Missouri EMOMED Billing in Ankota

Overview

EMOMED is the Missouri Medicaid portal which allows for manual entry of billing as well as EDI billing. In order to successfully bill EMOMED using EDI files built by Ankota, you will need to complete the following steps:

Provide your Ankota specialist your EMOMED log-in name and confirm you are set up for EMOMED
Ensure you have a trading partner agreement and are set up for ERA/835 files with EMOMED
Complete billing as usual
Use the Export Merged HealthCare Claims button to create your EDI file for EMOMED
- Complete a test and be moved to production if you have not previously been approved for EDI file upload
Upload these files to EMOMED
- Note that EMOMED still requires you use Internet Explorer to access the system.

Once you have uploaded your files, assuming you have filed the appropriate forms, you can watch for remittance advice files (835s) in EMOMED as well. These 835 files can also be uploaded directly into Ankota for instant updates of your billing records.

This article includes the following sections:

Set-up

First, make sure you have a trading partner agreement on file. If not, you can file one by going to the EMOMED log-in page, log in, and using the form on its front page. You must have a trading partner agreement on file before you can proceed. You must be logged in to see this form.

Trading Partner Ageement:

TradingPartnerAgreement.pdf (emomed.com)

Next, you'll need to complete your ERA/835 request form. As of May 2021, the request form can be found on their website BEFORE you log in (if you are logged in you will not see this):

When you get the trading partner agreement and 835 request form, fill them out and turn them back in. In filling out the 835 form, you will need to confirm the method of retrieval is INET EMOMED and that no clearinghouse is used.

Pre-Billing Preparations

During implementation, your implementation specialist will collect your NPI numbers, taxonomy codes, address, and other information and will code this into your system. To bill, Ankota users simply perform the usual visit review and billing processes in Ankota. In other words, after ensuring client and caregiver data is correctly entered (including primary diagnosis codes), ensuring visits are closed, reviewing the Visit Approval Dashboard, calculating billing, and completing draft invoices, you will export the Merged Health Care Claim and upload it in the EMOMED portal. Note this will change when billing moves to going through Sandata. IMPORTANT NOTE: If you have different Medicaid IDs from the main client ID, please be sure to request to use the Admission ID field in the authorization to ensure your client's Medicaid ID is sent to the customer.

Testing

Initial Test EDI File in EMOMED You cannot bill if you skip this section!

Your first step in billing EMOMED will be to complete a standard test. You must complete an approved test before being moved to Production. Only then can you bill.

To complete your test,

Calculate billing as per usual in Ankota
Export the appropriate claims on the Billing Report (Complete) page by clicking the Export as Merged Health Care Claim button
Log into EMOMED
Click on File Management
Click on Manage Test Files
Upload the Merged Health Care Claim file (click the Select File button, select the file, click the Send Files button

Test File Response

Within 24-48 hours, you can check for a claim confirmation file. Then email help.desk@momed.com using the following script and and ask to be moved to production.

Hi! I'm writing to request a test file review so that I can be moved to Production.
My submitter ID is [YOUR ID]. I submitted a test file on DATE. The transaction type I submitted was an EDI file (in the HIPAA Test Files folder). Could you confirm this file and move me to Production, please?
Of course, if there’s any issue, just let me know.

Thank you so much!
[Your name & company]

When you receive the confirmation, then you can move to billing regularly. Without the confirmation that you are moved to production, EMOMED will not process your data. Do not proceed without completing your test and confirming you are moved to production.

Regular EDI File Uploads in EMOMED

Once your test is complete AND you are confirmed as having been moved to Production by EMOMED, you will upload files for billing as needed using the standard process below.

To upload an EDI file to EMOMED,

Calculate billing as per usual in Ankota
Export the appropriate claims on the Billing Report page by clicking the Export as Merged Health Care Claim button
Log into EMOMED
Click on File Management
Click Upload Files
Upload the Merged Health Care Claim file (click the Select File button, select the file, click the Send Files button)

Within 24-48 hours, you can check for a claim confirmation file or 835 response file.

Claim Confirmation Files

For clients who prefer to use the manual review process, EMOMED's claim confirmation files are available within 24-48 hours after submitting claims.

To review claim confirmations,

Log back into EMOMED the next business day to see what was accepted and what was rejected
In EMOMED, click on claim confirmation, then click search

The claim confirmation file will have the date and whether it is confirmed or rejected
Log back in the next business day to see what was accepted and what was rejected
If wasn’t paid (like in the red squares above), look for the reason. You will need to look that reason code up in the list you have from EMOMED.
Fix the issue in Ankota (in this case, the DCN was different than what EMOMED had on record).
Once fixed, you can resubmit the claim.
If an unpaid claim does not have a code, please call the EMOMED help desk (573-635-3559) for more information.

For more information on your response codes, see:

Reason Code 1 explanations: https://x12.org/codes/claim-adjustment-reason-codes
RA Remark Code 1 explanations: https://x12.org/codes/remittance-advice-remark-codes

Missouri’s FAQ on claims is also available here.

Remittance Advice Files (835s)

For a faster, digital version of claim confirmations, 835 files (also known as electronic remittance advice files, or ERAs) are provided at the end of the billing cycle in response to your EDI files, so long as you have completed the appropriate forms. To see the results of your claims and enjoy the benefits of automated billing updates and exceptions reports, upload your 835 on our AR screen.

NOTE: the ERA lists all of the claims you submitted during the previous billing cycle. You will not receive an ERA until after the current billing cycle ends and more specifically three business days prior to receiving the check. You can view the claims processing and payment schedule here: http://manuals.momed.com/ClaimsProcessingSchedule.html