DDE
WEB PORTAL DIRECT DATA ENTRY
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What or why is "real time" better? |
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What or why is "real time" better? Real time, is so much better. The claim is transmitted and validated as it is received (once you submit it). What this really means is that you will know right away your claim has been received (no more wondering or dealing with "reject" reports) also you will know right away the status of your claim. Real time process is immediate! |
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When is the best time to directly enter my claim? The best time to directly enter your claim is Sunday through Friday between the hours of 6 a.m. - 6 p.m. (MST). Claims entered by Friday 6 pm could be adjudicated and reflect as early as Monday on your Remittance Advice. |
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What is claim adjudication? Claim adjudication is the process of comparing the data on a claim to the recipient's authorized benefits and Medicaid rules and requirements (edits) for payment. |
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How quickly can I check the status of my claim using the Web Portal? With Direct Data Entry you will know the status of your claim as soon as you submit the claim. A TCN number is generated when the claim is submitted. |
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How much time will it take to create my claim on the web portal? It always takes longer when you're doing something for the first time. However, after entering a few claims, you will find that Direct Data Entry is more time efficient as you are not completing a full claim form. All required information is marked with a red asterisk to make it easier for you to create claims. |
| Can I submit adjustment/voids via the NM Medicaid Web Portal? |
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Yes. However, only paid claims that have been processed via the NM Medicaid Portal can be adjusted or voided online. |
| Can I submit Third Party Liability claims through the web portal? |
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Yes. TPL claims can be submitted through the portal, due to the ability to upload attachments. |
| Can I rebill through the web portal? |
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Yes. Claims that have been entered through the portal can be rebilled immediately through the web portal. |
| Is there technical support if I have questions with using the web portal? |
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The NM Medicaid Web Portal is supported by a team of knowledgeable professionals via the Consolidated Customer Service Center (CCSC). They can be reached at HIPAA.Desk.NM@state.nm.us or at 1-800-299-7304. |
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