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MITS Overview for Providers
Welcome to the MITS Overview for Providers course.
MITS Overview for Providers

Welcome

OVERVIEW

Welcome to the MITS Overview for Providers course. The goal of this course is to provide you with basic information to help you understand the history of the Medicaid Information Technology System (MITS), the benefits of using MITS, what you can expect from MITS, as well as how to prepare for using MITS. You will need this information to assist you in your role as a provider using MITS in the state of Ohio.

OBJECTIVES

By the end of this course you should be able to:

  • Identify the benefits of using MITS over the current system of doing business with the state
  • Identify what you can do to prepare yourself and your organization for use of MITS

History of MITS

OVERVIEW

In June 2004, the Centers for Medicare and Medicaid Services (CMS) approved Ohio’s plan for the new Medicaid system and selected Ohio as an early adopter state for their new Medicaid Information Technology System, or MITS. In 2005, the Ohio Department of Job and Family Services (ODJFS) identified approximately 3,000 business requirements that were needed to support the business needs of Ohio’s ever-evolving Medicaid program. In autumn 2007, Electronic Data Systems (HP) was selected to design MITS. By the end of 2010, Ohio Medicaid is requiring providers who bill on paper to use standard claim forms. All other proprietary claim forms for institutional claims are being discontinued and will not be accepted after the December 2010 implementation of the new MITS. If claims are received in any format other than those listed above, the claims will be returned to providers.

What Is MITS?

MITS is a browser-based healthcare administration platform and integrated, streamlined system that supports payers more efficiently, reimburses providers more quickly, and resolves patient claims swiftly and fairly.

Essentially, submitting claims using the new MITS Web Portal is much more effective than submitting claims on paper. With the elimination of paper, money is saved on forms and office supplies. Furthermore, the risk of lost claims and human error is minimized. Billing electronically through the new MITS Web Portal, or Electronic Data Interchange (EDI), has the potential to reduce costs associated with labor, printing, postage, document management, and document storage.

For faster and more accurate claims processing, providers are encouraged to bill electronically using EDI or the secure MITS Web Portal. Both of these options allow your claim to enter directly into the MITS claims processing system, with same-day or real-time acknowledgment of your claim submissions.

RELEVANCE

By understanding the history of MITS, you will be better able to understand why MITS was created and how it can make your job simpler, easier, and more effective.

BENEFITS

One of the main benefits of MITS is the Internet-based, self-service Web Portal. The Web Portal is an interface to MITS and is an important component of MITS. It is probably the most highly visible component of the new system because it can be viewed by the public.

The secure part of the Web Portal will allow you to do most of your work in real time, online via the Internet, with reduced time and effort as well as increased accuracy and effectiveness.

CHECK YOUR UNDERSTANDING

This activity contains questions to assess your understanding of key concepts in this topic.

Each question is followed by the correct answer. Review the topic if your score is below your standards.

Question: MITS stands for Medicaid Information Technology System.
A. True
B. False

Answer: A. True

Question: MITS is not Internet-based.
A. True
B. False

Answer: B. False

SUMMARY

In this topic you learned about:

  • The history of MITS
  • The definition of MITS
  • The benefits of using MITS

Why MITS?

OVERVIEW

The federal government requires the Ohio Department of Job and Family Services (ODJFS) to process Medicaid claims through an automated claim processing system known as the Medicaid Information Technology System (MITS).

The new system also offers many improvements. One of the main improvements is the Internet-based, self-service Web Portal. The secure part of the Web Portal will allow you to complete and submit claims and attachments in real time, track claims, resubmit denied claims, and perform claims adjustments and voids via the Internet.

RELEVANCE

Learning why the change to MITS is being made will make the transition to the new system easier and faster.

WHY CHANGE

You will find that your job will be simpler, easier, and more effective. Paper claims will be a thing of the past and human error will be either greatly reduced or eliminated.

IMPACT ON PROVIDERS

Web billing offers speed and accuracy far superior to a paper claim. Submitting claims electronically typically results in faster claims processing and payments to providers. By eliminating paper claims, you can save money on claim forms, office supplies, printing, postage, the time it takes to complete a paper claim, document management, and document storage.

CHECK YOUR UNDERSTANDING

This activity contains questions to assess your understanding of key concepts in this topic.

Each question is followed by the correct answer. Review the topic if your score is below your standards.

Question: The federal government requires the Ohio Department of Job and Family Services (ODJFS) to process Medicaid claims through an automated claim processing system known as the Medicaid Information Technology System (MITS). 
A. True
B. False

Answer: A. True

Question:  By eliminating paper claims, providers can save money on which of the following items? (Select all that apply.)
A. Printing
B. Nothing
C. Postage
D. Office supplies

Answer: A, C, and D

SUMMARY

In this topic you learned about:

  • Why Ohio is changing to MITS
  • What this change means to you

MITS Changes

OVERVIEW

MITS will give providers many up-to-date features for secure self-service on the Web such as:

  • Viewable client eligibility information
  • Ability to submit claims and prior authorization requests
  • Web-based provider enrollment forms

RELEVANCE

When you change to MITS, you will find that your job becomes easier, and you will also discover that you spend significantly less time than you did when using the old system.

CHANGES TO EXPECT

With MITS you will be able to:

  • Submit claims electronically
  • Perform eligibility verification for recipients
  • Submit prior authorization requests and submit attachments electronically
  • Review current statuses for prior authorizations and claims
  • Electronically enroll to be a provider
  • Assign agents that can perform tasks on your behalf

If you are a long term care provider, you will also be able to request reports and download them from the Web Portal.

If you are a long term care or hospital provider, you will also be able to submit cost reports electronically.

CHECK YOUR UNDERSTANDING

This activity contains questions to assess your understanding of key concepts in this topic.

Each question is followed by the correct answer. Review the topic if your score is below your standards.

Question: With MITS, you will be able to enroll to be a provider electronically.
A. True
B. False

Answer: A. True

Question: MITS will give providers many up-to-date features for secure self-service on the Web such as: (Select all that apply.)
A. Ability to submit claims and prior authorization requests
B. Viewable client eligibility information
C. There will be no changes

Answer: A and B

SUMMARY

In this topic you learned about the changes that you can expect when MITS is implemented.

Web Portal Benefits and Functionality

OVERVIEW

The Web Portal is a real benefit to providers because it saves time and provides immediate access to the system, which in turn means quicker claim submissions and response times.

RELEVANCE

MITS is an easier, self-service system that allows you to increase your effectiveness while reducing the amount of time that it takes to perform your job.

Using the new MITS Web Portal provides the following benefits:

  • There are no mailing costs and claims are processed online in real time.
  • Speed and accuracy are far superior to a paper claim.
  • Turnaround time for paid claims is approximately seven to 10 days, which is faster than if mailed.
  • You will immediately see claim status and correct submission errors rather than waiting a week or more to discover that a claim denied because of data issues.
  • Claims can be submitted, adjusted, copied, voided, or viewed on the new Web Portal (pharmacy claims can only be viewed).
  • Claim attachments, with certain limitations such as X-rays, can be uploaded as electronic files via the new Web Portal.
  • Previously submitted paid claims can be copied and modified for a new submission.
  • Small provider groups can utilize electronic billing with no out-of-pocket cost. Using the MITS Web Portal is free.
  • “Pay To” providers will now be able to bill up to 50 new claims per day.

Following is an example of the MITS portal home page.

  • Click the Consumers link to access consumer information.
  • Click the Providers link to access provider or trading partner information.
  • Click the Resources link to access other helpful resources.

MITS portal home page

BENEFITS AND FUNCTIONALITY

One of the main benefits of MITS is the Internet-based, self-service Web Portal, as shown below. The secure part of the Web Portal will allow you to complete and submit claims and attachments in real time, track claims, resubmit denied claims, and perform claims adjustments and voids via the Internet. The Web Portal is divided into two parts:

  • The Public Portal is a real benefit to recipients, providers, Managed Care Organizations (MCOs), stakeholders, and trading partners because it saves time and puts valuable information right at their finger tips.
  • On the other hand, the Secure Portal requires a higher level of security and a secure sign-on process because of the sensitivity and confidentiality of the information. The Secure Portal is accessible only by providers, MCOs, trading partners, and users who have been authorized and have been issued a unique user name and PIN.
  • The Secure Portal contains information such as recipient eligibility, prior authorization (PA) information, claims information, and so on. The portal interacts directly with other subsystems such as PA and claims or the Ohio Medicaid Management Information System (MMIS) for transaction services that support the submission and retrieval of electronic transactions.

This is an example of the MITS portal Provider home page:

MITS portal Providers home page.

CHECK YOUR UNDERSTANDING

This activity contains questions to assess your understanding of key concepts in this topic.

Each question is followed by the correct answer. Review the topic if your score is below your standards.

Question: The Public Portal requires a sign-on process in order to gain access to the site.
A. True
B. False

Answer: B. False

Question: You will immediately see claim status and correct submission errors rather than waiting a week or more to discover that a claim denied.
A. True
B. False

Answer: A. True

SUMMARY

In this topic you learned about the benefits and functionality of the MITS system.

How to Prepare for MITS

OVERVIEW

Web Portal access is free of charge and designed to be available 24 hours a day, seven days a week, with the exception of minimal down time for maintenance. This ease of access makes it easy to use and also easy to prepare for.

RELEVANCE

By preparing for MITS you will be ready to start using it as soon as the system is available. Preparing now will save you time and also make the system ready to use as soon as you need it.

PREPARATION RECOMMENDATIONS

Preparation is simple and easy. You will need the following:

  • A computer with public Internet access via an Internet Service Provider (ISP)
  • Microsoft Internet Explorer version 6.0 or higher, as well as Firefox
  • A user ID and password for returning users who have already set up their account
  • First Time users can easily enroll on line and will receive a Welcome Letter after acceptance with directions to the Portal website

CHECK YOUR UNDERSTANDING

This activity contains questions to assess your understanding of key concepts in this topic.

Each question is followed by the correct answer. Review the topic if your score is below your standards.

Question: You will need Internet Explorer 6 or higher in order to prepare for MITS.
A. True
B. False

Answer: A. True

Question: Web Portal access is free of charge and designed to be available 24 hours a day, seven days a week, with the exception of minimal down time for maintenance.
A. True
B. False

Answer: A. True

SUMMARY

In this topic you learned about the requirements for preparing to use MITS.

Conclusion

In this course you learned how to:

  • Identify the benefits of using MITS over the current system of doing business with the state
  • Identify what a you can do to prepare yourself and your organization for using MITS

This is the end of the course.