University Physician Associates- UPA

Training Manual
Brijesh Kumar
ORGANIZATION CHART
SAI KUMAR EDLA
(AVP)

ANIL BIDLAN
(DIRECTOR)

PARAMJEET SINGH TULI

(MANAGER)
9899752195

DHEERAJ PRAJAPATI
(ASSISTANT MANAGER)
9310909452

RAJVEER SINGH
CHADEL ASHISH ARORA
RAJU OHJA
(TEAM LEAD) (TEAM LEAD)
(TEAM LEAD)
9899366030 9625756993
8389009820
System Login Procedure:-

Need to Connect VPN-ID & Password

Login to ARC- https://arc.accesshealthcare.co

Click on the option- Talk----this would route you to Akku Page--LogIn

through Email ID & Password-----Click on GSUITE to access Email.
Software Citrix -
https://remoteapps.ch
Login angehealthcare.com
Mocha/Infinity/PMS

Edit/New session -Select from

DROP down -Name: Infinity-CHC

IP Address :
somah001.prod.healthcareit.net

Terminal size:-27 x 132

Apply-Connect
 INFINITY/MOCHA
LOGIN ID PASSWORD
A/R Inquiry Screen -225 Patient Number-Claim history of Patient (Account
number)

Service Number - Individual Service

Omit Paid/Cancelled Services : To remove the Zero

balance accounts from claim history do "Y" "Y" &
vice versa.

Group Control# /Claim number (Opt-5 & F10)- To

check how many CPT's billed in a claim & also the
Total Balance of the claim.

Date Range & Procedure code Range

Physician Code- Physician wise claims

Carrier :-Carrier wise claim

Claim Review:- AR/Screen 225
Service# Enter • Claim Review

Service
Transaction • Option -1
Display

Service record • Option-3

Display

Patient Coverage • Option- 4

Display

Billing action • Option - 5

Display
Claim Review:- AR/Screen 225
• Claim Review
Service# Enter

Service
• Option -1
Transaction
Display

Service record • Option-3

Display

Patient Coverage • Option- 4

Display

Billing action • Option - 5

Display
 Registration: Patient
Patient search: Screen 100 Info
( Patient Name, Address,
• Option -02
DOB SSN Gender)

AR Inquiry Screen : 225

Screen
• Option -06

Courtesy Claim • Option-08

Coverage Management:-
Insurance Coverage • Option- 11
Update

Rebill • Option - 15

Service Reversal &

Adjust
• Option – 16
Coverage Update
Add/Remove Coverage- Copy Patient#

Option 100-- Paste patient number Enter

Section 11 enter- Go to the Set for addition or modification press 1

Enter

To Inactivate - Status I(I as India) press F8, Default coverage will be

same as Previous coverage, F8.

To Add- Select the Set press 1 enter, Choose Priority(PTY) which is

not used, Car ID( Insurance ID), Policy number, Effective Date, F8,
Default Coverage will be same as Previous coverage, F8.
 Carrier Master Inquiry (Insurance Details & Code)-636

Screen use to obtain insurance codes and insurance contact#

Physician provider inquiry-719
Check Provider Details(NPI, Provider ID, Taxonomy (Specialty), Billing address, Physician Type, Effective date of
enrollment with Insurance.Taxonomy (Specialty), Billing address, Physician Type, Effective date of enrollment with
Insurance.
Adjustment Screen -170 To perform Adjustment or reversal on
service

Copy Service#- Go to option 170-

Give service number# Enter Opt-3

Trans Code (As per

Instruction/pathways)

Balance---Enter & F8.

Authorization Inquiry Screen- 130/131
To Check authorization# copy patient
number- option 130 enter,

paste patient number Enter, Check

with Incident number in which
authorization# is linked.

Incident number-Service record

display
Service Edit Prompt-175
To change/add referring physician , update
modifier

Copy Service number

Option 175 enter-Paste service number

Press 1 enter

Any thing highlighted in yellow can be

modified/removed.
Rebill selection Prompt-180 Copy Service number--option 180

paste Service number Enter---option 2 for

coverage set selection

press 1 on the Set & Pty to be billed & F8.

Corrected Claim

After Rebill press option 7 Enter

Rebill Type 7 & ICN : Claim number----F8.

 Payment Inquiry Screen- 190

To check if a payment is posted in system via Check/EFT

number.
EOB Status 158 for posting

Remarks/Note:- To Be applied -Need to allow time & Pending for EOB-

Download EOB & sent for payment posting.
631- Adjustment codes
835 - Paid to patient
 Claim paid to Patient - Go to screen 835 paste the patient number---select the date
range of the service--Enter--press 1 on the service which is paid to patient----
 Responding press ? Enter choose Carrier(Insurance)---Code PP Enter---send to AR
follow up- Y--Note:
Perceptive Content 7_3 (Image Now)
 The software is for documents like EOB, Medical records, any correspondence
from Insurance.
 Open perceptive 7.3- Login with (Citrix ID & Password)
 go to Transaction Display screen in Mocha(Infinity/PMS)---
 Click on application in Image now—
 select Option Infinity Screen library 2.0, do not move the mouse cursor---it
will automatically copy the service & documents would displayed in a new tab
of Image now
 find the document by service number.
RAI PORTAL:- https://rai.changehealthcare.com
Status Code & Status Description:-
Denial Descriptions & Action Code
Tax – Id:-222095812 (PAR)
Tax – Id:-223644535 (Non-Par)
Medicare/Medicaid – P-Tan & Group NPI
Pay-to Address:- PO Box 23301, New York, NY 10087-3301
PAPER CLAIM/ COURTESY CLAIM-CLMPRT

Firstly check the coverage set for the service eg-

19000514 the coverage set is #4.

Go to 100 screen and go to 11- coverage maintenance

Now go to the particular coverage set, update as per

requirement (address change/coverage changes).
And selection has to be 15 as shown in image 3.
PAPER CLAIM/ COURTESY CLAIM-CLMPRTFile normal claim after select and rebill

And finally we to do CLMPRT need to select 08

Out “Q” CLMPRT Hold(Y/N) N

If want to attach any EOB or other

document claim has to be hold via “Y”
otherwise “N”.
Than F16
PAPER CLAIM/ COURTESY CLAIM-CLMPRT

Now need to select

particular coverage set
against the payer name
and write 1 and enter
with,
F8 And you are done.
HOW TO ENTER THE NOTES IN THE NOTES

To enter the Notes on SSP screen open option F13 or go to Option

375. Select Patient Notes Entry option.

We have two options to Enter the Notes. F15 for general Notes Entry
and F9 Mass Service note Entry ( only valid for one line Note)
Select Option F15.

Enter Service Number

HOW TO ENTER THE NOTES IN THE NOTES
Enter Service Number
Then Enter One line
notes from your notes

Enter Service Number then

enter your notes in line.
Then Hit F21

Then enter your remaining notes and Hit

F8 to save the note.
Website Link:-
 UHC Provider Portal – https://identity.onehealthcareid.com/app/index.html#/login

 Availity :- https://apps.availity.com/availity/web/public.elegant.login

 Medicaid NJ: -https://www.njmmis.com/default.aspx?err=logoff

 Navient Provider Portal:- https://navinet.navimedix.com/claims/status/hnjh/detail?clientUId=ac492b72-b110-4944-8a3e-e633111913ff

 Meritain Provider Portal :- https://connect.meritain.com/Provider/Home

 Health-First :- https://hfproviderportal.org/

 Cigna Provider Portal:- https://cignaforhcp.cigna.com/app/login

 UMR Provider Portal :- https://provider.umr.com/tpa-ap-web/?navDeepDive=publicStandAloneUMROIDCLogin

 Encoder Pro:- https://www.encoderpro.com/epro/index.jsp

 Citrix Login:- https://remoteapps.changehealthcare.com/vpn/index.html

 Pingone Login:- https://desktop.pingone.com/changehealthcare/Selection

 RAI Portal :- https://rai.changehealthcare.com/Home/Index

 TCN Calling Portal :- https://operator.tcn.com

 Geha Provider Portal:- https://www.geha.com › login

 Magnacare:- https://clm.magnacare.com/MgProviderClms//Login.aspx

 Medicare MUE Tool:- https://www.cgsmedicare.com/medicare_dynamic/j15/mue/mue_tool.aspx


Adjustment Code List:-
 4276 -Primary Paid Max

 4252- Medicaid Process Primary paid max

 4745- CPT Bundle

 4654- True Duplicate

 4766- Initial Untimely filing

 4768- Untimely filing after Incorrect Submission

 4702- Appeal Corrected claim TFL passed- No RAI Created

 4767- RAI Already Created, TFL Passed for appeal and corrected claim.

 4741- RAI Already Created, RAI Response - No Auth# or Referral available.

 4781- Provider Not enroll on DOS.

 4278- Non covered charges

 4279- RAI Already Created, RAI Response – No coding corrected adjust the charges

 4905- Maximum benefits exhausted in terms of services.

 4250- Anesthesia service billed to Medicaid without AA modifier- No HMO available.

 4090- Out of state Medicaid. Provider NPI Not enroll/ Listed.

 4091- Out of state Medicaid HMO Provider not enroll.

 4703- Non covered charges- CPT Not in Medicaid fee schedule

 4912- Medical records not supported or As per RAI Response no medical records available.

 4003- Provider capitated with insurance.

 4101- Medicaid QMB Plan. Not payable as secondary.

Divisional Management Assigned:
Jyoti Verma Rick Shafto
 SURG  RAD
 EMMD  PATH
 NEUR  RONC
 NESU  MED
 ORTH  OBG
 ANES  PMRH
 OTO  PSYC
 LIV  PACL
 OPHT  FAM
 PAIN