Trading Partner Account Presentation

Trading Partner Account Presentation

Trading Partner Account Presentation Molina Medicaid Solutions, Maine Presentation Objective The purpose of this presentation is to provide a step by step process for providers in order for them to sign into or create a new Trading Partner Account (TPA). Secondly, this presentation will inform providers about the new Health PAS Online Portal. Lastly, this presentation will supply providers with some additional information regarding maintenance. 2 Health PAS Online Portal Home Page Existing trading partners sign in here

The information on these three tabs are non-secure general information for providers and members. To obtain more detailed information, you will need to sign into your TPA. If you do not have one, you can create your own. 3 New trading partners register here Existing Providers with a Trading Partner Account Click here to return to the previous

page. 4 Check this box to attest to Health Insurance Portability and Accountability Act (HIPAA) Protected Health Information (PHI) standards. This is required every time you sign in. You will not be able to move forward without checking this box. New Trading Partner Registration-Already Enrolled For current MaineCare providers who have never registered as a trading partner Required to obtain access to the provider enrollment

application (PEA) and secure area of portal. Your Federal Employer Identification Number, National Provider Identification (NPI), or Atypical Identification, Personal Identification Number (PIN) all are required fields

5 Your PIN is the original enrollment case ID. If you do not have this number, please call 1-866-690-5585, option 2 for assistance. Click NEXT and complete steps 2-5 New Trading Partner Registration-Not Yet Enrolled Providers including Non-billing, Ordering, Prescribing, or Referring (NOPRs) who are not enrolled with MaineCare Required to obtain access to the provider enrollment application

Tax ID and NPI numbers are required Click NEXT and complete steps 2-4 6 Trading Partner Registration-Billing Agent An entity that submits claims on a providers behalf Required to obtain access to the provider enrollment application and secure area of portal. Your Federal

Employer Identification Number, National Provider ID, or Atypical ID, PIN all are required fields Providers PIN is the original enrollment case ID or revalidating case ID. Obtain case ID from the provider. Click NEXT and complete steps 2-4 7 Trading Partner Registration-Health Plan

An entity who is requesting access to MaineCare member eligibility. Required to obtain access to submit Eligibility request to MaineCare Tax ID is required Click NEXT and complete steps 2-4 8 Trading Partner Registration- Clearinghouse An entity that submits, receives, and processes EDI transactions for a provider. Required to obtain

access to submit X12 transactions and claim submission. Electronic Data Interchange (EDI) Help Desk approves Clearinghouses. Tax ID is required Click NEXT and complete steps 2-4 9 Access to Secure Functions Upon Signing In Secure functions

Form Entry The portal displays the functional sections horizontally across the web page. The menus available will differ depending on your trading partner permissions. 10 Used to send and receive secure emails to Molina Trading Partners

can access additional training materials Help with the LMS email or call the number displayed. For training purposes. Used to start Enrollment/ Maintenance cases Secure Email Function All providers have the ability to send secure email. This will send an email to the Molina inbox. Protected Health Information (PHI) may be sent via secure email. All sent and received emails are displayed here. This feature has

the same functions as other email services. Click on New Message and select the topic pertaining to your inquiry: -Claims Assistance -EDI Related Issues -Eligibility Inquiry -Prior Authorization Assistance -Web Portal Assistance -Other 11 Account Maintenance Account Maintenance is where you manage your TPA and user

account. Click on the titles to choose the selected function. 12 Manage Providers allows you to associate providers to your TPA. File Exchange Click on File Exchange to access the functions below. These will

differ depending on your trading partner permissions. Click on X12 Upload to submit EDI transactions. Provider enrollment, prior authorization, and other letters from the MIHMS system will be available in Correspondence. 13 Provider Directory The MaineCare Provider Directory

enables the user to search for other providers using specific search criteria. 14 Click on Provider Directory to display the drop down menu. Click on NOPRS Report to display a list of available Nonbilling, Ordering, Prescribing, or Referring (NOPR) providers. These providers may also be associated to a fully enrolled MaineCare PayTo provider and therefore able to provide full MaineCare services at that location. For

example, providers who provide services under a Rural Health Center, Federally Qualified Health Center, or Indian Health Services. MaineCare Information Click on MaineCare Information to display the drop down menu. MaineCare Information is where to locate forms, manuals, and user guides in one location. 15

Information related to Prior Authorizations can be found here. Accessing the Provider Enrollment Application Two ways to access provider enrollment/maintenance functions: Option 1 is from the Form Entry page once you are signed into your TPA (just under the email option), shown below: Provider Maintenance is found under Provider Enrollment Application

16 Accessing the Provider Enrollment Application There are two ways to access provider enrollment/maintenance functions: Option 2 is by choosing Account Maintenance and clicking Provider Enrollment Click on Provider Enrollment to access the enrollment function. 17 New Provider Enrollment New Application Paper applications will no longer be accepted. Only online applications will be accepted. The Provider Enrollment Application

may be used for new enrollments. Click this box before you start your enrollment. Click on Read More to review the MaineCare Provider Enrollment Privacy Statement. Click Save And Continue 18 MaineCare Provider Enrollment Privacy Statement 19

Questions If you have questions, please contact Provider Services at 1866-690-5585, Option 1; TTY users, dial 711 (Maine Relay). If you have questions regarding enrollment or maintenance, please contact Provider Services at 1-866-690-5585, Option 2. If you have questions regarding trading partner or portal issues, please contact EDI at 1-866-690-5585 Option 3. 20

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