2017 Qualified Health Plans Educational Webinars. Frequently Asked Questions (FAQ) from sessions held week of: 1/2/2017 1/6/2017
|
|
- Rosanna Rich
- 5 years ago
- Views:
Transcription
1 2017 Qualified Health Plans Educational Webinars Frequently Asked Questions (FAQ) from sessions held week of: 1/2/2017 1/6/ Can a specialist submit for preauth or will this have to go through the PCP? 2. It is my understanding that if the service needed is not available in the Hometown North network and we have to send our patients to Kootenai Health for specialists, these services will be processed as in-network? 3. If an ambulatory surgery center (ASC) bills for a surgery, does the ASC also need to put the referring PCP in box 17? 4. Are referrals from a PCP to in-network specialists automatically approved? 5. How long are referrals from a PCP to a specialist valid for? 6. As a specialist requesting authorization for CT scans, do we still go through the AIM portal or do these now go through the referral portal? 7. If we have a referral for a patient to see our provider and he needs to order imaging or other services, does the referral cover these services or do we still need a separate referral for each service? 8. Is there a way to get more urgent gap referrals if it is felt that the patient should not wait that long? 9. Will retro referrals be approved? 10. With the understanding that authorizations for services still must obtained either through AIM or the referral portal (JIVA), what about the radiologist that is reading the imaging? Do we need a referral for that? 11. Can one office have more than one login for bcidaho.com? 12. If a specialist must refer the patient to another specialist, must they go through the PCP? 13. If we don t have a copy of the patient s insurance card and the patient gives us their ID number so we may check their eligibility, will their eligibility say if their policy is one of the new QHP plans? 14. Did I hear correctly that an ambulatory surgery center (ASC) does not need a referral? 15. Can you show us where we find a list of our patients? 16. Where can we find a list of alpha prefixes for QHP members? 17. Where do we sign up for JIVA, the online referral tool?
2 18. For x-ray claims, whose name should appear in box 17? 19. I do prior authorizations for multiple physicians and offices for their patients to be sent to a facility for diagnostic testing. Do I or the facility need to be concerned if the patient is being sent from a specialist that there is a referral in place for that specialist? 20. When looking at authorization status, does processed mean the referral was approved? 21. Are claims processed as member liability or provider liability if referrals or prior authorizations are not obtained? 22. Do the True Blue Medicare Advantage plans need referrals? 23. We have many patients who live in Idaho but deliver their babies in Wyoming, which is out-of-network. Patients are telling us that Blue Cross of Idaho is requiring them to obtain a gap referral for this hospital. How do we do this? Is it an inpatient referral? If so, how would we know an admission date and how far in advance does this need to be done? 24. Where are the weekly webinar FAQs posted? 25. Are these referrals only necessary for Blue Cross of Idaho plans obtained through the healthcare exchange or do the plans offered through employers also need referrals? 26. Are facilities required to have their own referral? 27. We have a patient whose network is Hometown North. Per the Provider Directory, it shows the patient s preferred PCP is contracted with Kootenai Care Network but not the Hometown North network. Will a referral request be considered out-of-network? 28. We are an ASC and if we need a referral or authorization, does our name need to be on the referral and/or authorization for it to be valid for us? 29. Where on the Blue Cross of Idaho website can we find the patient s PCP? 30. We have patients who live in the Hometown East network that are currently receiving chemotherapy at our Mountain View network facility. What do we do with them? Do we have to hold treatment until they can get an approved gap referral? 31. Podiatrists have never had to have a referral before. Do we have to have one now? 32. We just tried to access the online referral system (JIVA), and we are receiving a message that says that our browser is not compatible. What does this mean? 33. Some of our QHP patients have not yet picked a PCP. Is there a grace period offered to patients while they are deciding on one? If patients have not yet picked a PCP, how can specialists obtain referrals? 34. Can you please further clarify oncology services? Is it the specialist that needs the referral or the specialist and the facility that administers chemotherapy that needs a referral?
3 35. We are an urgent care and family practice office that is located in Madison County and therefore are in the Hometown East network. When searching our facility in the provider directory, it shows that we accept Hometown East and Mountain View networks. Does that mean we can accept patients from either network without a referral? 36. Are these webinars recorded and will they be available to view online at a later time? Answers 1. Can a specialist submit for preauth or will this have to go through the PCP? Specialists must obtain their own prior authorization for any services that require it. Referrals must be submitted by the PCP for the patient to see a specialist. Remember that referrals are for provider to provider. Prior authorization is a pre-service request to validate medical necessity. 2. It is my understanding that if the service needed is not available in the Hometown North network and we have to send our patients to Kootenai Health for specialists, these services will be processed as in-network? If a patient must be referred for specialist care outside of their network, an approved gap referral would be required. An approved gap referral would mean that services would process for in-network benefits. Keep in mind that any specialist service that requires prior authorization would need to be requested by that specialist. For a list of services that require prior authorization, please select here. 3. If an ambulatory surgery center (ASC) bills for a surgery, does the ASC also need to put the referring PCP in box 17? Yes. All providers other than PCPs will need to enter the name and NPI of the referring PCP into box 17 of the claim form or box 17b of the electronic claim submission. 4. Are referrals from a PCP to in-network specialists automatically approved? Yes. Referrals from a PCP to an in-network specialist will be approved in a matter of minutes. Out-of-network or gap referrals will take longer to approve and could take up to days. 5. How long are referrals from a PCP to a specialist valid for? Generally, most referrals are approved for the remainder of the current year unless specifically requested otherwise by the PCP. Gap referrals for out-of-network providers may have other time or visit restrictions and this will be communicated to the patient, the PCP, and the specialist by Healthcare Operations.
4 6. As a specialist requesting authorization for CT scans, do we still go through the AIM portal or do these now go through the referral portal? Prior authorization for imaging will still go through the AIM portal. Referrals do no negate the need for prior authorizations. 7. If we have a referral for a patient to see our provider and he needs to order imaging or other services, does the referral cover these services or do we still need a separate referral for each service? Remember that referrals are from provider to provider. Approved referrals allow the specialist to see and treat the patient during the dates that the referral is valid for. However, if any treatment, imaging or surgery requires prior authorization, this must be obtained by the specialist prior to rendering services. 8. Is there a way to get more urgent gap referrals if it is felt that the patient should not wait that long? In step 2 of the referral process through the provider portal, a PCP may chose referral type Urgent to denote the urgency of their request. Also, step 7 of the referral process allows a PCP to explain why they are requesting a gap referral and the urgency of that referral request may also be explained here. For referral entry instructions, select here. 9. Will retro referrals be approved? Providers will have 60 days to request a retro-referral if specific criteria are met. Provider Administrative Policy (PAP) 1005 further explains these criteria. 10. With the understanding that authorizations for services still must obtained either through AIM or the referral portal (JIVA), what about the radiologist that is reading the imaging? Do we need a referral for that? No. Radiology services, including readings, do not require a referral. Referrals will not be required and in-network benefits will apply for the following provider types: radiologist (exception-interventional radiology services), anesthesiologist (exceptionpain management), independent laboratory, and pathologists. 11. Can one office have more than one login for bcidaho.com? Yes. Each individual user should have their own individual username and password. To request additional or delete usernames and passwords, the existing administrator of the bcidaho.com account can logon to the provider portal and select My Account icon at the top of the page. Then select Account Maintenance and then add user. Enter all the information regarding the new user and select finish. To make a modification to an existing user account, select edit to make the necessary changes.
5 12. If a specialist must refer the patient to another specialist, must they go through the PCP? Yes. All referrals must be generated by the PCP. This process is the intent of the 2017 QHP plans in which the PCP is the cornerstone of a patient s care and it is meant to keep the PCP well informed of the specialty care their patient s need. 13. If we don t have a copy of the patient s insurance card and the patient gives us their ID number so we may check their eligibility, will their eligibility say if their policy is one of the new QHP plans? Patient s eligibility will clearly indicate if they are in one of the new tailored network plans. The ID card that may be printed from a patient s eligibility screen will have the network name at the top, middle, and bottom banner of the card. The phrase referrals required will also be listed on the card. To view specific examples of ID cards, select the 2017 Qualified Health Plans link on the right side of the main page of the provider portal. You may then select your region from the state map that will appear and examples of ID cards will be listed. 14. Did I hear correctly that an ambulatory surgery center (ASC) does not need a referral? Yes but only if the ASC is in-network with the patient s plan. The referral issued to a specialist will follow that specialist regardless of where the specialist renders services. If, however, the ASC is out-of-network for the patient, then a referral would be required for the ASC. 15. Can you show us where we find a list of our patients? PCPs are mailed a patient roster list each month. Please refer to Member Tracking Information in PAP 611 for more information about patient rosters. 16. Where can we find a list of alpha prefixes for QHP members? PAP 102 contains a list of all alpha prefixes. This list also indicates whether a plan was purchased on or off the healthcare exchange. You may also find examples of ID cards by selecting the 2017 Qualified Health Plans link on the right side of the main page of the provider portal. Select your region from the state map and examples of ID cards will be listed. 17. Where do we sign up for JIVA, the online referral tool? If you have a username and password for the provider portal, you already have access to the JIVA system to enter and/or view referrals.
6 18. For x-ray or lab claims, whose name should appear in box 17? For x-ray or lab claims, the name of the ordering provider, regardless if it s the PCP or specialist, is required in box 17. Only referral-required specialty services need the name of the referring PCP and their NPI in box 17 or 17b of the CMS1500 claim form. For more information, please review PAP For a list of services that do not require a referral, select here. 19. I do prior authorizations for multiple physicians and offices for their patients to be sent to a facility for diagnostic testing. Do I or the facility need to be concerned if the patient is being sent from a specialist that there is a referral in place for that specialist? No. A specialist may refer a patient to any facility for diagnostic testing as long as that facility is within the patient s network.if the facility that patient needs is out-of-network, then a referral from the PCP would be required. If the diagnostic testing or imaging requires prior authorization, it is the responsibility of the ordering provider to obtain that prior authorization prior to services being rendered. 20. When looking at authorization status, does processed mean the referral was approved? When viewing the status of a referral, the term processed means that a determination has been made. To review the determination status, select the reference ID or OP under episode type and refer to Authorization Details for the approved or denied status. 21. Are claims processed as member liability or provider liability if referrals or prior authorizations are not obtained? If no referral is obtained for an in-network specialist, services will process at the allowed rate, and benefits may apply to the patient s out-of-network benefit. If no referral is obtained for an out-of-network specialist, services will process at the allowed rate and will apply to the member s out-of-network benefit. If a prior authorization is not obtained for in-network services, benefits will process as provider liability. 22. Do the True Blue Medicare Advantage plans need referrals? No. The information we are providing in these webinars only applies to the individual Qualified Health Plans, also known as the Affordable Care Act (ACA) plans. Referrals are not required for True Blue Medicare Advantage plans, the commercial PPO plans or Traditional plans.
7 23. We have many patients who live in Idaho but deliver their babies in Wyoming, which is out-of-network. Patients are telling us that Blue Cross of Idaho is requiring them to obtain a gap referral for this hospital. How do we do this? Is it an inpatient referral? If so, how would we know an admission date and how far in advance does this need to be done? In an instance like this, a gap referral would be required if the patient must go out-ofstate for their delivery, even though maternity services would not normally require a referral. The patient s designated PCP will need to enter a gap referral for the out-ofnetwork facility, following the same steps they would as if submitting a gap referral for a specialist. Please include notations explaining the circumstances as to why services are being requested for an out-of-network facility. Without an approved gap referral, facility charges will apply to the patient s out-of-network benefits regardless of the performing provider s network or referral status. Regardless of referral, maternity admission notification must be submitted within 24 hours of the admission or by the end of the next working day after admission on a weekend or legal holiday. For more inpatient notification information, please refer to PAP Where are the weekly webinar FAQs posted? All the questions asked during our weekly webinars and their answers are posted to a link on the main page of the provider portal titled 2017 QHP Educational Webinars- Weekly FAQs. This is located under the Important Announcements heading and is right below the webinar invite section. Each week s FAQs are usually posted to the provider portal by Wednesday of the following week. 25. Are these referrals only necessary for Blue Cross of Idaho plans obtained through the healthcare exchange or do the plans offered through employers also need referrals? Referrals are required for any individual QHP plan regardless of whether it was purchased through the healthcare exchange, through a broker or through our Blue Cross of Idaho shopper s website. Referrals are not required for commercial PPO plans offered through employers. 26. Are facilities required to have their own referral? Facilities are not required to have their own referral as long as they are within the patient s network. Out-of-network facilities will need a gap referral from the PCP. This can be done by following the same steps they would as if submitting a gap referral for a specialist and include notations explaining the circumstances why services are being requested at an out-of-network facility. Without an approved gap referral, facility charges will apply to the patient s out-of-network benefits regardless of the performing provider s network or referral status.
8 27. We have a patient whose network is Hometown North. Per the Provider Directory, it shows the patient s preferred PCP is contracted with Kootenai Care Network but not the Hometown North network. Will a referral request be considered out-of-network? A patient may only select a PCP that is contracting with their specific network. In this case, a patient in the Hometown North network would not have the option to select a PCP in the Kootenai Care network. If this patient needs to be referred to an out-ofnetwork specialist, then an approved gap referral would be required for the patient to receive in-network benefits. 28. We are an ASC and if we need a referral or authorization, does our name need to be on the referral and/or authorization for it to be valid for us? If you are within the patient s network, your ASC will not need its own separate referral. If, however, you are serving a patient that is outside of your network, the patient s PCP would also have to issue a referral for your facility. If the services being performed require prior authorization then the prior authorization would need to include your ASC or facility name. 29. Where on the Blue Cross of Idaho website can we find the patient s PCP? A patient s PCP can be found by performing a member search. After logging onto the provider portal, hover over the Eligibility & Claims tab and select Member Search from the drop down menu. You will then be prompted to enter the member s last name and date of birth or enrollee ID if you have it, then select the blue Search button. You will then see a list of policies for that patient, with the most current policy being at the top of the list. From here, you may select View ID Card and an image of the member s card will open, or you may select their name and an Eligibility Information screen will then appear. If the patient has chosen a PCP by the time of your search, it will display under the Member Information heading. Remember, a patient may often change their PCP so a patient s ID card information may not be current. The Blue Cross of Idaho website will provide the most up-to-date PCP and plan information. 30. We have patients who live in the Hometown East network that are currently receiving chemotherapy at our Mountain View network facility. What do we do with them? Do we have to hold treatment until they can get an approved gap referral? If the patients that you are referring to are currently receiving active treatment, this care would fall under the provisions of Continuity of Treatment; please see PAP 1005 for more information and the definition of active treatment. In this case, patients or their providers should contact customer service to inform us of this situation so that the patient may be assigned a case manager by our Healthcare Operations department. This enables a 90- day referral to be added to the patient s plan so that their active treatment may continue to be processed at in-network benefits. A patient will then be
9 redirected to an in-network provider or facility or an approved gap referral must be obtained. 31. Podiatrists have never had to have a referral before. Do we have to have one now? If you are treating a patient that has one of the new 2017 QHP plans, then you would be considered a specialist, or a non-pcp provider, and your services would require a referral. Remember, if the patient s most current ID card says Referrals Required or if their member information on our website indicates that they have chosen a QHP plan, then any care provided by a specialist requires a referral from their PCP. 32. We just tried to access the online referral system (JIVA), and we are receiving a message that says that our browser is not compatible. What does this mean? At this time due to system limitations, the JIVA system is only compatible with Internet Explorer 9 or 10, Google Chrome, or Firefox browsers. If you are using Internet Explorer 11 or higher, you may also try hovering over the white gear-shaped icon in the very top right of your screen and select Compatibility View Settings from the dropdown list. This will open another small screen and bcidaho.com should appear in the section titled Add this website. Select Add and this will move bcidaho.com to the window below titled Websites you ve added to Compatibility View. You may then close this window and then try using JIVA again. There is also a Troubleshooting article in red font on the main page of our provider portal, right above the Important Announcements heading that can provide additional assistance. 33. Some of our QHP patients have not yet picked a PCP. Is there a grace period offered to patients while they are deciding on one? If patients have not yet picked a PCP, how can specialists obtain referrals? Yes but ONLY for the month of January. Patient who have not selected a PCP will be able to notify Blue Cross of Idaho of their PCP choice and the PCP selected will be retro-effective for that patient to January 1, Beginning in February, patients who have not notified Blue Cross of Idaho of their PCP of choice will be auto-assigned one based on their geographical location and claims history. No referrals may be issued until a patient has been assigned a PCP. A patient may logon to the member portal to view and update their PCP or they can contact customer service and let them know of their PCP choice. 34. Can you please further clarify oncology services? Is it the specialist that needs the referral or the specialist and the facility that administers chemotherapy that needs a referral? In the case of oncology services, the oncologist would need a referral regardless if they were in or out-of-network; if the facility administering the chemotherapy is in the patient s network, no additional facility referral would be required. However, if the
10 chemotherapy services required prior authorization, the facility that would be administering those chemotherapy services would need to be included in the prior authorization request. 35. We are an urgent care and family practice office that is located in Madison County and therefore are in the Hometown East network. When searching our facility in the provider directory, it shows that we accept Hometown East and Mountain View networks. Does that mean we can accept patients from either network without a referral? Family Practice Services: You may only see patients with the Hometown East network without a referral for family practice services, as family practice is a primary care provider type that does not require referrals when within the network. You will need to obtain a gap referral for patients with the Mountain View network from their designated Mountain View. Urgent Care Services: Urgent care services, when billed with Place of Service 20 do not require a referral regardless of the patient s network. 36. Are these webinars recorded and will they be available to view online at a later time? Each webinar is recorded and a copy of the recording will be made available upon request to those who have attended. To request a copy of the webinar, please reply to either your invite to the WebEx or to the survey request sent at the end of each week. Special Reminder: The changes discussed above only apply to the Affordable Care Act (ACA) plans purchased through the healthcare exchanges, insurance brokers, or through the shopper s page on the Blue Cross of Idaho website for individual members and their family. Large commercial insurance plans that are furnished through employer groups such as Albertson s or Simplot for example, will not be affected by these changes.
2017 Qualified Health Plans Educational Webinars. Frequently Asked Questions (FAQ) from sessions held week of: 12/19/ /23/2016
2017 Qualified Health Plans Educational Webinars Frequently Asked Questions (FAQ) from sessions held week of: 12/19/2016 12/23/2016 1. You have referred us to the Blue Cross of Idaho website to check the
More information2017 Qualified Health Plans Educational Webinars. Frequently Asked Questions (FAQ) from sessions held week of: 1/23/2017 1/27/2017
2017 Qualified Health Plans Educational Webinars Frequently Asked Questions (FAQ) from sessions held week of: 1/23/2017 1/27/2017 1. Do the reference or certification numbers of the referral need to be
More informationCareTracker Patient Portal Tips
CareTracker Patient Portal Tips by Phasis Group, LLC CONTENTS Purpose... 2 Patient Portal Manual and Help... 2 Requirements for Patient s Computer... 2 Operating System / Internet Browsers... 2 Internet
More informationCreating A Patient Portal Link From More Patient Button
Creating A Patient Portal Link From More Patient Button Go to More Patient and click on the Export PHI tab. From this tab, click on Create Patient Portal Link. Note: Allow Internet Based Delivery Of Reminders
More informationCareCore National & Alliance Provider Training Material
EVIDENCE-BASED HEALTHCARE SOLUTIONS CareCore National & Alliance Provider Training Material Prepared for: March 6, 2014 Contents CareCore National... 3 Alliance and CareCore National Partnership... 4 Radiology
More informationOnline Application Help
Online Application Help The Search for Grants website is noted throughout this document, however we also manage many other foundations that are not hosted on the website, but do utilize our online applications.
More informationNIA Magellan 1 Frequently Asked Questions (FAQ s) For Coventry Health Care of Illinois Providers
NIA Magellan 1 Frequently Asked Questions (FAQ s) For Coventry Health Care of Illinois Providers Question GENERAL Why is Coventry Health Care of Illinois implementing an outpatient imaging program? Answer
More informationPA/MND Review of Spine Surgery services Questions & Answers
PA/MND Review of Spine Surgery services Questions & Answers 1. What is the Musculoskeletal Program? Horizon BCBSNJ has expanded our Pain Management Program with evicore to include Pain Management and Spine
More informationPrecertification Tips & Tools
Working with Anthem Subject Specific Webinar Series Precertification Tips & Tools Access to Audio Portion of Conference: Dial-In Number: 877-497-8913 Conference Code: 1322819809# Please Mute Your Phone
More informationHELLO HEALTH TRAINING MANUAL
HELLO HEALTH TRAINING MANUAL Please note: As with all training materials, the names and data used in this training manual are purely fictitious and for information and training purposes only Login/What
More informationGuide to Enterprise Zone Pre-Certification
This user guide provides web screen shots to reach the application portal from OEDIT s website, navigate the application portal, and complete an Enterprise Zone Pre-Certification application. The OEDIT
More informationSCHOOL VOLUNTEER PROGRAM (For School Liaisons) TABLE OF CONTENTS
TABLE OF CONTENTS Getting Started... 1 Employee Portal - Apps Services and Sites... 2 School Liaison - My Volunteers... 3 Approve/Deny Volunteer Applicants... 4 Select Service Activities For Volunteers
More informationBE A SCHOOL VOLUNTEER (For Parents and Community Members) TABLE OF CONTENTS
TABLE OF CONTENTS Getting Started... 1 Log Into the Community Portal... 2 Log Into the Parent Portal... 3 Volunteer Registration... 5 Select Volunteer Interests and Locations... 6 Edit Service Activities...
More informationAtlas LabWorks User Guide Table of Contents
http://lab.parkview.com Atlas LabWorks User Guide Table of Contents Technical Support 2 Online Directory of Services.......3 Log into Connect.Parkview.com Account... 4 Log into Atlas Account....6 Patient
More informationLOGIN TO INFINITE CAMPUS: A. In Chrome or Firefox, copy and paste the following URL and hit return and the IC login window will open
A staff member that has been given IC rights to review and approve the application. Usually Office Support or staff member certified in Census/Enrollment. The staff member can only approve applications
More informationAdvanced Diagnostic Imaging (ADI)
Advanced Diagnostic Imaging (ADI) 2016 1 eqhealth Solutions 2 Overview of eqsuite» 24/7 accessibility to submit review requests to eqhealth via web.» Secure transmission protocols that are HIPPA security
More informationBCBSNC Best Practices
BCBSNC Best Practices Thank you for attending today! We value your commitment of caring for our members your patients and our shared goals for their improved health An independent licensee of the Blue
More informationClinical Forms Training Guide
Clinical Forms Training Guide 900-1177-0715 1 Summary On August 3, 2015, Florida Blue implemented an electronic Certificate of Medical Necessity called Clinical Form. For certain procedures, a Certificate
More informationBlue Cross Physician Choice PPO Provider FAQ 8/1/17
Blue Cross Physician Choice PPO Provider FAQ 8/1/17 Background Blue Cross Physician Choice PPO is an innovative group plan centered on coordinating care through Organized Systems of Care, or OSCs. Physician
More informationDMA Provider Services Medicaid and NCHC Providers. November-December 2016
DMA Provider Services Medicaid and NCHC Providers November-December 2016 Purpose and Agenda Purpose To provide answers and clarification regarding OPR and CCNC/CA billing guidance for Medicaid and NCHC
More informationMyHealthPortal: Frequently Asked Questions Updated: June Using MyHealthPortal
MyHealthPortal: Frequently Asked Questions Updated: June 15 2018 Using MyHealthPortal What do I see in the portal? Interior Health (IH) lab results, medical imaging reports (such as X-ray, CT and ultrasounds)
More informationKentucky Spirit Health Plan Provider Training Program
Kentucky Spirit Health Plan Provider Training Program Provider Training Program Agenda Welcome and Opening Remarks About NIA The Provider Partnership The Program Components The Provider Assessment Program
More informationOnline Grant Application Instructions
Online Grant Application Instructions Before You Begin 1. Visit www.mainecf.org/grantapp.aspx. Review the instructions and gather the information you will need. Getting Started After you have gathered
More informationPsychiatric Consultant Guide CMTS. Care Management Tracking System. University of Washington aims.uw.edu
Psychiatric Consultant Guide CMTS Care Management Tracking System University of Washington aims.uw.edu rev. 8/13/2018 Table of Contents TOP TIPS & TRICKS... 1 INTRODUCTION... 2 PSYCHIATRIC CONSULTANT ACCOUNT
More informationProvider Additions and Demographic Maintenance Reference Guide
Table of Contents Introduction... 3 Anthem public provider website... 3 Council for Quality Affordable Healthcare (CAQH )... 3 Providers Requiring Credentialing Medical... 4 Facilities and Health Delivery
More informationBCBSIL iexchange Reference Guide
BCBSIL iexchange Reference Guide April 2010 A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. Table of
More informationGrant Program
Preventive Controls Alliance Training Grant Program http://afdo.org/pcgrants REPORTING AND REIMBURSEMENT INSTRUCTIONS CALENDAR YEAR 2017 Providing funds for state, local, tribal, and territorial food safety
More informationOnline Eligibility Training will be held via WebEx on
Online Eligibility Training will be held via WebEx on Thursday, August 4 th, 2016 at 02-3:00 PM or Tuesday, August 9 th, 2016 at 11-12:00 Noon Presented by BHS Billing Unit 1380 Howard Street, SF 94103
More informationUser Guide for Patients
User Guide for Patients December 2016 Contents Health365 Overview... 3 What can I do with Health365?... 3 How to get started... 4 Sign In... 4 Home Page - Patient options... 6 Appointments... 7 To make
More informationSite Manager Guide CMTS. Care Management Tracking System. University of Washington aims.uw.edu
Site Manager Guide CMTS Care Management Tracking System University of Washington aims.uw.edu rev. 8/13/2018 Table of Contents INTRODUCTION... 1 SITE MANAGER ACCOUNT ROLE... 1 ACCESSING CMTS... 2 SITE NAVIGATION
More informationMEDICAL SPECIALISTS OF THE PALM BEACHES, INC. Chronic Care Management (CCM) Program Training Manual
MEDICAL SPECIALISTS OF THE PALM BEACHES, INC. Chronic Care Management (CCM) Program Training Manual September 2017 Table of Contents CCM PROGRAM OVERVIEW... 4 3 STEPS TO BEGIN CCM:... 5 Identify the Patient...
More informationDiagnostic Imaging Management
Diagnostic Imaging Management Provider Office Staff Training Updated May 2012 An independent licensee of the Blue Cross and Blue Shield Association. U7430b, 2/11 Diagnostic Imaging Management Program
More informationRE: Important Information Regarding Prior Authorization for High Tech Imaging Services
Name Address City, St Zip RE: Important Information Regarding Prior Authorization for High Tech Imaging Services Dear Provider: Blue Cross and Blue Shield of Louisiana and HMO of Louisiana, Inc., (HMOLA),
More informationOptima 101: PARTICIPANT GUIDE
Optima 101: Introduction to Care Operations Management (COM) PARTICIPANT GUIDE 2017 Optima Healthcare Solutions Page 1 CONTENTS CONTENTS... 2 ABOUT THIS GUIDE... 3 LEARNING OUTCOMES... 4 1. LOGGING INTO
More informationApplicant User Guide
Office of Certification and Professional Preparation Process for Online Initial Teaching Applications (Form 20T) Applicant User Guide Last Updated 4/21/2016 The West Virginia Department of Education, Office
More informationBlue Cross and Blue Shield of Kansas Electronic Inpatient Precertification System Manual. February 2017
Blue Cross and Blue Shield of Kansas Electronic Inpatient Precertification System Manual February 2017 ACKNOWLEDGEMENT: CPT codes, descriptions and material only are copyright American Medical Association.
More informationChoice PPO Retired Employees Health Program Non-Medicare Eligible Retired Members
Choice PPO Retired Employees Health Program Non-Medicare Eligible Retired Members DEDUCTIBLE (per calendar year) Annual in-network deductible must be paid first for the following services: Imaging, hospital
More informationMagellan Healthcare 1 Frequently Asked Questions (FAQ s) For Magellan Complete Care of Florida Providers
Magellan Healthcare 1 Frequently Asked Questions (FAQ s) For Magellan Complete Care of Florida Providers Question GENERAL Why did Magellan Complete Care implement a Medical Specialty Solutions Program?
More informationTraining: Federally Facilitated Marketplace. Registration Process and Tips from Custom Benefit Plans, Inc.
Training: Federally Facilitated Marketplace Registration Process and Tips from Custom Benefit Plans, Inc. Introduction All agents who wish to participate in the Federally Facilitated Marketplaces or off
More informationSTEP ONE: Set Up an Account to Access the Fluxx Grant Portal
STEP ONE: Set Up an Account to Access the Fluxx Grant Portal 1. Log on to http://hillman.fluxx.io to create a grantee account, or if you are a returning user, please login with your username and password.
More informationPsychiatric Consultant Guide SPIRIT CMTS. Care Management Tracking System. University of Washington aims.uw.edu
Psychiatric Consultant Guide SPIRIT CMTS Care Management Tracking System University of Washington aims.uw.edu rev. 9/20/2016 Table of Contents TOP TIPS & TRICKS... 1 INTRODUCTION... 2 PSYCHIATRIC CONSULTANT
More informationTABLE OF CONTENTS. Updated 1/20/2014 Updated ref phy doc Page 2 of 10
TABLE OF CONTENTS Referring Physician Portal Log In................................................... Pg 3 WEB PORTAL Usage of PatientKeeper...........................................................
More informationRETRIEVAL AND CRITICAL HEALTH INFORMATION SYSTEM
RETRIEVAL AND CRITICAL HEALTH INFORMATION SYSTEM USER GUIDE November 2014 Contents Introduction... 4 Access to REACH... 4 Homepage... 4 Roles within REACH... 5 Hospital Administrator... 5 Hospital User...
More informationeqsuite User Guide for Electronic Review Request Acute Inpatient Medical/Surgical DRG Reimbursed
eqsuite User Guide for Electronic Review Request Acute Inpatient Medical/Surgical DRG Reimbursed CONTENTS OVERVIEW OF SYSTEM FEATURES... 3 ACCESSING THE SYSTEM... 4 USER LOG IN - GETTING STARTED... 5 SUBMITTING
More informationGrants emanagement System (GeMS)
Grants emanagement System (GeMS) Affiliate Applicant User Guide Version 2.0 1 Table of Contents Grant emanagement System Guide Overview... 3 Create a Grants emanagement System (GeMS) Account... 5 Creating
More informationSoarian Clinicals Results Viewing Quick User Guide
Soarian Clinicals Results Viewing Quick User Guide Physicians, Medical Secretaries, Residents and Nurse Practitioners (For clinicians who provide care in one unit/location) December, 2008 Vs. c5 Table
More informationHPHConnect for Providers. Habilitative & Rehabilitative Therapies Notifications User Guide
HPHConnect for Providers Habilitative & Rehabilitative Therapies Notifications User Guide December 2017 HPHCONNECT HOME REHABILITATIVE THERAPIES NOTIFICATIONS USER GUIDE Table of Contents A. HABILITATIVE
More informationAHP Online Guide Contact Changes Sponsor or Member
INTRODUCTION Congratulations on your Affordable Housing Program (AHP) award! An AHP award requires the member and sponsor to provide timely reporting on the status of the project. Compliance reporting
More informationGLOBALMEET GLOBALMEET USER GUIDE
GLOBALMEET GLOBALMEET USER GUIDE Version: 3.1 Document Date: 1/25/2013 TABLE OF CONTENTS Table of Contents INTRODUCTION... 1 GlobalMeet Overview... 2 GlobalMeet HD... 3 GlobalMeet Toolbar for Outlook...
More informationApplicant User Guide
Office of Certification and Professional Preparation Process for Renewal/Conversion/Permanent Professional Teaching, Student Support, and Administrative Certificates (Form 4) Applicant User Guide Last
More informationPATIENT PORTAL USERS GUIDE
PATIENT PORTAL USERS GUIDE V 5.0 December 2012 eclinicalworks, 2012. All rights reserved Login and Pre-Registration Patients enter a valid Username and secure Password, then click the Sign In button to
More informationCareer Matchmaker Self-Assessments Module 3
Career Matchmaker Self-Assessments Module 3 Use Career Matchmaker in the Career Cruising software to complete electronic surveys of your interests, skills, and educational levels that you would like to
More informationApplicant Reviewer Quick Guide
Applicant Reviewer Quick Guide Creating a Hiring Proposal January 22, 2016 Contents Applicant Reviewer... 3 Logging In... 3 Changing User Groups... 3 Viewing Postings... 4 Viewing Applicants... 4 Hiring
More informationHealthChoice Radiology Management. March 1, 2010
HealthChoice Radiology Management March 1, 2010 Introduction Acting on behalf of our Medicaid customers in Maryland (HealthChoice), UnitedHealthcare has worked with external physician advisory groups to
More informationEducational Grant and Outcomes Database User Guide
Educational Grant and Outcomes Database User Guide June 06 Table of Contents Getting Started System Tips and Useful Hints p.3 Where to Find Us p.4 Logging in as a Registered User p.5 Registering as a First-Time
More informationSoarian Clinicals View Only
Soarian Clinicals View Only Participant Guide Table of Contents 1. Welcome!... 5 Course Description... 5 Learning Objectives... 5 What to Expect... 5 Evaluation... 5 Agenda... 5 2. Getting Started... 6
More informationRETRIEVAL AND CRITICAL HEALTH INFORMATION SYSTEM
RETRIEVAL AND CRITICAL HEALTH INFORMATION SYSTEM USER GUIDE May 2017 Contents Introduction... 3 Access to REACH... 3 Homepage... 3 Roles within REACH... 4 Hospital Administrator... 4 Hospital User... 4
More informationAMBULATORY SURGERY FACILITY GENERAL INFORMATION
AMBULATORY SURGERY FACILITY GENERAL INFORMATION I. BCBSM s Ambulatory Surgery Facility Programs Traditional BCBSM s Traditional Ambulatory Surgery Facility Program includes all facilities that are licensed
More informationEnvironmental Finance Center at Boise State University
Environmental Finance Center at Boise State University The Directory of Watershed Resources General User and Program Manager Tutorial Texas Directory of Watershed Resources sponsored by the Texas Water
More informationLONDON COMMUNITY GRANTS. Online Application Guide
LONDON COMMUNITY GRANTS 2017 Online Application Guide This application guide is intended to be used with ALL streams of the London Community Grants Program. Pictures shown in this guide are from the Multi-Year
More informationAre your patients up to date?
SUMMER 2014 Are your patients up to date? As your patients physician, you can play a big part in keeping them on track for preventive screenings. You have a stronger influence on the health of your patients
More informationJob Board Guide: Candidates
1 (1) To register: click https://ncpubliccharters.org/jobs/cand idate-panel-2/candidate-registration/ to register yourself as a candidate. Enter your name, username, password, email, and click Register
More informationBlue Essentials SM, Blue Advantage HMO SM and Blue Premier SM Provider Manual - Roles and Responsibilities
In this Section Blue Essentials SM, Blue Advantage HMO SM and Blue Premier SM Provider Manual - Roles and Responsibilities Throughout this provider manual there will be instances when there are references
More informationSponsored Candidate Application Guide. This guide will assist you through the Pharmacy Technician Certification Exam (PTCE) application process.
Sponsored Candidate Application Guide This guide will assist you through the Pharmacy Technician Certification Exam (PTCE) application process. Sponsored Candidate Application Guide Table of Contents Creating
More informationMedical Assistance Provider Incentive Repository. User Guide. For Eligible Hospitals
Medical Assistance Provider Incentive Repository User Guide For Eligible Hospitals February 25, 2013 Contents Introduction...1 Before You Begin...2 Complete your R&A registration... 2 Identify one individual
More informationCare360 EHR Frequently Asked Questions
Care360 EHR Frequently Asked Questions Table of Contents Care360 EHR... 4 What is Care360 EHR?... 4 What are the current capabilities of Care 360 EHR?... 4 Is Care 360 EHR an EMR?... 5 Can I have Care360
More informationfor more information visit GradLeaders.com
for CANDIDATES at our Partner Schools how to REGISTER + SEARCH FOR JOBS with your career services portal powered by GradLeaders last updated July 20, 2017 for more information visit how to REGISTER + SEARCH
More informationCalibrating your tablet allows you to ensure accuracy as you handwrite on the screen and/or select items on the screen. Prime Clinical Systems, Inc 1
Calibrating your tablet allows you to ensure accuracy as you handwrite on the screen and/or select items on the screen. 1 Every user has the capability to set various defaults for themselves. 2 You can
More informationGuide to Enterprise Zone Certification
Guide to Enterprise Zone Certification This user guide provides web screen shots to reach the application portal from OEDIT s website, navigate the application portal, and complete an Enterprise Zone Certification
More informationPHMPapers.org The PHM Society s paper submission, review, and distribution portal Conference Submission Instructions for Authors
PHMPapers.org The PHM Society s paper submission, review, and distribution portal Conference Submission Instructions for Authors 1 Introduction Welcome to PHMPapers.org! The PHM Society is now using a
More informationCare Management User Guide for Dashboards and Alerts. December 21, 2016
Care Management User Guide for Dashboards and Alerts December 21, 2016 Table of contents User Guide Care Management Dashboard and Alerts What are Care Management Alerts and Care Management Dashboards?...
More informationKY Kids Recovery Program (KKRP) and AHARTT Client Information System
KY Kids Recovery Program (KKRP) and AHARTT Client Information System A Collaboration between the Department for Behavioral Health, Developmental and Intellectual Disabilities, the University of Kentucky
More informationMagellan Healthcare 1 Frequently Asked Questions (FAQ s) For Magellan Complete Care of Virginia Providers
Magellan Healthcare 1 Frequently Asked Questions (FAQ s) For Magellan Complete Care of Virginia Providers Question GENERAL Why is Magellan Complete Care of Virginia implementing a Medical Specialty Solutions
More informationTRECA Tri-Rivers Educational Computer Association 2222 Marion-Mt. Gilead Road Marion, OH Parent Assist Module Parents
Tri-Rivers Educational Computer Association 2222 Marion-Mt. Gilead Road Marion, OH 43302 740-389-4798 Parent Assist Module Parents October 2006 DOCUMENT REVISION INFORMATION... 3 TRAINING GUIDE OBJECTIVE...
More informationHow to Use Provider Data Management Tools in Availity
September 2017 How to Use Provider Data Management Tools in Availity Florida Blue conducts all provider data activities through Availity 1. Please refer to the Table of Contents (with embedded links) below
More informationProvider Town Hall Presentation
Provider Town Hall Presentation Topics HAP & Health Care Reform Overview Healthy Engagement Reminder Healthy Michigan Plan HAP Midwest Health Plan Overview ICD-10 & HAP Provider Newsroom Updates 2 HAP
More informationInstructions to apply for fellowships
Instructions to apply for fellowships 2017-2018 Important Note: It is the responsibility of the applicant to be aware of the fellowships deadlines New applicants who are in the process of being admitted
More informationApplicant Tutorial. Overview. Registration Page
Overview This document is designed to provide grant applicants with instructions for use of the Foundant Grant Lifecycle Manager application. Remember while this document attempts to provide step-by-step
More informationReferred Patient Alerts & Online Recruitment Manager for Sites Instructions
Referred Patient Alerts & Online Recruitment Manager for Sites Instructions The following training documentation will explain how you will obtain Referred Patient Alerts (RPAs), update a patient s enrollment
More informationBuilding Plan Approval System
Building Plan Approval System Citizen Copyrights reserved with EGovernments Foundation 2018 Page 1 Copyright egov Building Plan Approval User Manual March 2017 Copyright 2017 egovernments Foundation. All
More informationHealth Alliance. Utilization Management Changes Overview. Maxine Wallner Director Provider Services. February 2017
Health Alliance Utilization Management Changes Overview February 2017 Maxine Wallner Director Provider Services Agenda Decision Overview Utilization Management Program Changes Expansions and modifications
More informationBlue Cross provides administrative claims services only. Your employer or plan sponsor is financially responsible for claims.
HOPE COLLEGE - HOURLY ORANGE 007013084/0011/0012/0013/0014/0015/0016/0017 Simply Blue PPO HSA ASC Effective Date: On or after July 2018 Benefits-at-a-glance This is intended as an easy-to-read summary
More informationSystem to Track and Approve Research STAR Principal Investigator/Proxy User Guide
System to Track and Approve Research STAR Principal Investigator/Proxy User Guide Research Administration 125 Worth Street, 4 th Floor New York, NY 10013 Contents I) BACKGROUND INFORMATION... 3 II) ACCESSING
More informationAIM Alberta Online Measurement Tool Manual. Instructions for Use Part 1: Set Up and Data Collection
AIM Alberta Online Measurement Tool Manual Instructions for Use Part 1: Set Up and Data Collection Spring 2015 Table of Contents Introduction... 2 Getting Started... 3 Set up your Clinic Profile... 4 Enter
More informationSection 4 - Referrals and Authorizations: UM Department
Section 4 - Referrals and Authorizations: UM Department Primary Care Referral Process 1 Referrals to In-Network Specialists 1 Referrals to Out-Of-Network Specialists 2 Consultation Referral Forms 2 Consultation
More informationNavigating Grants.gov
11 Navigating Grants.gov 12 Navigating Grants.gov Search Grants and Applicant Tabs on the Homepage 13 Navigating Grants.gov Applicant Resources: Videos, User Guide, Training Content, FAQs and More 14 Navigating
More informationTeacher Guide to the Florida Department of Education Roster Verification Tool
Teacher Guide to the 2016-17 Florida Department of Education Roster Verification Tool Table of Contents Overview... 1 Timeline... 1 Contact and Help Desk... 1 Teacher Login Instructions... 2 Teacher Review,
More informationBlueOptions - Healthy Rewards HRA Plan
BlueOptions - Healthy Rewards HRA Plan Schedule of Benefits Plan 03359 Important things to keep in mind as you review this Schedule of Benefits: This Schedule of Benefits is part of your Benefit Booklet,
More informationGLOBALMEET FOR ANDROID GLOBALMEET FOR ANDROID USER GUIDE
GLOBALMEET FOR ANDROID GLOBALMEET FOR ANDROID USER GUIDE Release 1.0 June 2013 TABLE OF CONTENTS GlobalMeet for Android Overview 2 Install GlobalMeet for Android 3 Download the App 3 System Requirements
More informationProfessional Development Committee
STEP 1: Go to the Grants & Sponsored Projects page, on the KU website. 1. The application guidelines are also available on this page for detailed information on categories, funding levels and allowable
More informationChapter 02 Jobseekers Jobseeker creates an account
Chapter 02 Jobseekers Jobseeker creates an account 1. Universal Jobmatch (UJ) is available to all people looking for work whether they are claiming benefits or in work. Although staff in Jobcentres usually
More informationFREQUENTLY ASKED QUESTIONS FOR HOSPITALS AND ASCS OAS CAHPS
FREQUENTLY ASKED QUESTIONS FOR HOSPITALS AND ASCS OAS CAHPS How do I know if my hospital or ASC is eligible to participate in the OAS CAHPS Survey? An eligible hospital has an outpatient surgery department
More informationOnline Course Submission Instructions
Online Course Submission Instructions Contents Pre-requisite Checklist... 1 Procedure New Submission... 2 Procedure Continue an Existing Submission... 4 Procedure Upload a CSV... 6 Procedure Manually Enter
More informationQuick Reference Card Basic
Process: Use this procedure to post mid-term or final grades via the myuk portal All students MUST be assigned a grade in the final grading period BEFORE the grade roster may be submitted to the Registrar
More informationTRICARE West Region Authorizations and Referrals
TRICARE West Region Authorizations and Referrals March 2018 last updated March 19, 2018 TRICARE is a registered trademark of the Department of Defense, Defense Health Agency. All rights reserved. 1 Welcome
More informationUnityPoint Health System
UnityPoint Health System EpicCare Link is A web-based portal system that allows your hospital to extend view only information to external care facilities and clinics in your community Improve the continuity
More informationMedicare Advantage Referral-Required Plans
Medicare Advantage Referral-Required Plans Overview UnitedHealthcare Medicare Advantage referral-required plans emphasize the role of the primary care physician (PCP). Members choose a PCP who oversees
More informationFrequently Asked Questions
Frequently Asked Questions General Questions... 2 What is DOS Grants?... 2 How do I navigate the site?... 2 Accounts and Profiles... 2 How do I create an account?... 2 Why does it say I already have an
More informationReference Guide for Applicants
Grants Ontario System Reference Guide for Applicants Please inform us if you need a different format or other accommodation to access this information. Version Date: July 2017 Table of Contents Introduction...
More informationGo To The Employee s Page on dadeschools.net
Approver User Guide Overview Designated administrators will approve, reject, or request revisions to Agenda Items entered by the Item Authors prior to the scheduled Agenda Prep meeting. Getting Started
More information