OptumInsight Training – Provider/Client5010 837P PO BOX SolutionHEC Manage Provider Information Changes: Billing Provider Address and Pay-To AddressJanuary 3, 2012

Proprietary and Confidential. Do not distribute. 2

Purpose of Training Document (Provider/Client):

• What is the purpose the Billing Provider/Pay-To Address Training Document?

– To provide OptumInsight’s Providers and Clients with a full understanding of the upcoming changes to the Health-e Claim Manage Provider Information screens.

– To provide OptumInsight’s new and existing Health-e Claims submitters with the detailed instructions on how they can make the required changes or updates to their Billing Provider Address within Manage Provider Information.

• Required if currently using a post office box or lockbox as their Billing Provider Address.

– Will include:

• Step-by-step instructions on how to make these necessary changes.

• Screen-shots of Manage Provider Information screen changes.

Proprietary and Confidential. Do not distribute. 3

Summary of the Manage Provider Information Changes:

• Why is the Billing Provider Address changing within the OptumInsight Health-e Claim Manage Provider Information?

– The adoption of 5010 standards has required many changes, including to the transactions that are a part of the HIPAA regulation.

• One of the most impactful changes that the industry is working through as part of this adoption is the requirement that the Billing Provider Address (2010AA) submitted on a claim be a physical (street) address.

• Once 5010 is implemented with each health plan, Providers can no longer submit a post office box or lockbox as the Billing Provider Address (2010AA). Claims submitted in this manner WILL REJECT.

• However, Providers can submit the post office box or lockbox for payment or correspondence in the Pay-to Address (2010AB).

– For Health-e Claim submitters, which would include Direct Data Entry and Print Image submitters, OptumInsight has developed a solution that includes an update to the Health-e Network Services Manage Provider Information section.

• This change includes adding a Pay-To Address under the Billing Provider.

• As a result of this solution, organizations will be able set up both a Billing Address and a Pay-to Address.

• The Delivery Date of this solution into the OptumInsight Production environment is 01/26/2012.

Proprietary and Confidential. Do not distribute. 4

Getting Started:

• Go to: http://www.enshealth.com

• Select “Client Access Login”.

Proprietary and Confidential. Do not distribute. 5

Getting Started (cont.):

• Log into the OptumInsight (ENS Health) Medical Claims Center.

– This will require the Client / User / S&S Tech to Login as the OptumInsight Submitter.

Proprietary and Confidential. Do not distribute. 6

Getting Started (cont.):

• Once on the Health-e Network Services home page:

– Select “Manage Provider Information”.

Proprietary and Confidential. Do not distribute. 7

How to change the Billing Provider Address:

• Once the Manage Provider Information screen is visible:

– Locate the Billing Address in question (PO BOX in Address column).

– Select “Edit”.

Proprietary and Confidential. Do not distribute. 8

How to change the Billing Provider Address (cont.):

• NOTE: The Billing Address screen displays a PO BOX in the Address 1* field in the Billing Address section. This MUST be changed (claims will reject).

Proprietary and Confidential. Do not distribute. 9

How to change the Billing Provider Address (cont.):

• Step 1 (Remove Billing Provider Address) :

– Delete the PO BOX information from the Billing Provider Address 1 field.

– Delete City (if physical address City is different).

– Delete Zip Code (if physical address Zip Code is different).

Proprietary and Confidential. Do not distribute. 10

How to change the Billing Provider Address (cont.):

• Step 2 (Change/Enter Billing Provider Address): – Enter the Physical Street Address into the Address 1 field.

– Enter the City.

– Enter the Zip Code.

Proprietary and Confidential. Do not distribute. 11

How to change the Billing Provider Address (cont.):

• Step 3 (Enter Pay-To Address – PO BOX): – Enter the original PO BOX information into the Address 1 field.

– Enter the City.

– Select State from State drop-down field.

– Enter the Zip Code.

Proprietary and Confidential. Do not distribute. 12

How to change the Billing Provider Address (cont.):

• Step 4 (Verify Billing Address and Pay-To Address):

– Verify all details entered on the screen are correct.

– If correct, Select “Save”.

Proprietary and Confidential. Do not distribute. 13

How to change the Billing Provider Address (cont.):

• Step 5 (Final):

– Once Billing Provider and Pay-To Provider Addresses have been saved, you should see the following screen.

– Select “Manage Provider Information”.

Proprietary and Confidential. Do not distribute. 14

How to change the Billing Provider Address (cont.):

• Once the Manage Provider Information screen is visible:

– Locate the Billing Address in question.

• NOTE: The physical street address is now visible in the Address column. Address change is now complete.

– At this point, claims submitted via Health-e Network will now go out to the payer with the physical street address in the 2100AA Loop, and the Pay-To Provider PO BOX address in the 2100AB Loop.

Thank You.

For additional 5010 information:

http://www.ingenix.com/hipaa-5010/clearinghouse-readiness/