Getting Started with EDISS and Total

OnBoarding (TOB)

Teleconference Number: (866) 699-3239

Note: Today's presentation will also be available at www.edissweb.comunder the Workshop section of the Training and Help page in approximately one business week.

2

Housekeeping

Connecting to WebEx.When possible, use a quiet location.Phone line is muted upon login to workshop.Do not place the call on Hold.Identify yourself when asking questions.

3

Intent of EDI Workshops

Interactive learning for providers and the employee’s who work for them. An opportunity for providers to ask any EDI-related questions.An opportunity to see EDI demonstrations.

Getting Started with EDISS and Total

OnBoarding (TOB)

5

Agenda

Getting Started with EDIDefine TOBComponents of TOBTOB AdvantagesSecurityAdded ValueSystem Demonstration

6

Getting Started with EDI

Two Simple Steps!

STEP ONE: Complete registration through Total OnBoarding (TOB)

STEP TWO: Complete the Testing Process (if applicable)

Note: These steps are broken down in detail on the Getting Started with EDI page of www.edissweb.com

7

Step One: Registration through Total OnBoarding (TOB)

Enter basic facility information (e.g., address, contact e-mail, phone number, etc.)TOB requires accurate facility information to be entered upon registration. If any information changes, simply log into TOB and update your profile.Add billing NPIEDISS requires providers to register their billing NPI’s for electronic transactions. Rendering NPI’sare not required in TOB.Add appropriate lines of business (LOB)Any LOB that has electronic transactions must be added to the appropriate NPI. Select desired electronic transactions for their profileDepending on the LOB, EDISS supports multiple electronic transactions. Electronic Claim Submission, Electronic Remittances, Claim Status, and Eligibility Benefit Inquiry are a few of the transactions providers may choose from. Select a HIPAA compliant vendorEDISS defines a vendor as an entity that provides hardware, software and/or ongoing technical support. There are three types of vendors EDISS works with.Complete the Digital Certificate process (if applicable)Users who have a direct transaction that requires testing with EDISS must complete the Identity Validation Form process to obtain a Digital Certificate.

8

What is TOB?A secure URL/web application where providers can register, add, modify, and test electronic transactions A new technology that removes the majority of manual work tied to paper registration and gives submitters complete control of their trading partner profile Allows providers to have the ability to test quickly and identify issues on their own, which provides faster service and reduces calls.

9

TOB Advantages

Easy control/management of user profileDemographicsNPIs, Tax IDsAdding submitters

Cost savings (Administrative and Operational)Real-time registration

Changes to profile are immediate

Email driven notificationsSecurity

10

Security (Digital Certificate)

Proven Track RecordProven model developed by Visionshare Inc. that was approved by CMSMilitary-grade encryption

Various authentication pointsInitial online account creationIdentity Validation & Certificate (IVF)Acts as “ID Card” for access to TOB features

11

Added ValueReal-time testing statusEfficiencies in customer support

Email remindersInstant notifications

Real-time validation of EDI status

Future Enhancements:Scenario based testing suites5010 Trading Partner certification

Cost and resource reduction

12

Step Two: Testing

The testing process verifies the format and structural accuracy of the electronic claim file sent by a Trading Partner. EDISS requires all providers to test their electronic health care claim transactions through TOB before being granted production status. If providers selected a billing service or clearinghouse to do their billing, the billing service or clearinghouse tests through TOB on the provider’s behalf.

13

TOB Registration and Testing vs. Production Claim Submission

14

Testing vs. Production

It is important to note the differences between testing claims and live production claims. TOB is for Testing claims and online registrationonly.Production claims cannot be sent over the internet (TOB). CMS mandates a direct modem to modem connection. Providers are responsible for reviewing reports that are generated from production file submissions.

15

Additional Resources

Visit the Total OnBoarding page of www.edissweb.com to for the additional resources of:User GuideTOB Tutorials

16

System Demonstration

NOTE: If you did not attend the live EDISS workshop for this topic, the next series of slides will be screen shots of what was covered during the live presentation. We recommend that you reference the EDISS TOB User Guide that is found under the Online Registration and Testing header on the Forms page of www.edissweb.com if you have questions. You may also contact EDISS at 800-967-7902 and speak to a Customer Service Specialist.

17

Users in TOBNew users to EDI, (providers or vendors) are not auto loaded into TOB.

The difference between a new user and auto loaded user are:

A new user will:Provide facility information and a contact personEnter in appropriate Billing NPI number(s)

A user will be prompted to complete these steps automatically if they are not auto loaded into TOB.

Create User ID and password for facilityAgree to Visionshare Service AgreementsComplete the Digital Certificate process (if applicable)Take control and build their Provider profile

Select Line of BusinessAssign TransactionsAssign Vendors, if applicable Complete testing, if applicable

Auto loaded users will:Create User ID and password for facilityAgree to Visionshare Service AgreementsComplete the Digital Certificate process (if applicable)Take control and update their Provider profile if necessary

18

The TOB Process for Users

2 Main Login Options

*The Login option is for providers who have already created a TOB profile. Anyone new to TOB will need to create an account.

19

Existing User in TOB

*Provider’s and Vendor’s use the same login page for TOB.

20

Existing Providers or Vendors

If a provider has been previously enrolled with EDISS, their information will be auto loaded into TOB.

The provider will need to verify their Tax Identification Number and EDISS Submitter ID combination in order to access their profile.

A vendor will need to verify a security pass code that will be distributed by EDISS in order to take control of their profile.

21

Existing User Continued…

NOTE: If ‘No’ is selected the Provider will begin as brand new to EDISS, please see Slide 12.

22

Existing User Continued…

NOTE: If ‘No’ is selected the Provider will begin as brand new to EDISS, please see Slide 12.

23

Existing User Continued…

*EDISS recommends that you use your unique submitter id for a User ID*

24

Existing User Continued…(Agreements)

25

Existing User Continued…(IVF)

26

IVF Process

The IVF process relates directly to obtaining a Digital Certificate.

Visionshare requires paperwork to be completed for validation and Digital Certificate assignment.

A Digital Certificate only needs to be obtained by a provider who will be interacting directly with EDISS for transactions.

Vendors who will be testing on the behalf of providers will need to obtain a Digital Certificate.

27

Provider Summary Page

*The Provider Summary page is a overview of your profile, and is where profile management will occur.

28

The Provider Summary page acts as a home base for providers. Within this page providers will have control to:

Manage TestingView Testing ScorecardView Production Options/Status

Manage Profile/FacilityView FormsAdd/Delete/Edit Facility InformationManage LOB’s – Add, Remove, ChangeAdd NPIManage Transactions – Add, Remove, ChangeManage Vendors - Add, Remove, Change

Provider Summary Page Cont.

29

Steps to Building Profile

Add Line of Business (LOB)Manage appropriate LOBsSelect desired transactions for each LOB

Manage VendorsSelect Vendor for applicable transactions

If handling transactions direct, this step will differ.

Submit the Required EDISS formsMultiple forms could be needed if multiple LOB’s are selected.

30

Selecting a Line of Business

*More then one LOB can be selected per NPI/Profile if applicable.

31

Selecting and Adding a Vendor

NOTE: If submitting directly, this process will be omitted by selecting next with a blank search field in the first screen.

32

Selecting Transaction Screen

33

Assigning Transactions to Vendors

34

PC-ACE Pro32 Option

NOTE: The prompt for PC-Ace will only appear if ‘Direct’ is selected as a transmission type.

35

Submitting Required Forms

Note: Enrollment forms are still required to be turned into EDISS for each LOB that applies. They can be downloaded, completed,

and faxed in

36

Submitting a Test File

Test files can be saved anywhere electronically. Users just need to browse to that specific location to complete submission.

37

Test File Results/Scorecard

38

Test File Results/Scorecard Cont.If the “Details” option is selected in the scorecard screen, the provider suite scorecard screen will appear.

Both the Scorecard and Scenarios options will pull open additional screens within the testing profile.

39

Provider Scorecard Details Page

G

O

O

D

B

AD

40

EDISS Analysis Report*The EDISS Analysis Report can be used for viewing the raw electronic data that was sent to EDISS.

Getting Started with Total OnBoarding (TOB)

Question & Answer Session

Thank you for

attending!Getting Started with Total OnBoarding (TOB)

Phone: 1-800-967-7902Fax: 1-877-269-1472

Email: support@edissweb.comWebsite: www.edissweb.com