Change Healthcare thru Barnestorm for NC Medicaid PCS Managed Care


Change Healthcare thru Barnestorm for NC Medicaid PCS Managed Care


Barnestorm has a Claims Builder monthly service that allows you to use EVV visits in Barnestorm the way you normally would, and then build a billing claim for MCO patients that you can upload to the Change Healthcare portal through a sftp interface in Barnestorm. There is a monthly charge for this service, and we will need to turn it on for you to use it.

Overview

This process is done from Barnestorm Office > Billing > HIPAA Transactions> Transmit to Change Healthcare.   

Once the connection has been established the left side of the screen will load all of the eligibility and claim files from the local folder. None of the Change Healthcare payers post electronic remittance; you have to retrieve/download those from the payer portal. Barnestorm does not have instructions for payer portals, so please contact the payer for those instructions.


Using this Feature

Click the Connect button to establish a connection.

The left panel are local files, ie. claims generated in Barnestorm. The right panel are files in your mailbox to receive. 

The files are displayed in date/time order, from newest to oldest.  The left panel files have symbols to tell you the status of the file:

(1) a red arrow pointing left-to-right on a white background = file has not been transmitted; 

(2) a red arrow pointing up on a black background = file has been transmitted but no response (.277 file) has been received back; 

(3) a green check mark = response file received indicating the claims were accepted;

(4) a red exclamation mark on a yellow triangle = response file received indicating the claims were rejected;

(5) yellow caution icon = there's an issue with the claim and it was rejected.  The entire batch needs to be recreated and sent again. 


When you click on a file in the left panel, and the image is the red arrow pointing to the right, then the Send button will be visible between the panels. Multiple files can be selected by holding down the Shift or Ctrl keys and clicking on other files in that panel. Clicking the Send button to transmit all selected files.

Any file sent to Change Healthcare can be rejected, whether it’s claims or eligibility verification. If the icon to the left of a file is a red exclamation mark on a yellow triangle, and you click on that file name, a screen with an explanation of the problem will pop up that tries to indicate what the problem is and which patient has the problem. That icon means that the ENTIRE batch has been rejected, not just that one patient, and when the problem is fixed, the entire batch must be created again and sent to Change Healthcare.

Download and view the 277 file to see if claims were accepted or rejected


Review of each Button

Empl# = Enter the Barnestorm employee code for the files you want to view (the employee who created the file). 

Days = The number of days to pull up in the list.

View Selected File = Select a file from left panel and view the contents.

Validate Files = This process is done once you receive files from Change Healthcare.  If you notice the files you receive from Change Healthcare do not appear on the left side, you will want to select it.  It will review all file types that are not saved with proper name and renames them so that Barnestorm will recognize them.  Also, if it is a 999 file then it looks for the corresponding file from the local machine and marks it as accepted or rejected.  You will want to select this button if you have to manually download files from Change Healthcare

Select One Folder = If you save files under multiple folders you can select which one to view.

SEND  / RECEIVE  = Select a file to send to Change Healthcare.