Claims may be submitted electronically through:
• Medicaid’s Interactive Web Portal – Allows claims to be submitted in an online real time environment. This service is available at no charge to providers.
• Provider Electronic Solutions (PES) software – Allows claims to be submitted in batch mode for processing. This service is available at no charge to providers.
• Private software vendor – This service would involve a fee determined by the selected vendor.
In addition, Medicaid recipient eligibility must also be checked electronically as of March 1.
Electronic options for verifying eligibility:
• Medicaid’s Interactive Web Portal – Allows providers to check eligibility in an online real time environment. This service is available at no charge to providers.
• Provider Electronic Solutions (PES) software – Allows eligibility verification to be submitted in batch mode. This service is available at no charge to providers.
• Automated Voice Response System (AVRS) – Allows providers to check eligibility by telephone by dialing (800) 727-7848 (in-state) or (334) 215-0111 Option 5 (out-of-state). This service is available at no charge to providers.
• Private vendor – This service would involve a fee determined by the selected vendor.
Medicaid officials expect these changes to save the program more than $2 million by the end of FY 2011.
