Provider Claims User Guide - storage.googleapis.com · BHSDSTAR Provider Claims User Guide Version 1.2 BHSD User Guide Page 8 of 18 ... Click SMI drop-down and click status. 73. Click

BHSDSTAR

ProviderClaimsUserGuideVersion1.2

BHSD User Guide Page 1 of 18

UserGuide-ProviderClaims

Version1.2Updated6/15/17

BHSDSTAR



TableofContents1. PurposeandIntroduction....................................................................................................................31.1 GeneralInformation....................................................................................................................3

2. LogInandAccountSettings................................................................................................................32.1 ToLogin:.....................................................................................................................................32.2 ToeditProfileSettings:................................................................................................................52.3 ToeditPassword:........................................................................................................................52.4 TocontactSupportviaEmail:......................................................................................................62.5 ToLogout:....................................................................................................................................6

3. ClientEligibility....................................................................................................................................64. ClientRegistration...............................................................................................................................65. ClientFind..........................................................................................................................................106. ClientContactInformation................................................................................................................117. ClientMandatedData........................................................................................................................127.1 AddUpdate:...............................................................................................................................127.2 AddDischarge............................................................................................................................13

8. ClientNotes.......................................................................................................................................148.1 ToaddaNote:...........................................................................................................................14

9. Services..............................................................................................................................................1510. ProjectTrackingItems...................................................................................................................1510.1 ClaimFailures.............................................................................................................................1510.2 ClaimsAccepted........................................................................................................................1510.3 InvoiceIconDefinitions:............................................................................................................1610.4 ToReviewyourPendingInvoices:.............................................................................................1610.5 ToAddComments:....................................................................................................................1710.6 ToReviewyourInvoiceHistory:................................................................................................1810.7 Reports......................................................................................................................................18

11. Questions......................................................................................................................................18

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1. PurposeandIntroductionThisdocumentdescribesthebasicsofnavigatingintheBHSDSTARClaimsapplication.

1.1 General Information

1. Youmusthaveyourownuniqueemailaddresstohaveanaccount.2. AllactivitydoneusinganaccountistrackedandrecordedinBHSDSTAR.Donotshareyouraccount

information.3. Itisimportanttoknowyourorganizationsprimaryand/orsecondaryaccountmanagerforBHSDSTAR.

Theywillbeabletoanswermostquestionsforyouabouthowtheywantyoutousetheapplication.4. Onlinevideos,super-quickguidesandcomprehensiveuserguidesareavailableonbhsdstar.org.For

questionthatcan’tbeansweredbytheonlineresourcesoryourprimary/secondarycontact,oranyissuesyoumayencounterinBHSDSTAR,[email protected].

5. AnyidentifyingclientinformationsentthroughemailisaHIPAAviolation.UseonlytheBHSDSTARClientIDwhenneedingtoreferenceaspecificclient.

6. TheTrackingmoduleforanygivenprogramprovidesquicklinksandinformationaboutimportantitemsspecifictotheprogram.Thisislocatedonthelandingpagefortheprogram.

2. LogInandAccountSettings 2.1 ToLogin:

1. Fromthedesktopdouble-clickyourinternetbrowsertolaunch.(ForbestresultswerecommendGoggleChromebutotherbrowserscanalsobeused.)

2. Enterbhsdstar.org/inthebrowserwindowandpresstheEnterkey.

3. ClicktheLoginbutton.4. ClickintheUsernamefieldandenterusername.5. PresstheTabkeyorclickinthePasswordfieldandenteruserpassword.6. ClicktheLoginbutton.

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7. TheHomescreenwilldisplaylistingProgramsontheLeftNavigationandwhenselectedtheirTracking

IconsandGraphs.

Tip:ThisscreencanbeviewedatanytimebyclickingProgramsintheupperrightcornerofthescreenorbyclickingtheOverviewontheleftnavigation.

Tip:Itemsrequiringactionaredisplayedwithan Iconlistingthe#ofitemsforeachTrackingItemandtheTakeActionbuttonisdisplayed.8. ClicktheClaimsProjectontheleftnavigation.9. TheClaimsdashboardwilldisplayTrackingIconsandGraphs.

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2.2 To edit Profile Settings: 1. ClickonyourloggedinNameintheupperrightcorner.2. ClickUpdateProfile.3. Clickthefieldyouwanttoeditandenternewinformation.4. ClickSave.

2.3 To edit Password: 1. ClickonyourloggedinNameintheupperrightcorner.2. ClickChangePassword.3. Entercurrentpassword.4. Enteranewpassword.5. Re-enterthenewpassword.6. ClickUpdate.

Tip:Password must be changed every 90 days, contain at least eight characters, contain at least one number, contain at least one lower case letter, contain at least one upper case letter, and contain at least one special character.

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2.4 To contact Support via Email: Tip:Neversendaclient’snameinthefreetextsectionoftheemail-refertothembythelast5digitsoftheirBHSDSTARClientID.1. ClickonyourloggedinNameintheupperrightcorner.2. ClickContactSupport.

2.5 To Logout: 1. ClickonyourloggedinNameintheupperrightcorner.2. ClickLogout.

3. ClientEligibility Vendorsareresponsibletodeterminetheeligibilityofaclientatthetimeserviceisrendered.Non-MedicaidfundsareintendedforservicestoindividualsnotcoveredbyMedicaid.VendorsmustchecktheMedicaidportalpriorto administering a service for non-Medicaid reimbursement. By submitting a service for non-Medicaidreimbursement, Vendors are attesting that they have verified a client’s non-Medicaid eligibility. Done here:https://nmmedicaid.acs-inc.comDependingonspecificsofscopesofwork,additionaleligibilitycriteriamayexist.Ifyouareunsureoftheeligibilityofaclientforthenon-Medicaidfundingyouarereceiving,pleasecontactyourStateAgencyprogrammanager. 4. ClientRegistration FromtheHomescreen:

1. ClickClient,Register.2. ClicktheFirstNamefieldandentername.3. ClicktheLastNamefieldandentername.4. ClicktheDateofBirthFieldandenterDOB.5. ClickSearch.6. Thesystemdisplayspossiblematchesortheregistrationscreenifnomatchesarefound.(ClickNoneif

Theseiftheclientisnotlisted)

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Tip:Registration is used to identify existing records in BHSDSTAR first to avoid duplication of individuals in the system. One individual can be participating in other programs with other providers or have done so in the past.

7. ClicktheMiddleInitialfieldandentermiddleinitial.8. ClicktheSuffixdrop-downandclicksuffix.9. ClicktheSSNfieldandenterSSNorclicktheNoSSNcheckboxtoselect.10. ClicktheMedicalRecordNumberfieldandenterMRN.11. ClicktheMedicaidRecipientcheckboxtoselect.12. ClicktheMedicaidIDfieldandenterID.13. ClicktheMCOdrop-downandclickMCO.14. ClicktheCCLdrop-downandclickCCL.15. ClicktheGenderfieldandclickgender.16. ClicktheSexualPreferencedrop-downandclickpreference.17. ClicktheEthnicitydrop-downandclickEthnicity.18. ClicktheRacedrop-downandclickRace.19. ClicktheActiveMilitarydrop-downandclickstatus.20. ClicktheLanguagedrop-downandclicklanguage.21. ClicktheOtherLanguagefieldandenterotherlanguage.22. ClicktheTribalAffiliationdrop-downandclickaffiliation.23. ClickSaveandContinue.

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24. ClicktheAddress1fieldandenteraddressorclicktheHomelesscheckboxtoselect.25. ClicktheAddress2fieldandenteraddress.26. ClicktheCityfieldandentercity.27. ClicktheStatedrop-downandclickstate.28. ClicktheZipCodefieldandenterzipcode.29. ClickthePhonefieldandenternumberorclicktheNoPhonecheckboxtoselect.30. ClicktheMessagedrop-downandclickYesorNo.31. ClicktheOtherPhonefieldandenternumber.32. ClicktheMessagedrop-downandclickYesorNo.33. ClickSaveandContinue.

34. ClicktheNamefieldunderParent1andenteraname35. ClickthePhoneNumberfieldunderParent1andenteraphonenumber36. ClicktheRelationtoClientdrop-downunderParent1andselectarelationshipstatus37. ClickthetextboxunderParent1anddescribetherelationshipif‘Other’isselectedinstep#3638. ClicktheNamefieldunderParent2andenteraname39. ClickthePhoneNumberfieldunderParent2andenteraphonenumber40. ClicktheRelationtoClientdrop-downunderParent2andselectarelationshipstatus41. ClickthetextboxunderParent2anddescribetherelationshipif‘Other’isselectedinstep#36

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42. ClicktheNamefieldunderLegalRepresentative/Guardianandenteraname43. ClickthePhoneNumberfieldunderLegalRepresentative/Guardianandenteraphonenumber44. ClicktheRelationtoClientdrop-downunderLegalRepresentative/Guardianandselectarelationship

status45. ClickthetextboxunderLegalRepresentative/Guardiananddescribetherelationshipif‘Other’is

selectedinstep#3646. ClicktheNamefieldunderEmergencyContactandenteraname47. ClickthePhoneNumberfieldunderEmergencyContactandenteraphonenumber48. ClicktheRelationtoClientdrop-downunderEmergencyContactandselectarelationshipstatus49. ClickthetextboxunderEmergencyContactanddescribetherelationshipif‘Other’isselectedinstep

#3650. ClicktheNamefieldunderNon-medicalpersonandenteraname51. ClickthePhoneNumberfieldunderNon-medicalpersonandenteraphonenumber52. ClicktheRelationtoClientdrop-downunderNon-medicalpersonandselectarelationshipstatus53. ClickthetextboxunderNon-medicalpersonanddescribetherelationshipif‘Other’isselectedinstep

#3654. ClicktheNamefieldunderOtherandenteraname55. ClickthePhoneNumberfieldunderOtherandenteraphonenumber56. ClicktheRelationtoClientdrop-downunderOtherandselectarelationshipstatus57. ClickthetextboxunderOtheranddescribetherelationshipif‘Other’isselectedinstep#3658. ClickSaveandContinue.

59. ClickDateofInitialRegistrationcalendarandclickdate.60. ClickVeterandrop-downandclickstatus.61. ClickMaritalStatusdrop-downandclickstatus.62. ClickPregnantdrop-downandclickstatus.(AppearsforFemaleclients)63. ClickLivingArrangementdrop-downandclickarrangement.64. ClickEducationdrop-downandclickstatus.65. ClickSchoolAttendanceStatusdrop-downandclickstatus.66. ClickEmploymentStatusdrop-downandclickstatus.67. ClickSourceofincomedrop-downandclicksource.68. ClickLegalStatusatAdmissiondrop-downandclickstatus.

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69. ClickReferralSourcedrop-downandclicksource.70. ClickArrestinPast30daysdrop-downandclick#ofarrests.71. ClickHealthInsurancedrop-downandclickinsurancecarrier.72. ClickSMIdrop-downandclickstatus.73. ClickSEDdrop-downandclickstatus.74. ClickCodependentdrop-downandclickstatus.75. ClickSubstanceAbuseProblemand/orMentalHealthDiagnosisdrop-downandclickstatus.76. Additionalfieldswilldisplayforentryasneeded.77. Completetheentry/selectionforthedisplayedrequiredfields.

78. ClickFinish.79. TheClientDashboard/ProjectsTabisdisplayed.

5. ClientFindTip:Findisusedtofindclientsregisteredatyourprovideronly.FromtheHomescreen:

1. ClickClient,FindClient.2. ClicktheFirstNamefieldandentername.3. ClicktheLastNamefieldandentername.4. ClicktheDateofBirthFieldandenterDOB.5. ClicktheIndividualIDfieldandenterID.6. ClicktheLast4SSNfieldandenterthelast4digitsoftheSSN.7. ClickMedicalRecordNumberandenternumber.8. ClicktheMedicaidIDfieldandenternumber.

Tip: Not all fields are required to Find a Client. You can Find by First Name only as an example.

9. ClickFindClient.10. ClicktheClientIDoftheindividualfoundonthelistofpossiblematches.

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11. TheClientDashboardisdisplayed.

6. ClientContactInformationFromtheClientDashboard:

1. ClickProfile,Address&Phone,orContacttab.2. Clickanyofthefieldsandenter/edittheinformation.3. ClickSave.4. TheClientDashboardisdisplayed.

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7. ClientMandatedData 7.1 Add Update: FromtheClientDashboard:

1. ClickMandatedDatatab.2. ClickAddAssessmentdrop-downandclickUpdate.3. ClickDateofUpdatecalendarandclickdate.4. ClickVeterandrop-downandclickstatus.5. ClickMaritalStatusdrop-downandclickstatus.6. ClickPregnantdrop-downandclickstatus.7. ClickLivingArrangementdrop-downandclickarrangement.8. ClickEducationdrop-downandclickstatus.9. ClickSchoolAttendanceStatusdrop-downandclickstatus.10. ClickEmploymentStatusdrop-downandclickstatus.11. ClickSourceofincomedrop-downandclicksource.12. ClickHealthInsurancedrop-downandclickinsurancecarrier.13. ClickSMIdrop-downandclickstatus.14. ClickSEDdrop-downandclickstatus.15. ClickCodependentdrop-downandclickstatus.16. ClickSubstanceAbuseProblemand/orMentalHealthDiagnosisdrop-downandclickstatus.17. Additionalfieldswilldisplayforentryasneeded.18. Completetheentry/selectionforthedisplayedrequiredfields.

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7.2 Add Discharge FromtheClientDashboard:

1. ClickMandatedDatatab.2. ClickAddAssessmentdrop-downandclickDischarge.3. ClickDateofLastContactcalendarandclickdate.4. ClickDischargeReasondrop-downandclickreason.5. ClickDateofDeactivationcalendarandclickdate.6. ClickVeterandrop-downandclickstatus.7. ClickMaritalStatusdrop-downandclickstatus.8. ClickPregnantdrop-downandclickstatus.9. ClickLivingArrangementdrop-downandclickarrangement.10. ClickEducationdrop-downandclickstatus.11. ClickSchoolAttendanceStatusdrop-downandclickstatus.12. ClickEmploymentStatusdrop-downandclickstatus.13. ClickSourceofincomedrop-downandclickincome.14. ClickHealthInsurancedrop-downandclickinsurancecarrier.15. ClickSMIdrop-downandclickstatus.16. ClickSEDdrop-downandclickstatus.17. ClickCodependentdrop-downandclickstatus.18. ClickSubstanceAbuseProblemand/orMentalHealthDiagnosisdrop-downandclickstatus.19. Additionalfieldswilldisplayforentryasneeded.20. Completetheentry/selectionforthedisplayedrequiredfields.

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8. ClientNotes

FromtheClientDashboard:

1. ClickNotestab.2. CurrentNotesfortheclientwilldisplay.

Tip: As notes are added the (0) on the tab will update. 8.1 To add a Note:

1. ClicktheNotessectionandenternotes.2. ClicktheDatecalendarandclickdate.3. ClickAddNote.4. ThenewlyaddednoteisdisplayedintheCurrentNotestablewithdate,text,andenteredby.

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9. ServicesFromtheClientDashboard:

1. ClickServicestab.2. CurrentServicesfortheclientwilldisplay.3. ClienttheServiceIDtoviewtheservicedetails.

Tip: As Services are added the (0) on the tab will update.

10. ProjectTrackingItems10.1 Claim Failures FromtheClaimsProjectscreen:

1. ClickView.2. ClaimFailuresaredisplayedincludingtheacceptanceandfailurecriteria.

10.2 Claims Accepted FromtheClaimsProjectscreen:

1. ClickView.

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2. ClaimsAcceptedaredisplayedincludingtheacceptancecriteria.

10.3 InvoiceIconDefinitions:

10.4 To Review your Pending Invoices: FromtheHomescreen:1. ClickviewunderPendingInvoices.2. Theinvoicesscreenwilldisplaylistingyourpendingapprovalandpaymentinvoices. 3. ClicktheSearchfieldandenterInvoice#.

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4. Theinvoicewilldisplayinthetable.5. ClicktheInvoiceDetailslink.6. InvoiceDetailsincludingServicesandInvoiceDecisionsaredisplayed.

10.5 ToAddComments: 1. ClickAddComment.2. Enterfreetextcomments.3. ClickSubmitComment.

4. CommentisdisplayedandsharedwiththeProgramManager.

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10.6 ToReviewyourInvoiceHistory:FromtheHomescreen:7. ClickviewunderInvoiceHistory.8. Theinvoicesscreenwilldisplaylistingyourprocessedinvoices. 9. ClicktheSearchfieldandenterInvoice#.10. Theinvoicewilldisplayinthetable.11. ClicktheInvoiceDetailslink.12. InvoiceDetailsincludingServicesandInvoiceDecisionsaredisplayed.

10.7 Reports FromtheOverviewProjectscreen:

3. ClickRunReportdrop-downandclickreport.4. Click/SelectReportCriteria.5. ClickRunReport.6. Reportdetailsaredisplayed.

11. Questions [email protected].

Documents

Provider Claims User Guide - storage.googleapis.com · BHSDSTAR Provider Claims User Guide Version 1.2 BHSD User Guide Page 8 of 18 ... Click SMI drop-down and click status. 73. Click