during the same session.

How To

Follow the steps below to switch from one provider to another.

Warning: You perform this task only if you are assigned to more than one provider.

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Click Account.

3

Click switch provider.

4

Select the appropriate provider row to display information for that provider.

5

Click switch to.

6

Click OK to confirm that you want to switch to the currently-selected provider.

7

Click Providers to display the provider to whom you just switched.

Success

You have successfully completed this task when a different provider displays in the Provider panel.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to switch from one provider to another. This task only applies if you are assigned to more than one provider.

Agent Home page with Account menu highlighted

Account menu selected with switch provider submenu highlighted

Switch Provider panel with a row highlighted

Switch Provider panel with the switch to button highlighted

Switch Provider panel with the confirmation window and the OK button highlighted

Agent Home page with Providers menu highlighted

  1. In this demonstration, your fictitious persona is agent Karen Jones, and you have two providers assigned to you. 

    You begin at your agent Home page that displays after you log on to the secure Portal. In this demonstration, your default Home page is for the Bay Medical Center, NPI (National Provider ID) 8297745718. To begin, you would click Account to display the Account menu options.
  2. Next, you would click switch provider to display the Switch Provider panel.
  3. Then you would click anywhere in the first row to display information for National Provider ID (NPI) 8702936645.
  4. Then you would click the switch to button.
  5. Next, you would click OK to confirm that you want to switch to the currently-selected provider.
  6. Finally, you would click Providers to display the provider to whom you just switched.

Summary

In this topic, you learned how to switch from one provider to another.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Submit a Trading Partner Enrollment Application

Overview

In this topic, you learn how to submit a trading partner enrollment application.

A trading partner is a healthcare provider, healthcare plan organization, or healthcare clearinghouse that processes claims through EDI (Electronic Data Interchange). EDI is a batch claims process.

Unlike other providers and agents, trading partners work mostly in the public Portal instead of the secure Portal, because the main focus of trading partners is to process claims through EDI instead of through standard panels.

Who

Trading partner enrollment applications can be submitted by any covered entity (CE) that uses electronic transactions in their role as an eligible Medicaid provider for purposes directly related to the administration or provision of medical assistance.

When

You must enroll in Ohio MITS as a trading partner if you want to process claims through EDI.

Relevance

Submitting claims through EDI instead of standard panels is faster and more efficient when you need to process a large volume of claims. EDI creates less paperwork, reduces claims preparation, and does not require postage or other mailing costs.

Requirements

When you submit a trading partner application, you must add these three contact types:

  • Business
  • Secondary
  • Technical

You can use the same person for all three contact types.

Guidelines

You use an enrollment wizard to complete and submit an enrollment application to become a trading partner.

The last page of the wizard provides a confirmation of your application submittal and states what must happen next. It is important to read the page thoroughly and proceed accordingly.

One of the requirements listed on the Confirmation page is to send two completed originals of the Trading Partner Agreement (TPA) form to ODJFS. You can download the form from the Confirmation page.

The TPA is a contract between parties that have chosen to become electronic business partners. The TPA stipulates the general terms and conditions under which the partners agree to exchange information electronically. The document defines these items:

  • Participant roles
  • Communication policies
  • Privacy and security requirements
  • Identification of the electronic documents to be exchanged

The TPA is used by all entities that wish to establish an EDI relationship with the state of Ohio. TPA signature approvals are required prior to testing. EDI production transactions are not allowed until all testing has been completed successfully and a signed TPA has been received by ODJFS. The ODJFS EDI team works with you and your staff to exchange and analyze technical information.

How To

Follow these steps from the ODJFS Home page to submit a trading partner enrollment application:

Step

Action

1

Click Ohio Medicaid.

Note: The Welcome to Ohio Medicaid page displays.

2

Click anywhere in the Providers section. (There are no individual links.)

Note: The Welcome Providers page displays. Information for trading partners is included in the Welcome Providers page.

3

Click Trading Partner Enrollment in the Enrollment and Support section.

Note: The trading-partner-enrollment wizard displays.

4

Click next.

5

Follow the steps in the wizard until you have submitted your enrollment application successfully.

Note: On the Contact Details page, you must add contact details for all three contact types: business, secondary, and technical. The contact information can be the same for all three.

6

Follow the instructions on the Confirmation page for what to do next, such as mailing paperwork to ODJFS.

Success

You have successfully completed this task when the Confirmation page displays with the tracking number for your TPP (Trading Partner Profile).

Next Steps

After ODJFS has approved your application, they will mail this information to you at the address you provided in your application:

  • Letter containing your:
    • Trading Partner Submitter ID
    • Personal Identification Number (PIN)
  • Test package for you to set up your secure Portal account and authorization testing

Follow the instructions in the letter and test package to continue the steps towards becoming an Ohio MITS trading partner.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to submit a trading partner application.

ODJFS Home page with the Ohio Medicaid link highlighted

Note: Information for trading partners is included in the Welcome Providers page.

Welcome to Ohio Medicaid page with Providers link highlighted

Welcome Providers page with Trading Partner Enrollment link highlighted

Enrollment wizard Instructions page with next button highlighted

Trading Partner Information panel

Trading Partner Information panel with the Address Line 1 field highlighted

Trading Partner Information panel with the City field highlighted

Trading Partner Information panel with the State drop-down arrow highlighted

Trading Partner Information panel with the Zip field highlighted

Trading Partner Information panel with the Tax ID field highlighted

Trading Partner Information panel with the next button highlighted

Note: You must add contact details for all three contact types: business, secondary, and technical. The contact information can be the same for all three.

Contact Details panel with the Contact Name field highlighted

Contact Details panel with the Contact Phone field highlighted

Contact Details panel with the Contact Extension field highlighted

Contact Details panel with the Contact Email field highlighted

Contact Details panel with the Secondary contact details row highlighted

Contact Details panel with the Contact Name field highlighted

Contact Details panel with the Contact Phone field highlighted

Contact Details panel with the Contact Extension field highlighted

Contact Details panel with the Contact Email field highlighted

Contact Details panel with the Technical contact details row highlighted

Contact Details panel with the Contact Name field highlighted

Contact Details panel with the Contact Phone field highlighted

Contact Details panel with the Contact Extension field highlighted

Contact Details panel with the Contact Email field highlighted

Contact Details panel with the next button highlighted

Transaction Sets panel

Transaction Sets panel

Transaction Sets panel

Transaction Sets panel

Transaction Sets panel with the next button highlighted

Summary panel with the submit button highlighted

Confirmation page

Bottom of the Confirmation page with the exit button highlighted

  1. In this demonstration, you begin at the ODJFS (Ohio Department of Job and Family Services) Home page and proceed to an enrollment wizard in which you follow the steps needed to complete and submit a trading partner enrollment application. To begin, you would click Ohio Medicaid to go to the Welcome to Ohio Medicaid page.
  2. Then you would click anywhere in the Providers section to go to the Welcome Providers page. (There are no individual links.)
  3. Next, you would click Trading Partner Enrollment.
  4. This is the first page of the enrollment wizard. These instructions describe what you must do to enroll as a trading partner in MITS. You would click next to begin the enrollment process.
  5. Then you would type your trading partner name in the Trading Partner Name field. For this demonstration, your name is Medical Support Enterprises. All other information in the demonstration is based on this fictitious persona.
  6. Then you would type 1920 Erford Road in the Address Line 1 field.
  7. Next, you would type Akron in the City field.
  8. You would click the State drop-down list to select the state.
  9. Then you would type 44301 in the Zip field.
  10. You would type 111233345 in the Tax ID field.
  11. Then you would click next to proceed to the Contact Details page.
  12. You would continue by typing Robert Chase in the Contact Name field. This is the business contact for your company.
  13. Then you would type 3055551234 in the Contact Phone field. The system automatically formats the number.
  14. You would then type 8820 in the Contact Extension field.
  15. You would type robert.chase@mse.com in the Contact Email field.
  16. To go on, you would click anywhere in the Secondary contact details row. After you select the Secondary row, the Business contact row shows the information you entered for Robert Chase and the Secondary contact fields are available for you to type information.
  17. Next, you would type Diane Linus in the Contact Name field. This is the secondary contact for your company.
  18. Then you would type 3055551234 in the Contact Phone field.
  19. You would type 8819 in the Contact Extension field.
  20. You would type diane.linus@mse.com in the Contact Email field.
  21. Next, you would click anywhere in the Technical contact details row. After you select the Technical row, the Secondary contact row shows the information you entered for Diane Linus and the Technical contact fields are available for you to type information.
  22. Then you would type Braden Torres in the Contact Name field. This is the technical contact for your company.
  23. To go on, you would type 3055551234 in the Contact Phone field.
  24. Then you would type 8810 in the Contact Extension field.
  25. Then you would type braden.torres@mse.com in the Contact Email field.
  26. Then you would click next to proceed to the Transaction Sets page.
  27. Next, you would select the 837 Healthcare Claim - Professional checkbox. When you perform your own enrollment application, you may select the checkboxes that apply to the transactions you will be exchanging in Ohio MITS.
  28. Now, you would select the 835 Healthcare Claim Payment/Remittance Advice checkbox.
  29. Then you would select the 270/271 Healthcare Eligibility Benefit Inquiry/Responsecheckbox.
  30. Next, you would select the 276/277 Healthcare Claim Status Inquiry/Responsecheckbox.
  31. You would click next to go to the Summary page.
  32. Next, you would click submit to submit the enrollment application.
  33. This is the Confirmation page. These instructions describe what you must do next when you submit your own trading partner enrollment application.
  34. Finally, you would click exit at the lower-right of the page.

Summary

In this topic, you learned how to submit a trading partner application.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Modify Trading Partner Demographic Information

Overview

In this topic, you learn how to modify trading partner demographic information.

Who

Only trading partners can modify trading partner demographic information.

When

You can modify your demographic information as soon as you have received your logon ID and password from ODJFS.

Relevance

After you are enrolled as an Ohio MITS trading partner, you can modify your demographic information at any time without having to call someone else to make the updates.

Guidelines

When you modify trading partner demographic information, it is helpful to print a copy of what you changed as confirmation in case questions arise in the future.

How To

Follow these steps to update trading partner demographic information:

Step

Action

1

Log on to the secure Portal using the URL and logon information sent to you by ODJFS.

2

Click trading partner profile update.

3

Follow the steps in the wizard to modify information.

Note: You must proceed through each page of the wizard before you can submit changes, but you are not required to modify data on any page. The Transaction Sets page is the only page that is not available for editing.

Success

You have successfully completed this task when the Confirmation page displays stating that your TPP (Trading Partner Profile) has been updated.

Demonstration

The screen illustrations and instructions below provide a demonstration to reinforce the procedures learned in this course.

This demonstration illustrates how to modify trading partner demographic information.

Trading Partner Home page

Profile-update wizard Instructions page with the next button highlighted

Trading Partner Information panel with the Address Line 2 field highlighted

Trading Partner Information panel with the next button highlighted

Contact Details panel with the Phone Extension field button highlighted

Contact Details panel with the Secondary contact details row highlighted

Contact Details panel with the Phone Extension field highlighted

Contact Details panel with the Technical contact details row highlighted

Contact Details panel with the Phone Extension field highlighted

Contact Details panel with the next button highlighted

Transaction Sets panel with the next button highlighted

Summary panel with the submit button highlighted

Confirmation panel with the exit button highlighted

  1. In this demonstration, your fictitious persona is Medical Support Enterprises, and all other information is based on this identity. You begin at your trading partner Home page that displays after you log on to the secure Portal. To begin, you would click trading partner profile update to display the profile-update wizard.
  2. This is the first page of the profile-update wizard. These instructions describe what you must do to update your information, and also provide additional helpful instructions for trading-partner requirements. Here you would click next to go to the Trading Partner Information page.
  3. In this demonstration, you are going to add a second address line. When you perform your own trading partner profile updates, you may add and edit information as applicable to your situation. You must proceed through each page of the wizard before you can submit changes, but you are not required to modify data on any page. To continue, you would type P.O. Box 7500 in the Address Line 2 field.
  4. Then you would click next to go to the Contact Details page.
  5. During the next steps, you are going to add a phone extension number for all three contact types. To go on, you would type 7000 in the Phone Extension field.
  6. Then you would click anywhere in the Secondary row to display the information for editing.
  7. You would type 7001 in the Phone Extension field.
  8. Then you would click anywhere in the Technical row to display the information for editing.
  9. You would type 7002 in the Phone Extension field.
  10. Here you would click next to go to the Transaction Sets page; however, that page cannot be edited.
  11. This page is not available for editing. You would click next to go to the Summary page.
  12. This is the Summary page. These instructions describe what you must do when you make modifications for your own organization. You would click submit to submit the modifications you made.
  13. This is the Confirmation page. These instructions describe what you must do next when you submit your own modifications. To finish this task, you would click exit.

Summary

In this topic, you learned how to modify trading partner demographic information.

You can click here to return to the Table of Contents, or you can continue through this course in the order presented.

Conclusion

Objectives

In this course, you learned how to:

  • Submit a provider enrollment application
  • Modify provider demographic information
  • Verify recipient eligibility
  • Submit a prior authorization request
  • Search for a prior authorization
  • Void a prior authorization
  • Assign agent roles
  • Modify agent role assignments
  • Remove an agent and associated role assignments
  • Set a default provider
  • Switch from one provider to another
  • Submit a trading partner enrollment application
  • Modify trading partner demographic information

This is the end of the course.