BCCP Web Data and Billing System

1. BCCP Web Data and Billing System Cycles and Data (results of office visits, labs and procedures) Filing claims Checking Claim status Viewing EOB Troubleshooting

2. The CyclesShow history of client services with the BCCP • Breast Cycle • Contains data related to all breast services • Results are entered by provider as soon as they are received. • A cycle can be short (normal screening procedures) • Or long (diagnostic procedures) • Cervical Cycle • Contains data results related to all cervical services • May also be short or long depending on needed procedures

3. What is a Cycle? • A cycle is the interval during which screening and diagnostic procedures take place. • BCCP Cycles contain: • Breast (normal) • CBE • Mammogram • Cervical (normal) • Pelvic • Pap • A cycle begins on the date of the first BCCP paid, performed procedure. • A cycle ends when the final outcome is “Follow Routine Screening” or when final results are entered.

4. Breast and Cervical Cycles • The “Cycle Tree” • Open BCC Web System • Log In • Click “Clients” at top • Search for Client • Verify client name and • date of birth • Scroll to bottom left

5. Breast CycleOpening a New Cycle • In the Actions menu, click New Breast Screening OR • In the Cycle tree, click New Cycle • Client history from a prior cycle is visible, if available • Fill in information for the current cycle of care • If no cervical services are being provided select a reason from Drop Down Menu in the • Click Save after completing the Clinical Breast Exam section

6. Breast Cycle Continued • If test results are pending, click Save at the very end. The data is saved, but the cycle remains open so you can enter results when they are received. • When all data is entered, click Save and Close in the pop-up window. The cycle is complete. • After both breast and cervical cycles are complete, you are ready to file claims for reimbursement.

7. System Announcements • Effective 7-1-2012Important Change in Reimbursement for Surgical Breast BiopsiesPrior BCCP authorization is now required for all surgical breast biopsies (CPT codes 19101, 19120, 19125, 19126, 19290, 19291). These biopsies will only be covered as diagnostic procedures to rule out breast cancer. These procedures will not be covered for treatment of benign conditions.Please call Kathy Mix at 971-673-1054 or 971-673-0581 for prior authorization. A review of medical records may be necessary. You may fax medical records to 971-673-0997. Providers may not bill clients for these services without signed consent. (ORS 409.50; 409.010) The list of approved procedures on the BCCP website (www.healthoregon.org/bcc) is updated to reflect these changes.

8. Closing the Breast Cycle

9. Correcting a cycle • If a cycle is closed and you need to correct or change data, you must open the cycle first. • Select Breast History in the “Cycle Tree” • Scroll to bottom of page • Select Open Cycle • Select Breast History again in the “Cycle Tree” • Change and save data

10. Filing a New Claim

11. Filing a Claim • Log into BCCP Web Data System • Select “Claims” Button along the top • At the left, select “Client Search” • Search for Client by ID# and DOB • In Results Box, click on name of Client • On left hand side, click on New Claim • Enter all information • Scroll to Bottom, click “Submit Claim”

12. Filing a ClaimClaim Complete, Submit Claim

13. Filing Claims Handy Hints and Helpful Tips • Go to www.healthoregon.org/BCC • Print out list of CPT and ICD-9 codes • Updated version: Effective July 1, 2012 • Keep it Handy, refer to it Often! • Any CPT or ICD-9 code not on the list is not covered by the BCCP. Your claim will be denied. • All 19xxx codes require that you enter a place of service • Claims are processed the 2nd and 4th Friday of every month

14. Explanation of Benefits (EOB) • Once you have received a payment from BCCP go online to obtain your EOB • Log into the Web Data System • At the top, click on Reports • At the left, click on EOB/Billing Report • From the Drop Down Menu, select date of the batch you wish to view • Usually, you will simply select the most recent date

15. Viewing Your Explanation of Benefits On your EOB you can see: • The TCN (transaction control #) • The Client BCCP ID # • Name of Client • Client DOB • Date of Service (DOS) • CPT codes that were filed • Amount Charged • Amount Paid • Error Messages

16. Explanation of Benefits(EOB) Screen shots do not contain real patient information

17. Transaction Control Number • What is that long number with all the zeros? • Transaction Control Number • TCN:   2010120700000010900 • The first 8 Digits are important! • This is the date you filed/entered your claim • BCCP Processes claims every 2nd and 4th Friday • When the claim was entered tells you which EOB to look at

18. Claim Status & TCN

19. View a Client Claim • To view the status of a claim you have filed: • Go to “Claims” at the top of the screen • Client Search, find, verify name and date of birth • Click on name of Client in Results Box • A list of all claims filed for client from your agency will show • To view claim and reason for denial: • Click on line of one of the claims • Claim opens • Claim will show status of each section and reason for denial if denied

20. Example of Denied Claim

21. Claims Problems? Please call: Emily Havel: 971-673-1060 System/Billing Specialist or e-mail: BCCP.info@state.or.us

22. Cycle/Data Questions? Please call Kate Schmidt: 971-673-1048 or e-mail your question to: BCCP.info@state.or.us Funding for this program generously provided by: