Complaint. Payspan, Provider Newsflash. Secure Provider Portal. Payspan. Administrative. Sign Up for Superior s PAYSPAN. Secure Provider Portal

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Secure Portal Electronic Funds Transfer (EFT) Solution Secure Prior Guide Portal Payspan Manage patient administrative Quick Reference Guide tasks quickly easily.

process. View Multiple TINs One point of entry allows for quick easy access to HealthPlan member information for multiple TINs/practices.

Tool Keep this Quick Reference Guidetonearby simplify pre-visit Use the Pre-Auth Needed quicklytodetermine if a service or procedure requires prior Daily Patient Lists Batch Claims planning

Submit manage claims, including batch Improve cash flow Funds Transfer (EFT) Maintain control over Eliminate re-keying of view detailed Electronic Website: HealthPlan.

payment Patient care forms eligibility manual by routingverify Manage how prioryou authorizations PROTECTED, EFTs member to the bank by choosing want to Simplify Prior Settle claims Pre-auth needed

View If a service requires prior authorization, submit through one of the following ways: Simplify Process through Electronic Fund HealthPlan news View patient gaps Member resources Obtain provider

1 Secure Portal Electronic Funds Transfer (EFT) Solution Secure Prior Guide Portal Payspan Manage patient administrative Quick Reference Guide tasks quickly easily. Get Paid Faster How to Obtain Prior Simplify Office HealthPlan offers Payspan, a free solution that helps providers simplify the Administrative Tasks Pre-Auth Needed Tool payment tracking transfer process. View Multiple TINs One point of entry allows for quick easy access to HealthPlan member information for multiple TINs/practices. Access Daily Patient Lists from One Screen One concise view allows Primary Care s to scan patient lists for details such as member Access Manage eligibility care gaps. Tool Keep this Quick Reference Guidetonearby simplify pre-visit Use the Pre-Auth Needed quicklytodetermine if a service or procedure requires prior Daily Patient Lists Batch Claims planning post-visit tasks. from One Screen for Free Manage Batch Claims for Free authorization, by visiting HealthPlan.com/providers/preauth-check/medicaid-pre-auth.html. Submit manage claims, including batch Improve cash flow Funds Transfer (EFT) Maintain control over Eliminate re-keying of view detailed Electronic Website: HealthPlan.com Secure Portal:.HealthPlan.com bank accounts remittance data by gettinghistory. payments faster. payment Patient care forms eligibility manual by routingverify Manage how prioryou authorizations PROTECTED, EFTs member to the bank by choosing want to Simplify Prior Settle claims Pre-auth needed tool electronically Access patient health records Preferred drug list account(s) Submit manage claims of your choice. CONVENIENT receive remittance details. View If a service requires prior authorization, submit through one of the following ways: Simplify Process through Electronic Fund HealthPlan news View patient gaps Member resources Obtain provider resources Multiple ACCESSCreate Prior Submit prior authorization requests using Match payments to custom reports Transfers (EFTs) Electronic TINs AT YOURincluding ACH summary reports, the Smart Sheets statements quickly Remittance Advicesfeature (ERAs).with prompts Process Member Patient Care Gaps easilyprior Claimssummary reports, foreligibility required clinical information. FINGERTIPS re-associate monthly Check member eligibility: Find recommended paymentsuse Pre-Auth Needed Timely filing guidelines: withthe claims. payment reports sorted by date. Utilize Additional Features to services a member Toolprovider on our website 95 days from date of service. Secure This isportal theoffice preferred that fastest method. The After normal business hours Streamline Operations: multiple payers, has not completed. Manage to determine if prior Submit Services: be a registered user. onclaims: holidays, calls are Streamline Check must View patient demographics history. is required. includingauthorization any payers that are 1. Visit the Secure Secure Portal Patient Care Office directed to s using Payspan toprior settle claims. Submit Use the secure messaging featureportal. to Operations Gaps 24-hour Nurse Advice Line. TTY/TDD: Clearinghouses: authorizations: communicate with. 2. Review patient EDI Payor ID information for any Secure Portal Update provider demographics. Mail paper claims to: gaps in care. Fax: HealthPlan 3. Plan to address care Phone: P.O. Box 3003 gaps during a future Visit PaySpanHealth.com click Register. Farmington, MO appointment Please note: Submit a Prior Request SECURE PROVIDER PORTAL.HealthPlan.com FAX Medical PHONE Behavioral Health SET UP YOUR PAYSPAN Visit our QUESTIONS? You may need your National Identifier (NPI) Started out-of-network servicesnow! require prior authorization except emergency care, ACCOUNT AllGet Tax ID Number (TIN) or Employer Identification Number (EIN). website for a Contact list of services HealthPlan at Pre-Visit TODAY that require prior Planning authorization. Checklist out-of-area urgent care out-of-area dialysis. click Create.HealthPlan.com VerifyVisit member eligibility. Failure to complete the required prior authorization or certification may result your tax ID number during Checkan foraccount. patient carehave gaps address them during ready upcoming office sign visit. up. in a denied claim. Use Pre-Auth Needed Tool to determine if prior authorization is needed before appointment. More resources available at HealthPlan.com/providers.html. Services: Services: HealthPlan.com How to Register for Complaints Sign Up for s Payspan Sign Up for s After-Hours Telephone Newsflash Newsflash Accessibility Stards HealthPlan has an online complaint submission form available through the website. The online form allows providers to file complaints for resolution. Payspan a free, secure online tool that gives providers optionnewsflash to: Don t missisimportant provider news updates! sthe is an Don t miss important provider news to updates! The e-newsletter Texas Health ed Human twoservices weeks (HHS) subscribing Uniform providers. Managed Take Care a moment Contracttosets subscribe Improve cash flowevery Manage multiple payers Submitting Complaints s Newsflash isrelevant an e-newsletter accessibility today start stards to receiving that news aaccounts Primary Care to your area (PCP) /or must follow, products. to allow patients Maintain control over bank Create custom reports every weeks to normal subscribing providers. to ed reach them bytwo phone after business hours. audits PCP offices after Settle claims electronically View remittance advice online ONLINE TakeMatch a moment subscribe today with start these to stards. Below are the basic business hours to to determine compliance payments to statements quickly s canrelevant access submit the assess Online Complaint Formafter-hours by visiting availability. receiving news totoyour specialt y current accessibility requirements helparea, you your Registering for Payspan is simple only takes about 10 minutes. HealthPlan.com/contact-us/complaint-form-information.html /or products. Stay up-to-date withonline the latest News! Follow(scroll the instructions begin. to the bottombelow of the to web page to begin). Follow instructions to begin. Whatthe meets the below stards? Visit HealthPlan.com. will answer OR FAXwith StayMAIL up-to-date thewhich latest News! A bilingual answering service, can contact the PCP or another designated medical practitioner. complaints within Clickcomplaint on the For s tab. completed The form can be printed, Customized news may include, but is not limited to: Registration mailed or faxed to: message that directs the patient to call another number to reach the PCP or A bilingual answering machine Click on News & Information found on the date the complaint is Mail: HealthPlan another designated provider another answering machine). Matory trainings(not left side bar navigation menu. ATTN: Complaint Department received. Office telephone systems that transfer calls to another location where someone will answer the telephone registration code. News on this page, click Sign up Under Billing information Visit PaySpanHealth.com click Register Now. to update yourclaims information to receive important Fax: the registration code click Submit. news unique updates onthe HealthPlan to WhatEnter doesn t meet stards? Health Human Services (HHS) OR begintexas the process. requirements The office telephone is not answered afterid office hours. CALL Enter registration code, Number Enterthe provider information select Submit when The answering machine message patients to leave a message. (PIN), Taxmay ID Number (TIN) ortells Employer s also fileupdates a verbal complaint by calling complete. policy Most of the time, can assist right away. There is no time limit for filing a complaint with. s can also submit a complaint to Texas Health Human Services (HHS) by calling Identification Numbermessage (EIN) National The answering machine is not bilingual (English Spanish). Identifier (NPI) click Startinstructs Registration. The answering machine message patients to go to an Emergency Room for any services needed. Please Note: The online feature written complaint process does not replace or include inquiries or appeals related to Claims Medical Necessity For those services, please continue to contact To sign up foror s Appeals. Newsflash, update your information or view current s may also view archived newsletters by visiting s applicable departments by visiting HealthPlan.com. news, please visit HealthPlan.com/provider-news.html. Need more information on accessibility stards? HealthPlan.com/providers/provider-news.html. Review s provider manual at HealthPlan.com HealthPlan.com Services: Services: HealthPlan.com/providers/training-manuals.html. HealthPlan.com Services: SHP_ G 2019 HealthPlan. All rights reserved. HealthPlan.com Services: HealthPlan.com Services:

How to Obtain Prior Pre-Auth Needed Tool Use the Pre-Auth Needed Tool to quickly determine if a service or procedure requires prior

Submit a Prior Request If a service requires prior authorization, submit through one of the following ways: 0 SECURE PROVIDER PORTAL PHONE.

FAX Medical 1-800-690-7030 Behavioral Health 1-855-772-7079 After normal business hours on holidays, calls are directed to 's 24-hour Nurse

Please note: All out-of-network services require prior authorization except emergency care, out-of-area urgent care out-of-area dialysis.

3 How to Obtain Prior Pre-Auth Needed Tool Use the Pre-Auth Needed Tool to quickly determine if a service or procedure requires prior superior healthplan authorization, by visiting HealthPlan.com/providers/preauth-check/medicaid-pre-auth.html. Submit a Prior Request If a service requires prior authorization, submit through one of the following ways: 0 SECURE PROVIDER PORTAL PHONE.HealthPlan.com This is the preferred fastest method. The provider must be a registered user. FAX Medical Behavioral Health After normal business hours on holidays, calls are directed to 's 24-hour Nurse Advice Line. Visit our website for a list of services that require prior authorization. Please note: All out-of-network services require prior authorization except emergency care, out-of-area urgent care out-of-area dialysis. Failure to complete the required prior authorization or certification may result in a denied claim. More resources available at HealthPlan.com/providers.html HealthPlan. All rights reserved. SHP_ B Services: Su periorh ealth Plan.com

5 Secure Portal Secure Portal Manage patient administrative tasks quickly easily. View Multiple TINs One point of entry allows for quick easy access to HealthPlan member information for multiple TINs/practices. Access Daily Patient Lists from One Screen One concise view allows Primary Care s to scan patient lists for details such as member eligibility care gaps. Manage Batch Claims for Free Submit manage claims, including batch view detailed Electronic Funds Transfer (EFT) payment history. Simplify Prior Process Submit prior authorization requests using the Smart Sheets feature with prompts for required clinical information. Utilize Additional Features to Streamline Office Operations: View patient demographics history. Use the secure messaging feature to communicate with. Update provider demographics. View Multiple TINs Access Daily Patient Lists from One Screen Streamline Office Operations PROTECTED, CONVENIENT ACCESS AT YOUR FINGERTIPS Manage Batch Claims for Free Check Patient Care Gaps Simplify Prior Process QUESTIONS? Contact HealthPlan at Get Started Now! Visit.HealthPlan.com click Create an Account. Have your tax ID number ready during sign up. HealthPlan.com

7 Sign Up for s Newsflash Don t miss important provider news updates! s Newsflash is an e-newsletter ed every two weeks to subscribing providers. Take a moment to subscribe today start to receiving news relevant to your area, specialty /or products. Stay up-to-date with the latest News! Customized news may include, but is not limited to: Matory trainings Billing claims information Texas Health Human Services (HHS) requirements policy updates To sign up for s Newsflash, update your information or view current news, please visit HealthPlan.com/provider-news.html. HealthPlan.com SHP_ G Services: HealthPlan. All rights reserved.