Slide 2 MO HealthNet Internet Provider Training Program
Presented by the Provider Education Unit MO HealthNet Division 1
Slide 3 Proper Completion of the Online Medicare Part B Crossover
Claim Presented by the Provider Education Unit MO HealthNet
Division 2 Slide 4 To file a claim go to the Internet Web site
www.emomed.com and log on under the appropriate NPI and Taxonomy
code, if applicable for the claim to be submitted. Enter your user
ID and Password. This will bring up the eProvider Home Page. At the
top of each page is a Help button in the form of a question mark.
You can print out field-by-field instructions. www.emomed.com MO
HealthNet Division3 Slide 5 4 CLAIM MANAGEMENT Slide 6 MO HealthNet
Division5 NEW XOVER CLAIM Slide 7 MO HealthNet Division6 MEDICARE
CMS-1500 PART B PROFESSIONAL Slide 8 Participant DCNParticipant
Last NameParticipant First Name Patient Account NumberParticipant
Medicare ID (HIC) 7MO HealthNet Division Slide 9 Participant
DCNParticipant Last NameParticipant First Name Patient Account
NumberParticipant Medicare ID (HIC) 8MO HealthNet Division Slide 10
Participant DCNParticipant Last NameParticipant First Name Patient
Account NumberParticipant Medicare ID (HIC) 9MO HealthNet Division
Slide 11 Participant DCNParticipant Last NameParticipant First Name
Patient Account NumberParticipant Medicare ID (HIC) 10MO HealthNet
Division Slide 12 Participant DCNParticipant Last NameParticipant
First Name Patient Account NumberParticipant Medicare ID (HIC) 11MO
HealthNet Division Slide 13 12 Medicare Provider NPIHospitalization
Dates Save Claim HeaderDiagnosis Codes Slide 14 MO HealthNet
Division13 Medicare Provider NPIHospitalization Dates Save Claim
HeaderDiagnosis Codes Slide 15 MO HealthNet Division14 Medicare
Provider NPIHospitalization Dates Save Claim HeaderDiagnosis Codes
Slide 16 MO HealthNet Division15 Medicare Provider
NPIHospitalization Dates Save Claim HeaderDiagnosis Codes Slide 17
MO HealthNet Division16 Dates of ServicePlace of Service Procedure
CodeModifiers Slide 18 MO HealthNet Division17 Dates of
ServicePlace of Service Procedure CodeModifiers Slide 19 MO
HealthNet Division18 Dates of ServicePlace of Service Procedure
CodeModifiers Slide 20 MO HealthNet Division19 Dates of
ServicePlace of Service Procedure CodeModifiers Slide 21 MO
HealthNet Division20 National Drug CodeDecimal Quantity Diagnosis
Code Billed Charges Days/Units Billed Slide 22 MO HealthNet
Division21 National Drug CodeDecimal Quantity Diagnosis Code Billed
Charges Days/Units Billed Slide 23 MO HealthNet Division22 National
Drug CodeDecimal Quantity Diagnosis Code Billed Charges Days/Units
Billed Slide 24 MO HealthNet Division23 National Drug CodeDecimal
Quantity Diagnosis Code Billed Charges Days/Units Billed Slide 25
MO HealthNet Division24 National Drug CodeDecimal Quantity
Diagnosis Code Billed Charges Days/Units Billed Slide 26 MO
HealthNet Division25 Paid Amount Performing Provider NPI Save
Detail Line to Claim Slide 27 MO HealthNet Division26 Paid Amount
Performing Provider NPI Save Detail Line to Claim Slide 28 MO
HealthNet Division27 Paid Amount Performing Provider NPI Save
Detail Line to Claim Slide 29 MO HealthNet Division28 Dates of
Service Place of Service Procedure CodeModifiers Slide 30 MO
HealthNet Division29 Dates of Service Place of Service Procedure
CodeModifiers Slide 31 MO HealthNet Division30 Dates of Service
Place of Service Procedure CodeModifiers Slide 32 MO HealthNet
Division31 Dates of Service Place of Service Procedure
CodeModifiers Slide 33 MO HealthNet Division32 Diagnosis CodeBilled
ChargesDays/Units Billed Paid AmountPerforming Provider NPI Save
Detail Line to Claim Slide 34 MO HealthNet Division33 Diagnosis
CodeBilled ChargesDays/Units Billed Paid AmountPerforming Provider
NPI Save Detail Line to Claim Slide 35 MO HealthNet Division34
Diagnosis CodeBilled ChargesDays/Units Billed Paid AmountPerforming
Provider NPI Save Detail Line to Claim Slide 36 MO HealthNet
Division35 Diagnosis CodeBilled ChargesDays/Units Billed Paid
AmountPerforming Provider NPI Save Detail Line to Claim Slide 37 MO
HealthNet Division36 Diagnosis CodeBilled ChargesDays/Units Billed
Paid AmountPerforming Provider NPI Save Detail Line to Claim Slide
38 MO HealthNet Division37 Diagnosis CodeBilled ChargesDays/Units
Billed Paid AmountPerforming Provider NPI Save Detail Line to Claim
Slide 39 MO HealthNet Division38 Filing Indicator Other Payer
IDOther Payer NamePaid Date Slide 40 MO HealthNet Division39 Filing
Indicator Other Payer IDOther Payer NamePaid Date Slide 41 MO
HealthNet Division40 Filing Indicator Other Payer IDOther Payer
NamePaid Date Slide 42 MO HealthNet Division41 Filing Indicator
Other Payer IDOther Payer NamePaid Date Slide 43 MO HealthNet
Division42 Paid AmountTotal Denied AmountRemittance Advice Remark
Codes Save Other Payer Data and Manage Codes Slide 44 MO HealthNet
Division43 Paid AmountTotal Denied AmountRemittance Advice Remark
Codes Save Other Payer Data and Manage Codes Slide 45 MO HealthNet
Division44 Paid AmountTotal Denied AmountRemittance Advice Remark
Codes Save Other Payer Data and Manage Codes Slide 46 MO HealthNet
Division45 Paid AmountTotal Denied AmountRemittance Advice Remark
Codes Save Other Payer Data and Manage Codes Slide 47 MO HealthNet
Division46 Associated Line Items Claim Group CodeClaim Adjustment
Reason Code Adjustment Amount Slide 48 MO HealthNet Division47
Associated Line Items Claim Group CodeClaim Adjustment Reason Code
Adjustment Amount Slide 49 MO HealthNet Division48 Associated Line
Items Claim Group CodeClaim Adjustment Reason Code Adjustment
Amount Slide 50 MO HealthNet Division49 Associated Line Items Claim
Group CodeClaim Adjustment Reason Code Adjustment Amount Slide 51
MO HealthNet Division50 Claim Group CodeClaim Adjustment Reason
Code Adjustment Amount Slide 52 MO HealthNet Division51 Claim Group
CodeClaim Adjustment Reason Code Adjustment Amount Slide 53 MO
HealthNet Division52 Claim Group CodeClaim Adjustment Reason Code
Adjustment Amount Slide 54 MO HealthNet Division53 Claim Group
CodeClaim Adjustment Reason Code Adjustment Amount Slide 55 MO
HealthNet Division54 Claim Group CodeClaim Adjustment Reason Code
Adjustment Amount Slide 56 MO HealthNet Division55 Claim Group
CodeClaim Adjustment Reason Code Adjustment Amount Slide 57 MO
HealthNet Division56 Claim Group CodeClaim Adjustment Reason Code
Adjustment AmountSave Codes to Other Payer Slide 58 MO HealthNet
Division57 Associated Line Items Claim Group CodeClaim Adjustment
Reason Code Adjustment Amount Slide 59 MO HealthNet Division58
Associated Line Items Claim Group CodeClaim Adjustment Reason Code
Adjustment Amount Slide 60 MO HealthNet Division59 Associated Line
Items Claim Group CodeClaim Adjustment Reason Code Adjustment
Amount Slide 61 MO HealthNet Division60 Associated Line Items Claim
Group CodeClaim Adjustment Reason Code Adjustment Amount Slide 62
MO HealthNet Division61 Claim Group CodeClaim Adjustment Reason
Code Adjustment Amount Slide 63 MO HealthNet Division62 Claim Group
CodeClaim Adjustment Reason Code Adjustment Amount Slide 64 MO
HealthNet Division63 Claim Group CodeClaim Adjustment Reason Code
Adjustment Amount Slide 65 MO HealthNet Division64 Claim Group
CodeClaim Adjustment Reason Code Adjustment AmountSave Codes to
Other Payer Slide 66 MO HealthNet Division65 Save Other Payer to
Claim Slide 67 MO HealthNet Division66 Submit Claim Slide 68 MO
HealthNet Division67 Filing Indicator Other Payer IDOther Payer
NamePaid Date Slide 69 MO HealthNet Division68 Filing Indicator
Other Payer IDOther Payer NamePaid Date Slide 70 MO HealthNet
Division69 Filing Indicator Other Payer IDOther Payer NamePaid Date
Slide 71 MO HealthNet Division70 Filing Indicator Other Payer
IDOther Payer NamePaid Date Slide 72 MO HealthNet Division71 Paid
AmountTotal Denied Amount Save Other Payer Data and Manage Codes
Slide 73 MO HealthNet Division72 Paid AmountTotal Denied Amount
Save Other Payer Data and Manage Codes Slide 74 MO HealthNet
Division73 Paid AmountTotal Denied Amount Save Other Payer Data and
Manage Codes Slide 75 MO HealthNet Division74 Associated Line Items
Claim Group CodeClaim Adjustment Reason Code Adjustment Amount
Slide 76 MO HealthNet Division75 Associated Line Items Claim Group
CodeClaim Adjustment Reason Code Adjustment Amount Slide 77 MO
HealthNet Division76 Associated Line Items Claim Group CodeClaim
Adjustment Reason Code Adjustment Amount Slide 78 MO HealthNet
Division77 Associated Line Items Claim Group CodeClaim Adjustment
Reason Code Adjustment Amount Slide 79 MO HealthNet Division78
Claim Group CodeClaim Adjustment Reason Code Adjustment Amount
Slide 80 MO HealthNet Division79 Claim Group CodeClaim Adjustment
Reason Code Adjustment Amount Slide 81 MO HealthNet Division80
Claim Group CodeClaim Adjustment Reason Code Adjustment Amount
Slide 82 MO HealthNet Division81 Claim Group CodeClaim Adjustment
Reason Code Adjustment Amount Slide 83 MO HealthNet Division82
Claim Group CodeClaim Adjustment Reason Code Adjustment Amount
Slide 84 MO HealthNet Division83 Claim Group CodeClaim Adjustment
Reason Code Adjustment Amount Slide 85 MO HealthNet Division84
Claim Group CodeClaim Adjustment Reason Code Adjustment Amount Save
Codes to Other Payer Slide 86 MO HealthNet Division85 Associates
Line Items Claim Group Code Claim Adjustment Reason Code Adjustment
Amount Slide 87 MO HealthNet Division86 Associates Line Items Claim
Group Code Claim Adjustment Reason Code Adjustment Amount Slide 88
MO HealthNet Division87 Associates Line Items Claim Group Code
Claim Adjustment Reason Code Adjustment Amount Slide 89 MO
HealthNet Division88 Associates Line Items Claim Group Code Claim
Adjustment Reason Code Adjustment Amount Slide 90 MO HealthNet
Division89 Claim Group Code Claim Adjustment Reason Code Adjustment
Amount Slide 91 MO HealthNet Division90 Claim Group Code Claim
Adjustment Reason Code Adjustment Amount Slide 92 MO HealthNet
Division91 Claim Group Code Claim Adjustment Reason Code Adjustment
Amount Slide 93 MO HealthNet Division92 Claim Group Code Claim
Adjustment Reason Code Adjustment Amount Slide 94 MO HealthNet
Division93 Claim Group Code Claim Adjustment Reason Code Adjustment
Amount Slide 95 MO HealthNet Division94 Claim Group Code Claim
Adjustment Reason Code Adjustment Amount Slide 96 MO HealthNet
Division95 Claim Group Code Claim Adjustment Reason Code Adjustment
AmountSave Codes to Other Payer Slide 97 MO HealthNet Division96
Save Other Payer to Claim Slide 98 MO HealthNet Division97 Submit
Claim Slide 99 MO HealthNet Division98 Claim ReceivedCopy
ClaimPayment DetailsPrinter Friendly Slide 100 MO HealthNet
Division99 Claim ReceivedCopy ClaimPayment DetailsPrinter Friendly
Slide 101 MO HealthNet Division100 Claim ReceivedCopy ClaimPayment
DetailsPrinter Friendly Slide 102 MO HealthNet Division101 Claim
ReceivedCopy ClaimPayment DetailsPrinter Friendly Slide 103 MO
HealthNet Division102 Claim Status New ClaimFinish Slide 104 MO
HealthNet Division103 Claim Status New ClaimFinish Slide 105 Thank
you again for participating in this training program. If you have
questions regarding the information in this presentation, please
contact the Provider Education Unit at 573-751-6683. MO HealthNet
Division104
