Billing Agents And Clearinghouses - DOL

Billing Agents andClearinghouses

Change of Addresses – Effective August 1, 2020GENERAL CORRESPONDENCEDivision of Federal Employees’ Compensation (DFEC)General CorrespondencePO Box 8311London, KY 40742-8311Division of Energy Employees Occupational Illness Compensation (DEEOIC)General CorrespondencePO Box 8306London, KY 40742-8306Division of Coal Mine Workers’ Compensation (DCMWC)General CorrespondencePO Box 8307London, KY 40742-83072

Change of Addresses – Effective August 1, 2020PROVIDER ENROLLMENTProvider EnrollmentPO Box 8312London, KY 40742-83123

Change of Addresses – Effective August 1, 2020BILLS AND AUTHORIZATIONSDivision of Federal Employees’ Compensation (DFEC)General BillsPO Box 8300London, KY 40742-8300Division of Energy Employees Occupational Illness Compensation (DEEOIC)General BillsPO Box 8304London, KY 40742-8304Division of Coal Mine Workers’ Compensation (DCMWC)General BillsPO Box 8302London, KY 40742-83024

IntroductionThis webinar will provide information about: New Billing Agent or ClearinghouseEnrollment Legacy Billing Agent and ClearinghouseRegistration Provider Setup for Using a Billing Agentor Clearinghouse Submitting Bills via Web Batch or SFTP Questions

New Billing Agentor ClearinghouseEnrollmentThis section applies to Billing Agents orClearinghouses that either neverparticipated in the legacy system(Conduent) and those that did participatebut never had an OWCP ID, which isdifferent than a Trading Partner ID.

Accessing OWCP Connect via the WCMBP PortalGo tohttps://owcpmed.dol.govIn the Providers box,Click “Get Started”7

Accessing OWCP Connect via the WCMBP PortalClick the hyperlink in theNew Provider box8

Select Enrollment TypeSelect Billing Agent/ClearinghouseClick Submit9

Basic InformationSelect FEINFill out the top of the form-ORSelect SSNFill out the bottomThen click Next10

Adding Address InformationClick Address11

Address InformationFill in just TWO fields:Address Line 1 (2, 3)1Zip CodeThen click Validate Address2123

Automatic Address CompletionAll other fields areauto-populated!Just click OK13

Complete the DetailsAdd yourPhone Number, FaxNumber, and EmailAddressThen click Finish14

Capture the Application NumberStep 1 is done! Make sure to make a note of your Application Number!Now just click OKNote: If you provided your email on the Basic Information page during your enrollment, you should also receive the application numberin an email. If you need the application number for future reference (i.e. returning to an incomplete application or to check applicationstatus) and you didn’t receive the email and if you didn’t make a note of the application number, you can contact the call center. Phonenumbers can be found on the last slide of this presentation and also on the Medical Bill Processing Portal on the Contact Us page(https://owcpmed.dol.gov/portal/contactus).15

Add IdentifiersStep 2 is to Add IdentifiersMost BillingAgents andClearinghousesdo not use thisoptional step.The following is a list of identifiers a provider can select forthis step. These will likely not apply to enrolling Billing Agentsor Clearinghouses, which is why this is an optional step.IdentifierNoteDrug Enforcement Agency(DEA) NumberNPIOther Provider IDAdditional NPI the provider may have, e.g. for hospitalsProviders use this identifier for new enrollment afterbeing terminated. Providers are not allowed to re-enrollunder the same provider ID, for example when theprovider is terminated due to HHS exclusion.Previous Provider IDProvider MedicareNumberRequired for hospitals onlyUnited Mine Workers’ ofAmerica (UMWA) NumberNot displayed in identifier drop-down because allpharmacies will be created from the NCPDP file. ThisNCPDP Numbernumber is auto populated from NCPDP file. User is notallowed to change the number for pharmacyListed only in maintenance/expert mode after enrollmentApplication Numberis approved. Application Number is view only and cannotbe updated.16

EDI Submission MethodsStep 3 is to Add EDI Submission MethodClick Step 3Note: This step is optional since billing agents may choose not to use EDI.17

Select Submission MethodsEDI Submission Methods – Check off the appropriate checkboxes.Click OK18

Add EDI Contact InformationStep 4 is to Add EDI Contact InformationClick Step 419

Add Contact DetailsAdd the Required Information in the top section, then click AddressClick Address20

Fast Address LookupFill in Address Line 1 and Zip Code, then click Validate Address buttonClick Validate Address button21

Address ValidationAddress validation is successful – all required fields auto-populateClick OK22

EDI Contact InformationEDI Contact Information is completeClick OK23

View/Upload AttachmentsStep 5 is View/Upload AttachmentsClick Step 524

Attachment ListThis is the list of attachments (empty)To add attachments, click Upload Attachments25

Select Document TypeSelect the Document Type from the drop-down list26

Choose a File to UploadChoose a file to Upload and click OKClick OK27

Attachment ListThe file will be added to your list of attachmentsClick Close28

Submit ApplicationStep 6 is Submit Enrollment Application for ReviewClick Step 629

Submit ApplicationApplications requirea handwritten signature.Click the link todownload the signaturepage and cover sheet2Then click SubmitEnrollmentPut your applicationnumber on the coversheet and fax or mailyour cover sheet andsignature page toOWCP.301

Legacy Billing Agentand ClearinghouseRegistrationThis section applies to Billing Agents orClearinghouses that participated in thelegacy system (Conduent) and had anOWCP ID, which is different than a TradingPartner ID.

Accessing OWCP Connect via the WCMBP PortalGo to https://owcpmed.dol.govClick ProviderClick Get Started32

Get Started for ProvidersLegacy Providers will click on the middlebox at the top or the second drop–down menu at the bottom to access thelink to begin the registration process.Registration with OWCP Connect isrequired to obtain access tothe new WCMBP system.33

Begin Registration LinkClick the link to begin the registration process with OWCP Connect.34

Begin Registration LinkOn the OWCPConnect page,there are 2 links tobegin theregistrationprocess. You canclick on either link.35

OWCP Connect Registration1. Please enter all required information(Name and Email address)2. A message will populate to notifyyou if the email you are entering isavailable or if it is already linked toan existing user account.3. Enter the result of the additionproblem from the image.4. Click Next.36janedoe@yahoo.comjanedoe@yahoo.com

OWCP Connect Registration5. Once the validation has been completed, enter a passwordand retype the password to confirm it.6. Click Next.Note: Password Criteria should: be at least 8 characters long, include an uppercase letter, a lowercase letter, a number, anda special character.By clicking the “Next” button, providers will be taken to thesecurity image page where they must select an image andcreate a “Key Phrase”.37

OWCP Connect Registration387.Select a security image, andenter a key phrase.8.Click Next.

OWCP Connect Registration9.Select security questions fromthe drop-down menus andanswer the selected questions.10. Click Submit.39

OWCP Connect RegistrationThe system creates an account and a link to activate the account is sent to your email address usedin registration.Note: The account must be activated within 24 hrs.Click “Resend Email” if the email is not received within 10 minutes.40

OWCP Connect RegistrationLook for email from:from support@dol.gov.11. Click the “here” link.claimantportal1@gmail.com41

OWCP Connect RegistrationThe system creates an account and a link to activate the account is sent to your email address usedin registration.Note: The account must be activated within 24 hrs.Click “Resend Email” if the email is not received within 10 minutes.42

Access to the WCMBP Provider PortalThe Provider or System Administrator will need the Temporary ID and Temporary Key found in the ProviderLetters to log into the WCMBP System.Welcome LetterRegistration Letter43

Welcome to the WCMBP Provider Portal44

Provider Portal Profiles – Bill Processing45

Provider Portal – Home Page46

Billing Agents and Provider RequirementProviders must be enrolled in the WCMBP System in order for billing agents to bill on their behalf.Billing agents will want to provide their OWCP ID to the providers they are billing for so that theprovider can make the association within their profile. This will enable billing agents to view theresponse files (835). Otherwise, billing agents can still submit bills on behalf of the enrolled provider,but they will not receive the response files for the bills that are submitted.Note: Providers will receive payments, not the Billing Agents.47

Provider Setup forUsing a Billing AgentOr Clearinghouse

Maintain Provider InformationNote: While the information inthis section pertains to a provideraudience, it will be helpful to knowthis information if you have toinstruct providers on how toassociate you (billing agent) totheir profile. Remember, you willhave to be enrolled, have anOWCP ID, and provide the OWCPID to the provider for them tocomplete this process.Providers who are approvedand active will use MaintainProvider Information49The following profiles allow access to theMaintain Provider Information function: EXT Provider File MaintenanceEXT Provider Eligibility Checker – ClaimsSubmitterEXT Provider Super User

Maintain Provider InformationNew providers will useenrollment steps 7 and 8Approved providers willsee these same stepsunder Maintain ProviderInformation50

EDI Submission MethodsProviders will check the box for Billing Agent/ClearinghouseClick OK51

Maintain Provider InformationNew providers will use eenrollment steps 7 and 8Approved providers willsee these same stepsunder Maintain ProviderInformation52

Billing Agent/Clearinghouse ListThis step shows the list of billing agents and clearinghouses already set up.To add to the list, the provider will click Add.53

Billing Agent/Clearinghouse ListThe only information required is the Billing Agent/Clearinghouse OWCP ID – and how long they will beauthorized to represent the provider as their billing agent.Billing Agents/Clearinghouses will need to provide their OWCP ID to the providers they arerepresenting.54

Billing Agent/Clearinghouse ListAs they add you to their list, the OWCP ID auto-populates your name informationand the dates they specified55

SubmittingBilling Batches

Choosing Batch Submission Method57

Submit a Web BatchThe following profiles allowaccess to the Submit HIPAABatch Transaction function: EXT Provider BillsSubmitterEXT Provider EligibilityChecker – ClaimsSubmitterEXT Provider Super UserSubmit HIPAABatch Transaction58

Select a File to UploadClick Choose FileSelect the file to Uploadand click Open59

Upload AcknowledgementEach batch is acknowledgedafter uploading completes.60

Retrieve HIPAA BatchResponses

Retrieve HIPAA Batch Responses1Log in to the WCMBP System. The system will display thedefault “Select a provider ID Number” page. Select theappropriate profile from the drop-down list. Thefollowing profiles allow access to the Retrieve HIPAABatch Responses function: EXT Provider Bills Submitter262 EXT Provider Eligibility Checker – Claims Submitter EXT Provider Super User EXT Provider System AdministratorClick on the “Retrieve HIPAA Batch Responses"hyperlink in the column on the left under HIPAA.

HIPAA Response/Acknowledgement for HIPAA BatchThe system will display the following:63 HIPAA File Name Transaction Type Status (Accepted/Rejected) Upload Date TA1 Response File 999 Response FileUse the filter options such as Transaction Type, Upload Date orHIPAA File (File Name) to search for the EDI files of interest. Click thehyperlink under the HIPAA File to retrieve the response.Note: In order for billing agents to view 835s via the provider portal,the provider needs to associate the billing agent to their provider fileas explained earlier in this presentation.

SFTP User Set Up