Michigan Medicaid on BCBSM web-DENIS

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Michigan Medicaid on BCBSM web-DENIS

• Eligibility Requests and Responses

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Agenda

• Web-DENIS Information
• Review of the Process
• Medicaid on web-DENIS Functionality
• How to access web-DENIS
• Web-DENIS Examples

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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.

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The Process
Provider Site
Internet

270 Request
Eligibility Files
271 Response
MDCH
MPHI Database
BCBSM web-DENIS
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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.

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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).

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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.

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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.

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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.

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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)

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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.

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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.

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Example 1

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

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Example 2

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

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Example 3

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

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Example 4

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

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Questions

• Contact Provider Inquiry at 1-800-292-2550 or
  e-mail providersupport_at_michigan.gov .
• Technical Problems, contact BCBSM at
  1-877-BLUE-WEB (1-877-258-3932).