Michigan Medicaid on BCBSM web-DENIS Eligibility Requests and Responses.

Michigan Medicaid on BCBSM web-DENIS

Eligibility Requests and Responses

Agenda

• Web-DENIS Information

• Review of the Process

• Medicaid on web-DENIS Functionality

• How to access web-DENIS

• Web-DENIS Examples

Web-DENIS Information:• Collaborative effort between BCBSM and MDCH.• Internet based eligibility verification system.• Available to Medicaid Providers free of charge

(Participating and Non-Participating BC/BS providers)

• Participating BC/BS Providers are already familiar with using web-DENIS.

The Process

``BCBSM web-DENIS MDCHMPHI Database

Provider Site

270 Request

271 Response Eligibility Files

Internet

Medicaid on web-DENIS Functionality• User can submit single request or roster request (up to

10 requests at one time).• Single Date of Service is entered but user receives

eligibility for the entire month.• Provides the following eligibility information:

- Medicaid (Title XIX) - Coverage not active- ABW - Pending Eligibility- MOMS - Third Party Liability (TPL)- CSHCS (Title V) - Dental Information

• Coming in July – MIChild eligibility.

How to access web-DENIS

• Providers need to go to the BC/BS website at www.BCBSM.com .• Then click on the ‘Provider’ tab (See the next slide for an example).

How to access web-DENIS

Login Screen (See next slide for an example):

• Current web-DENIS users can enter their user ID and password on this screen • Information on how to obtain access to web-DENIS is also available for providers on this screen.

How to access web-DENIS

Welcome Providers Screen (See next slide for an example).

• Click on the ‘web-DENIS’ link in the left column. • Links to the MDCH website are also available on this

screen for Medicaid Providers.

How to access web-DENIS

Welcome to web-DENIS screen (See next slide for an example):

• Click on the ‘Subscriber Information’ link listed on this screen.

How to access web-DENIS

Subscriber Information Screen (See next slide for an example):

• Click on ‘Eligibility/Coverage/COB’ link on this screen (See the next slide)

How to access web-DENIS

Eligibility Coverage Screen (See next slide for an example):

• Enter the Beneficiary ID in the ‘Contract Number’ field (this can be left blank).

• Then click on the ‘Medicaid’ radio button and then click on the ‘Enter’ button.

How to access web-DENIS Eligibility Benefit Inquiry Screen (See next slide for an

example):

• Enter the Beneficiary ID. If you do not have the Beneficiary ID, you may search using the Beneficiary Last Name, First Name, and Date of Birth.

• Choose your Medicaid Provider Type from the drop down list and then enter in your Provider ID into the input fields as labeled.

• Enter the date of service that you are inquiring on. (The entire month of eligibility information will be returned to you.)

• Click on ‘Enter’ to begin your search.

Example # 1

• Eligibility Response: Beneficiary with Fee for Service Medicaid (See next Slide).

Example # 2

• Eligibility Response: Beneficiary with No coverage (See next slide).

Example # 3

• Eligibility Response: Beneficiary enrolled in A Medicaid Health Plan (See next slide).

Example # 4

• Eligibility Response: Beneficiary enrolled in An ABW County Health Plan (See next slide).

Questions

• Contact Provider Inquiry at 1-800-292-2550 or e-mail [email protected] .

• Technical Problems, contact BCBSM at 1-877-BLUE-WEB (1-877-258-3932).