Submit Institutional

To submit an institutional bill:

Access this page using the method below that applies to you:

WCMBP Users: From the Bills tab menu, select the Submit Institutional hyperlink.
Provider Portal Users:From the Provider Portal home page, select the On-line Bills Entry hyperlink. At the Online Bills Entry page, select the Submit Institutional hyperlink.

The system displays the Institutional Bill page.

Select the indicator from the Special Indicator drop-down.
Select the program from the Program drop-down list.
Under the Billing Provider Information heading, enter the billing provider ID in the Provider ID field, and select OWCP ID from the Type drop-down.
Under the Attending Provider Information heading, if applicable, enter the attending provider ID in the Provider ID field, and select NPI from the Type drop-down.
In the Claimant Information section, enter the claimant ID in the Claimant ID field, and select the type from the Type drop-down.

The system automatically refreshes the section with the rest of the claimant information fields populated.

In the Bill Information section, at a minimum, enter or select values for the required fields.
Select the plus sign next to the Other Diagnosis Information sub-heading and enter any additional diagnosis code in the Other Diagnosis Code field and selecting appropriate value from the Present on Admission drop-down. Select the Add Another hyperlink to add more of these fields as needed.
Expand the Condition Information sub-heading to add one or more condition codes.
Expand the Occurrence Information sub-heading to add one or more occurrence codes.
Expand the Occurrence Span Information sub-heading to add one or more occurrence span codes with from and through dates for each.
Expand the Value Information sub-heading to add one or more value codes with value amounts for each.
Expand the Delay Reason sub-heading to select the delay reason code.
If the bill has third-party liability, select Yes at the grid question, Does Bill have any Third Party Liability Amount? The grid expands so you can enter the amount in the Third Party Liability Amount field.
If applicable, enter the prior authorization number in the Prior Authorization Number field.
Expand the Procedure Information sub-heading to enter the principal procedure code and procedure date. If needed, expand the Other Procedure Information sub-heading to add one or more other procedure codes and procedure dates.
Expand the Operating Physician Information sub-heading to enter the physician’s provider ID and ID type.
Expand the Other Operating Physician Information sub-heading to enter the second operating physician’s provider ID and ID type.
Expand the Rendering Physician Information sub-heading to enter the rendering physician’s provider ID and ID type.
Expand the Referring Physician Information sub-heading to enter the referring physician’s provider ID and ID type.
Expand the Bill Note sub-heading to add a note to the bill.
In the Service Line Item Information section, at a minimum, enter or select values for the required fields.
Expand the Line Drug Information sub-heading to enter any required drug information on the bill.
When you are finished on the page, click the Add Service Line Item button.

The system updates the Institutional Bill page and displays the submitted details in the Line Item Information list at the bottom of the page.

If necessary, click the Line No. hyperlink at the bottom of the page to make any changes to the line information and then click the Update Service Line Item button.
Select Submit Bill.

The system displays a pop-up message asking if you want to submit any backup documentation.

Select OK.

The system displays the Backup Documentation page.

Select Browse to select the file to be uploaded as backup.

Note that only PDF, TIF, or TIFF files can be selected.

Select OK.

The system displays the Submitted Institutional Bill Details page with the newly generated TCN.

Select Submit to process the bill for adjudication.

The system displays a dialog message saying that the bill was submitted successfully.

Select OK to return to the Institutional Bill page and add another bill.

View the newly generated bills in the Inquire Bills section.

In the Inquire Bills list page, click the TCN hyperlink for the bill that you want to view.

The system displays the bill with the updated Bill Status and the Processing Status as Edits Processed.

Submit Institutional

Related Topics