Using the Availity Web Portal to build a healthier business

Transcription

1 Using the Availity Web Portal to build a healthier business

2 About Availity Agenda Availity and your practice Troubleshooting Enhancements Next Steps

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4 About Availity About Availity Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations.

5 About Availity: Multi-Payer Portal The Availity Multi-Payer Web Portal Multiple payers One website One log-in

6 About Availity: Multi-Payer Portal Availity Multi-Payer Portal Secure access to the health plans you need most. Aetna Anthem Cigna CCSTpa Humana Medicare E&B Universal Healthcare US Family Health Plan

7 About Availity: Multi-Payer Portal Offerings by Health Plan CO Offerings by Health Plan* Anthem Aetna Humana Cigna Medicare CCSTpa Eligibility and benefits Claim status Professional and facility claims Referrals and authorizations Patient care summary Patient payments Patient cost estimator Real-time claim adjudication Remittance viewer/era** Secure messaging Care reminders Claim research tool * Transaction availability varies by health plan. ** Enrollment may be required.

8 Availity and your practice The Availity Portal Improving Your Workflow Back Office Speed up claims processing Exam Room Include more patient information when making treatment decisions Receive care messages and alerts Make fewer calls to health plans Front Office Access patient information in real-time

9 Availity and your practice Front Office Solutions Real-time access to: Eligibility and Benefits Referrals and Authorizations Certificate of Coverage Front Office Exam Room Back Office

10 Availity and your practice Exam Office Solutions Real-time access to: Care Reminder Patient Care Summary Front Office Exam Room Back Office

11 Availity and your practice Exam Room Solutions Patient Care Summary Review patient history across multiple providers, including diagnoses, prescriptions and lab results Save as much as 5 minutes per encounter on patient intake Front Office Exam Room Back Office

12 Availity and your practice Back Office Solutions Real-time claim submission Real-time claim status review Remittance Viewer Front Office Exam Room Back Office

13 Availity and your practice Back Office Solutions Remittance Viewer Access accurate ERA information quickly and easily View detailed summaries of checks, claims Streamline the accounts receivable process Front Office Exam Room Back Office

14 Back Office Solutions Remittance Viewer Insert screenshot of Remittance Viewer

15 Availity and your practice Anthem Services Registration Value-added features for Anthem Secure Messaging AIM Specialty Health SM Provider Portal Single Sign On Front Office Exam Room Back Office

16 Anthem Services Registration Registering an Availity User for Anthem Services in Colorado Follow these steps: In the Availity portal, click My Account Anthem Services Registration. If prompted, select your organization. In the Display field, click Non-Registered Users.

17 Anthem Services Registration Registering an Availity User for Anthem Services in Colorado In the table: locate each user you want to register and type the user s valid ProviderAccess user ID in the Health Plan User ID field. Tip: Health Plan User ID is the same as your ProviderAccess User ID. Then click Register at the bottom of the page to access the User(s) Registered page. Note: By default, users are registered for all available services. If you want to remove a user s access to a specific service, see the following section Changing Access for Registered Users.

18 Anthem Services Registration Changing Access for Registered Users If necessary, you can also change or remove a user's access to Anthem services on Availity. On the Anthem Service Registration page, click Registered Users, add or remove services as needed, and then click Save Changes.

19 Troubleshooting Anthem Services Registration As the PAA, I tried to link my users and keep getting an error message. What am I doing wrong? Your user s first and last name must match exactly, letter by letter, case by case, in both ProviderAccess and Availity. The user id DOES NOT need to match. If a user wants access to Secure Messaging, or AIM Specialty Health SM they must have both a ProviderAccess user id and an Availity user id. Please note: The system will reference a Health Plan ID this is the same as their ProviderAccess User ID. ProviderAccess User Info First Name Minnie Last Name Mouse Last Name change First Name Last Name Availity User Info Minnie Duck ProviderAccess User Info First Name Jennifer Last Name Aniston First Name case First Name Last Name Availity User Info jennifer Aniston ProviderAccess User Info First Name Milo Last Name Abraham Perfect match! First Name Last Name Availity User Info Milo Abraham

20 Availity and your practice Back Office Solutions Secure Messaging Send questions about a claim Available for local Anthem Blue Cross and Blue Shield, Health Insurance Marketplace /ACA, BlueCard and FEP (Federal Employee Program) member claims. Front Office Exam Room Back Office

21 Back Office Solutions Secure Messaging

22 Back Office Solutions Secure Messaging From the Claim Status Detail screen, you will see the Secure Message hyperlink

23 Back Office Solutions Secure Messaging

24 Back Office Solutions Secure Messaging

25 Back Office Solutions Secure Messaging

26 Back Office Solutions Secure Messaging

27 Back Office Solutions Secure Messaging

28 Back Office Solutions Secure Messaging

29 Frequently Asked Questions Secure Messaging Why don t I see the Secure Messaging link when I run a claims status inquiry on an Anthem patient? Your PAA has not granted you access yet. Please contact your PAA quickly in order to gain access. How do I know Anthem received my Secure Message? Once you successfully submit a Secure Message you will receive an ICN# associated with each Secure Message. Can I access a response to a Secure Message that was submitted by someone else within my Organization? No. Because this is a Secure Message, this is only accessible by the individual User ID that submitted the original Secure Message. Can I submit attachments within a Secure Message? No, not at this time. You may be instructed within your Secure Message response on further actions, if needed.

30 Frequently Asked Questions Provider Portal Single Sign-On What is single sign on? Single sign-on allows users to link directly back into ProviderAcess from Availity without completing an additional log in. Do I have to be assigned access to single sign-on? Your PAA must give you access through Anthem Services Registration How do I use the single sign-on feature? Click on My Payer Portals Click on Anthem Provider Portal It will automatically log you into ProviderAccess Why do I need access to single sign-on? Allows you back into ProviderAccess to access Remittance Advice Inquiry, Contracted Pricing Tool, Clear Claim Connection, Reimbursement Policies, etc.

31 Frequently Asked Questions Provider Portal - Single Sign-On (cont d) Once the User has access to Provider Portal, to navigate to the link, simply: Select My Payer Portals Select Anthem Provider Portal Select I Agree

32 Availity and your practice Troubleshooting Eligibility and Benefits Claims Status Inquiry Common Rejections General Questions Front Office Exam Room Back Office

33 Troubleshooting Eligibility & Benefits I can t find the benefit details I need: Make sure to select the correct benefit type Shows what benefit details are included in the selected benefit type Select benefit type here

34 Troubleshooting Eligibility & Benefits I can t find deductible and co-insurance information From the Eligibility & Benefits Summary Results page, scroll to the bottom of the page under View Additional Benefits to see Deductible and Co-Insurance information NOTE: you must select Health Benefit Plan Coverage under Benefit Type on the Eligibility and Benefits Inquiry page to view this information.

35 Troubleshooting Eligibility & Benefits Viewing the certificate of coverage allows you to access more benefit detail. Click on View Certificate of Coverage if available

36 Troubleshooting Eligibility & Benefits Certificate of Coverage, or Evidence of Coverage, provides member benefit details. Certificate of Coverage is made available in a PDF format which allows for keyword searches.

37 Troubleshooting Eligibility & Benefits I don t have the patient DOB. What other options do I have? Multiple search options are available that don t require DOB. Click on search option to view other options

38 Troubleshooting Claim Status Inquiry ANTHEM Allows providers to send a question about a claim via Secure Messaging You must be granted access by the PAA in order to access this feature From the Claim Status Detail screen, you will see the Secure Message hyperlink

39 Troubleshooting Common Rejections Invalid/Missing Subscriber ID Please ensure you are entering the correct Alpha pre-fix and numbers Claim/Encounter not found This error occurs when the Patient data is incorrect or when the tax id entered is NOT the tax id the claim was paid to. Invalid/Missing Provider Identification If you receive this error, please fill out Anthem s ProviderAccess Account Administrator Change form and return into Anthem (per instructions indicated on the form)

40 Troubleshooting General Issues Please call Availity Client Services at AVAILITY or if any of the following apply to you. I forgot my user id and/or password I think my organization is already registered but I m not 100% sure My application was pended- why? The PAA who originally signed up has left. Now what? A PCA/PAA Change Request Form will need to be completed which can be obtained from Availity Client Services I m not sure how to add new users/delete users I need to change my Tax ID/NPI A Change Request Form Organization Maintenance Form will need to be completed which can be obtained from Availity Client Services

41 Troubleshooting Enhancements Recent Enhancements: Frequently Used Benefit Type: User s Top 5 frequently used/searched benefit type now appears at the top of the drop down list. Member Attribution: displays PCP information if the provider participates in one of the health plan's payment innovation programs. Show Me How: Interactive tool that walks PAA through tasks such as Anthem Services Registration and adding multiple users. Future Enhancements: All patient responsibilities will return on the same page and you will no longer need to select different benefit types to get full patient benefit details. Multiple member search (up to 10 patients at a time)

42 Getting Started What next? Check with your PAA to ensure you have appropriate access to all needed functionalities. Remember, you can access multiple payers on Availity. Consider registering for upcoming webinars to take a deeper dive into the Availity portal.

43 Training Options Register for Webinars: Register for an upcoming Availity Workshop (live, in person training)

44 Availity Web Portal Thank you Clinical Exchange Multi-Payer Portal Emely Funiestas Market Specialist- CA, CO, NV Revenue Cycle Management (800)