File Name: Provider Enrollment Profile Updates.pdf
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Provider Enrollment & Profile Updates IntroductionThis webinar will include pertinentinformation to discuss details and educateProviders about provider enrollment,updating provider information and theWorkers’ Compensation Medical Bill Process(WCMBP) System
• Enrollment Submissions • Legacy Provider Registration Process • Provider Information Updates • Provider Preparation EnrollmentSubmissions Enrollment Submission Methods Providers that seek reimbursement for services rendered to an OWCP claimant must be enrolled in order to receive payments. Provider enrollment applications can be submitted in the following methods: ▪ Direct Data Entry (DDE) online via WCMBP Provider Portal ▪ Paper Note: During this time, we strongly suggest applications to be submitted electronically via DDE
4 Enrollment via Direct Data Entry The Provider Enrollment OWCP 1168 form has been revamped and can be submitted electronically directly into the WCMBP via Direct Data Entry (DDE). The following enrollment types can be submitted via DDE: ▪ Individual - Any provider who is eligible to receive a Type I National Provider Identifier (NPI) through the National Plan and Provider Enumeration System (NPPES). Providers eligible to receive an NPI are those who deliver medical or health services, and Individuals providing only non-medical services, attendant care, or personal care services, who do not need an NPI
▪ Group Practice- One or more health care practitioners who practice their profession at a common location and have formed a partnership or corporation. These entities have a Type II National Provider Identifier (NPI) from the National Plan and Provider Enumeration System (NPPES)
▪ Billing Agent/Clearinghouse - Any third-party entity submitting health care or service bills on behalf of a health care provider or entity to the OWCP programs for reimbursement
5 Enrollment via Direct Data Entry Cont
The following enrollment types can be submitted via DDE: ▪ Facility/Agency/Organization/Institution - An Inpatient or Outpatient Hospital, a Skilled Nursing Facility, an Intermediate Care Facility, a Clinic (RHC, FQHC, Hospital Based Clinic, Urgent Care), a Psychiatric Facility, a Mental Institution, a Durable Medical Equipment Supplier, a Free Standing Ambulatory Surgical Center, a Long Term Care Facility, an Independent Clinical Laboratory, a Free Standing Radiology, a Dialysis Center, a Pharmacy, a Partnership, and a Corporation. In addition, you must also be eligible to receive and currently possess, a Type II National Provider Identifier, available through the National Plan and Provider Enumeration System (NPPES)
6 Accessing OWCP Connect via the WCMBP Portal On April 27, 2020, go to https://owcpmed.dol.gov: 1. Click Provider 2. Click Get Started7 Accessing the WCMBP System for New Providers Providers will need to first register with OWCP Connect before starting a new enrollment or accessing the new system
OWCP Connect is the mechanism by which all users are authenticated
8 Begin Registration Link On the OWCP Connect page, there are 2 links to begin the registration process. You can click on either link
9 OWCP Connect Registration 1. Please enter required information (Name and Email address)
2. A message will populate to notify you that the email you are entering is available or already linked to an existing user account
3. Enter result of the addition problem from the image
4. Click Next
10 OWCP Connect Registration 5. Once the validation is completed, enter a password and retype the password to confirm the password
6. Click Next
Note: Password Criteria should be: • at least 8 characters long, • include an uppercase letter, a lowercase letter, a number, and a special character
By clicking the “Next” button, providers will be taken to the security image page where they must select an image and create a “Key Phrase”
11 OWCP Connect Registration 7. Select a security image, enter a key phrase
8. Click Next
10. Enter the required information, including the OWCP Provider ID, Temporary ID, Temporary Key, and SSN/Tax ID. Note: You can find your OWCP Provider ID and Temporary ID in your …
Provider Enrollment is comprised of three business teams, Plan and Provider Enrollment and Outreach, Provider Eligibility and Compliance, and Provider Business Module Management.
Providers who choose not to use the Portal must complete an Indiana Health Coverage Programs Enrollment and Profile Maintenance Packet (IHCP provider packet) to enroll, add a service location, report a change of ownership, revalidate, or update certain provider profile information.
As a registered MN–ITS user, you can: It is the responsibility of the provider to keep all enrollment information updated. Report any changes and updated information to your enrollment application by submitting a change request through MPSE or fax the following form appropriate to your practice:
AHCCCS also launched the new Provider Enrollment Portal, APEP. After implementing APEP in August 2020, AHCCCS asked providers to “re-register.” All active providers were asked to create an account in APEP and confirm the data converted into the new portal is accurate and current.