BlueCross BlueShield of South Carolina and BlueChoice HealthPlan are introducing the Medical Forms Resource Center (MFRC). The MFRC is a new online

Similar documents
BlueCross BlueShield of South Carolina and BlueChoice HealthPlan are introducing the Medical Forms Resource Center (MFRC). The MFRC is a new online

The Credentialing Process. Note! Contents are subject to change and are not a guarantee of payment.

General Preauthorization Overview Capital BlueCross Effective Date: October 1, 2015 Revised: September 30, 2015 Preauthorization Contact Information:

Preauthorization Program Effective Date: 01/01/2015 PPO, COMP, POS

Managed Care Referrals and Authorizations (Central Region Products)

CUSTODIAL NURSING HOME CARE

FACILITY BASED SERVICES

Advanced Imaging and Cardiac Procedures Prior Authorization Update

FACILITY BASED SERVICES

Magellan Healthcare 1 Frequently Asked Questions (FAQ s) For Magellan Complete Care of Virginia Providers

Aetna/Coventry Pennsylvania and West Virginia Physical Medicine Overview for Providers

Covered (blood, blood components, human blood products, and their administration) Covered (Some restrictions)

Magellan Healthcare 1 Frequently Asked Questions (FAQ s) For Magellan Complete Care of Florida Providers

To Apply for BlueCross BlueShield of South Carolina and BlueChoice HealthPlan

for Providers BlueCross Honors Maternity Care in Hospitals With Blue Distinction Designation

Schedule of Benefits - Point of Service MOSINEE SCHOOL DISTRICT Benefit Year: January 1st Through December 31st Effective Date: 07/01/2016

Schedule of Benefits - HMO Group - MEDFORD AREA SCHOOL DISTRICT Benefit Year: January 1st through December 31st Effective Date: 01/01/2016

MHP Service Codes Requiring Preauthorization - Effective July 1, 2018

Metallic Policy Prior Approval Guide

CareFirst ICD-10 Claim Submission Guidelines

Schedule of Benefits - Indemnity Group - MEDFORD AREA SCHOOL DISTRICT Benefit Year: January 1st through December 31st Effective Date: 01/01/2016

NaviNet Authorizations transaction: Frequently asked questions

Kaiser Permanente Washington - Pre-Authorization requirements:

Creating A Patient Portal Link From More Patient Button

Precertification Frequently Asked Questions

BCBSIL iexchange Reference Guide

South Carolina Reporting & Identification Prescription Tracking System (SCRIPTS)

May 2017 BlueNewsSM. Realignment within the BlueCross BlueShield and BlueChoice Health Plan Provider Relations and Education Team

IMPORTANT NOTICES. All codes listed in this document require authorization, unless otherwise specified.

2016 Benefit Update Meeting

Maternity Initiatives

Empire BlueCross BlueShield Professional Commercial Reimbursement Policy

West Virginia Children s Health Insurance Program (WVCHIP) Crystal Fox, Benefit and Eligibility Specialist Fall 2017 Provider Workshop

Precertification Tips & Tools

Volunteer Registration Step by Step Guide

Connecting Care Across the Continuum

Benefits. Benefits Covered by UnitedHealthcare Community Plan

2018 Authorization and Notification Requirements Medical Services

VANTAGE HEALTH PLAN FACILITY CREDENTIALING APPLICATION

Dean Health Plan Physical Medicine Overview

Choice PPO Retired Employees Health Program Non-Medicare Eligible Retired Members

Benefits are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

RSNA EMPLOYEE BENEFIT TRUST PLAN II S2502 NON GRANDFATHERED PLAN BENEFIT SHEET

Creating your job seeker account

Blue Choice PPO SM Physician, Professional Provider, Facility and Ancillary Provider - Provider Manual Table of Contents (TOC)

PREFERRED CARE. combination of family members; however no single individual within the family will be subject to more than the individual

IMPORTANT NOTICES. Office visits and/or procedures at PAR/Network Providers do not require PA. Referrals to PAR/Network Specialists do not require PA.

Workers Compensation Health Care Network

Service Rendered EBCBS GHI Health Plan Notes Alcohol Detox/Rehab (IP or OP) Submit to GHI. Submit to GHI

Precertification Requirements for Medical Services

Centennial Care Provider Notification Grid

HMO West Pennsylvania Employees Benefit Trust Fund Benefit Highlights Active Eligible Members. Providers None $6,850 single / $13,700 family

Frequently Asked Questions (FAQs) of applicants to the: Susan G. Komen Training Program to Reduce Breast Cancer Disparities

Home Health Care Provider Training

SCHEDULE OF MEDICAL BENEFITS

Molina Healthcare of Michigan MI Health Link Presentation June 3, 2015 Nursing Facility FAQs

ECOS APPROVER TRAINING

Prior Authorization form for Post-Acute Care Admission and Recertification for SNF,LTAC and Rehab

I. Out of Network: There are no OON benefits. However for any medically necessary service not available in network, authorization will be provided

Provider Manual. Utilization Management Care Management

Billing for post-op care. New wellness initiatives for Federal Employee Program (FEP) HMSA s. What s Inside

Grant E-Management System Help User Guide for Applicants, Reviewers and Co-Signatories

HOME HEALTH CARE TABLE OF CONTENTS. OVERVIEW TRANSITIONAL... CARE... SERVICES . MEMBERS... MANAGED... BY... EVICORE

EVIDENCE-BASED HEALTHCARE SOLUTIONS. CareCore National. Frequently Asked Questions Prepared for. Prepared for. October 23, 2009

All Out-of-Network hospitalizations, surgeries, procedures, referrals, evaluations, services and treatment require prior authorization.

HCA APR-DRG and EAPG Rebasing Revised February 2017

Provider Portal Hints & Tips Frequently Asked Questions

BlueCare/TennCareSelect. Improving health care for TennCare members

CMNs Chapter 4. Chapter 4 Contents

USER GUIDE. Grant Application Portal (GAP)

Medicare Plus Blue SM Group PPO. Summary of Benefits. Michigan Public School Employees Retirement System

Medicare Advantage 2014 Precertification Requirements

HPHConnect for Providers. Habilitative & Rehabilitative Therapies Notifications User Guide

Welcome to Regence! Meet your employer health plan

TABLE OF CONTENTS Guidelines About the Leukemia & Lymphoma Society Description of Awards Who Can Apply General Eligibility Criteria

The MITRE Corporation Plan

Benefit Name In Network Out of Network Limits and Additional Information. N/A Pharmacy. N/A Pharmacy

VIRGINIA COALITION OF PRIVATE PROVIDER ASSOCIATIONS. Commonwealth Coordinated Care Plus (Anthem CCC Plus)

Must meet specific criteria. Prior authorization required. Must meet specific criteria

Excellus Blue PPO Signature Hybrid 1

FCPS BENEFITS COMPARISON FOR PLAN YEAR 2018 Active Employees and Retirees Under 65

Excellus BluePPO Signature Deduct 3

AND PROCEDURES WHICH REQUIRE AUTHORIZATION EFFECTIVE

Benefits and Premiums are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Procedures that require authorization by evicore healthcare

Provider Orientation to Magellan s Outpatient Behavioral Health Model

NIA Magellan 1 Frequently Asked Questions (FAQ s) For Coventry Health Care of Illinois Providers

PPO. Preferred Provider Organization. Flexible. Easy to use. No Referrals.

Skilled Nursing Facility Level of Payment Guidelines for Tufts Health Plan Senior Care Options Members

BlueAdvantage 2010 Julie Horton, RN, MSN Principle Clinical Consultant BCBST Senior Care Division

MyLCI. New Club Application. The Fastest Way to Start a New Club!

DME Services Provider Manual. Effective Date: December 1, 2013

BLUE CROSS BLUE SHIELD OF SOUTH CAROLINA

Dear Prospective Customer:

Complete instructions are located online at and within the online application system.

Gold Access+ HMO $30 OffEx Benefit Summary (For groups 1 to 50) (Uniform Health Plan Benefits and Coverage Matrix)

This document is updated quarterly. Please check this document before a Prior Authorization (PA) submission since codes may be removed or added

Measure #138: Melanoma: Coordination of Care National Quality Strategy Domain: Communication and Care Coordination

PeopleSoft Recruiting Solutions

MyAmeriBen Provider Portal FAQ

Transcription:

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan are introducing the Medical Forms Resource Center (MFRC). The MFRC is a new online tool to allow you to submit your precertification requests for some services electronically. The system is fast and easy to use and ensures accuracy. It also cuts down on follow up calls as all the required information is outlined on the form.

How Does it Work? Provider sees patient and determines need for preauthorization. Provider goes to the Medical Forms Resource Center online. Provider enters the data necessary for preauthorization. Reviewer receives the request quickly and can review efficiently. The data goes to our secure internal network. The data passes through our web server. To use the MFRC, visit www.formsresource.center or visit the Providers page of our websites, www.southcarolinablues.com or www.bluechoicesc.com. Under the Providers page of each site, go to the Education Center and choose Precertification. When you submit an MFRC request, it goes through a server that has the highest security certificate available for secure communications. The information is transferred to our private network where it is inaccessible from the Internet. The MFRC s one-way data transfer ensures the safety and privacy of the clinical information you submit to us. The MFRC can help you save time, cut down on miscommunication, prevent omissions, and ensure safe and accurate communication of your clinical data. When you complete an MFRC request, you ll be prompted to provide clinical information specific to the selected service. This ensures we receive the minimum necessary information to process your request quickly and accurately. The electronic format ensures that when we receive your data that it is clearly legible. This helps to prevent follow-up calls for faxes that didn t transmit or print properly. Precertification requests submitted through the MFRC receive priority processing as well. Medical Form Resource Center Guide 2

Types of Services Available MFRC allows you to initiate precertification requests for many services: Breast reduction Chemotherapy Excision of lesion tumor mass General medication request General precertification Durable medical equipment (DME) o Continuous glucose monitoring o Insulin pump o Lymphedema pump o Miscellaneous o Neuromuscular stimulator o Orthotics o Prosthetics o Wound vac Home health Hospice Hysterectomy Long term acute care (LTAC) Notifications o Maternity o Discharge Radiofrequency facet ablation Septoplasty Skilled nursing facility (SNF)/Inpatient rehab Spinal fusion diskectomy laminectomy You can select General Precertification for services not listed or continue to use My Insurance Manager SM. More services will be added in the future. Please note: if a plan requires precertification for any of these services through another benefit management partner or program (i.e., NIA Magellan, Avalon Healthcare Solutions, NovoLogix, etc.), you will need to obtain precertification through the appropriate benefit management partner. Medical Form Resource Center Guide 3

The MFRC can be completed in three easy steps Facility and Patient information, Basic Clinical Information and Request Specific Information. Step 1: Facility & Patient Information Complete the required fields for the facility (or practice) and patient. Medical Form Resource Center Guide 4

Step 1: Facility & Patient Information (continued) The Reporter Information is the contact information for the person submitting the request. Medical Form Resource Center Guide 5

Step 1: Facility & Patient Information (continued) Select the appropriate network based on the member s plan. This ensures the request is routed to the appropriate precertification reviewers. If the member s plan is neither BlueChoice nor BlueEssentials SM, select Other Network. Medical Form Resource Center Guide 6

Step 2: Clinical Information Enter the date of service, the procedure and diagnosis codes, and select the type of service from the drop-down menu options. Medical Form Resource Center Guide 7

Step 2: Clinical Information (continued) Choose from one of the selections listed. Each expands and provides more choices and specific options. Medical Form Resource Center Guide 8

Step 3: Complete Form Step 3 will prompt you to provide key clinical information, specific to the service you ve selected. You can do this by entering the information or copying and pasting it into the appropriate fields. Review the information for accuracy and submit. Once you ve completed the request, you ll have an opportunity to print a copy by choosing the Print this submission button on the last page. You can also save the documentation as a PDF. We highly recommend printing or saving this verification to a file so you have a reference of your submission. You will not have the ability to go back and view or print a copy of the information submitted. Other Important Information MFRC is one-way communication. You will not receive status or any other communication regarding your request through MFRC. Once you ve filled out the first screen, the next time you visit, your facility information will automatically fill the form, if your organization allows cookies. Once you ve completed your submission, it can take 10 15 minutes for the information to load to our precertification system. MFRC requests pend for review and are given first priority. You will receive approval or denial using existing processes. Use the Print this submission button to print or save a copy of the request. Medical Form Resource Center Guide 9