ProviderConnect Tips and Tricks. March 2018

Transcription

1 ProviderConnect Tips and Tricks March 2018

2 Agenda Services and Benefits of ProviderConnect Claims Process Improvement Program Accessing ProviderConnect Checking Member Eligibility and Benefits New Enhancements Demographic Updates Additional Training Options Contact Info 2

3 Services Verify member benefits and eligibility View and print forms Request and view authorizations Download and print authorization letters Submit claims and view status Access Provider Summary Vouchers (PSV) Request payment for EAP services Submit EAP case activity forms (CAF) Submit updates to provider demographic information Submit credentialing applications Submit customer service inquiries Access ProviderConnect message center Disclaimer: Please note that ProviderConnect may look different and have different functionalities based on individual contract needs, therefore some functions may not be available or may look different for your specific contract. 3

4 Benefits Free and secure online application, available 24/7 Reduces the need to call for routine information Integrates with practice management software Decreases labor expenses, paper files, and postage Efficient processing allows for quicker payment Less risk of human error or mishandling Mobile device friendly Mac and Windows compatible INCREASED CONVENIENCE, DECREASED ADMINISTRATIVE PROCESSES 4

5 Claims Process Improvement (CPI) Project Mailroom Project: Transition to a centralized shared-service process to improve paper claims intake Mailing addresses changed in 2017 Incomplete or incorrect claims will be rejected EDI/Data Exchange: Implement a single gateway for front-end claims intake for all Beacon submitters to improve intake and processing of electronically submitted batch claims New companion guides will be released for 837 and 277CA files Payment Integrity and Claims Analysis: Analyze claims to identify payment errors Documentation requests to verify submissions and payment accuracy Claim adjustments will occur if overpayment is identified 5

6 E-Commerce Providers in the Beacon Health Options network are expected to electronically conduct all routine transactions, including: Submission of claims Submission of authorization requests Verification of eligibility inquiries Submission of credentialing applications Updating of provider information Electronic fund transfer through PaySpan Health 6

7 Accessing ProviderConnect 7

8 How to Access ProviderConnect 8

9 How to Access ProviderConnect Go to choose Providers and Beacon Health Options (formerly ValueOptions) Providers Click on ProviderConnect on the right side of the screen and choose the appropriate portal. 9

10 How to Access ProviderConnect 10

11 Logging into ProviderConnect 11

12 Two Registration Options Online Account Request Form **Note: The online registration process includes e-signature for claims access Form is necessary for: Multiple users at one practice Establishing Super User access Setting up network-specific accounts 12

13 Forgot Your Password? 13

14 User ID 14

15 Option 1: Answer Secret Question 15

16 Password Changed 16

17 Option 2: 17

18 Address 18

19 Message 19

20 Update Password 20

21 Checking Member Eligibility and Benefits 21

22 Find a Specific Member 22

23 Eligibility and Benefits Search 23

24 Eligibility and Benefits Search 24

25 Eligibility and Benefits Search 25

26 Eligibility and Benefits Search 26

27 New Enhancements 27

28 Coordinating Care Communication is essential to promote quality health care, ensure safe practice, and prevent potential medical errors or complications PCP coordination is especially critical and has been an area of struggle for the behavioral health care community Beacon is committed to taking steps to improve PCP coordination, especially during Inpatient/Higher Level of Care admissions and has added fields to the authorization flow to capture this coordination Beacon hopes that capturing this data will allow the behavioral health community to focus more on the importance of that PCP interface as well as recognize some of the barriers to making that contact 28

29 Coordinating Care 29

30 Coordinating Care 30

31 EAP Case Activity Form Submission 31

32 EAP Case Activity Form Submission 32

33 Authorization Search 33

34 Enter EAP CAF 34

35 Online CAF Key Points Select a Billing Type Complete all case opening questions for both interim and final billing type If Final was selected for billing type, complete all case closing questions 35

36 Summary Page 36

37 Demographic Updates 37

38 Demographic Updates Review information on a regular basis to ensure member referral information is accurate Many changes can be made in real time in ProviderConnect Phone numbers Fax numbers addresses Website URLs Billing addresses Mailing address Disability access Office hours Service addresses Foreign languages Accepting new patients *Tax ID update takes 3-5 business days for validation Also review and update CAQH for consistency Update Tax ID with W9 upload* If unable to update demographic information online, contact Beacon for assistance 38

39 Demographic Update Features 39

40 Demographic Update Features 40

41 Demographic Update Features 41

42 Demographic Update Features 42

43 Demographic Update Features 43

44 Demographic Update Features 44

45 Demographic Update Features 45

46 Demographic Update Features 46

47 Demographic Update Features 47

48 Demographic Update Features 48

49 Demographic Update Features 49

50 Demographic Update Features 50

51 Demographic Update Features 51

52 Demographic Update Features 52

53 Demographic Update Features 53

54 Additional Training Options 54

55 Helpful Resources On the provider homepage choose ProviderConnect Scroll down to find: ProviderConnect Demo Guides Forms Compliance Resources EDI Resources How-to video tutorials Webinars and archives 55

56 Contact Information Website and EDI PaySpan Provider Relations Beacon Health Strategies eservices Phone: Electronic Data Interchange Phone: PaySpan Registration Provider Support Monday through Friday, 8 a.m. 8 p.m. ET Phone: providersupport@payspanhealth.com Provider Relations Phone: Provider.Relations@beaconhealthoptions.com Beacon Health Options (formerly ValueOptions) EDI Helpdesk Monday through Friday, 8 a.m.-6 p.m. ET Phone: e-supportservices@beaconhealthoptions.com Unable to locate your registration code? corporatefinance@beaconhealthoptions.com Reply will be received within three business days National Provider Services Line Monday through Friday, 8 a.m.-8 p.m. ET Phone: Regional Provider Relations Team 56

57 Questions 57