for benefit administrators online management services user guide ( )

Transcription

1 for benefit administrators online management services user guide ( )

2 Intro What is the guide? The lifewiseor.com secure Employer portal is your gateway to a suite of secure service features designed to help you administer your health benefit plan quickly and easily, in real time. This reference guide walks you through the available online tools to better assist with the day-to-day administration of your healthcare benefits. In the following pages, you ll find information on eligibility, enrollment, billing, cancellations, continuation of coverage and more. Online Management Services User Guide 1

3 Table of Contents Helpful Web Tips and Reminders 3-4 Getting Started 5 Log In 6 Register 7 Message Center 8-10 Enroll/Terminate 11 Employee/Family Enrollment 12 Add Spouse or Domestic Partner Add Newborns or Other Dependents Change Subgroup Information (if applicable) 17 Change Class (if applicable) 18 Terminate Member 19 Member Management 20 Member Search 21 Member Management/Employee Information 22 Eligibility and Plan Information Member Maintenance Billing Management 28 View Invoices Transaction Status Reports Request a Report 36 View Reports 37 Employer Management 38 Employee Roster Employee Contact Information 41 Health Tools Contact Information 44 Online Management Services User Guide 2

4 Helpful Web Reminders All adds (employee, spouse and /or dependents are updated nightly) Changes to existing members are real time When accessing individual members, you will need their ID number and suffix number or you can search for them by name Depending on your group s billing date, changes could appear on the next billing statement If your group has Prescription coverage, web enrollment takes approximately 48 hours to update Express Scripts It is recommended that you change your password every 120 days Technical help desk is available Monday through Friday from 6:00 am to 6:00 pm PST at The system is available 24x7 Items that cannot be completed online must be submitted to your Billing Representative COBRA/State Continuation this includes additions, terminations and changes Handicap certification Adoptions Gender corrections Date of birth corrections Court ordered coverage this includes legal guardianship or custody Qualifying events defined as loss of coverage Reinstatement or re-enrollment of a member Online Management Services User Guide 3

5 Helpful Web Tips Entry Guidelines Enter new enrollments or changes no more than 30 days in the past or future from today s date. Addresses can only be US addresses. For foreign addresses please contact your Billing Representative. The only symbols that can be used in member names are the hyphen (-) and the apostrophe ( ). In addition to those two symbols, the pound sign (#) can be used in the address. Names are limited to 26 characters. This includes their first name, middle initial and last name as well as the spaces in between. Entries using postal address standards will improve ID card/eob delivery. Online Management Services User Guide 4

6 Getting Started Go to lifewiseor.com and select the Employers link Online Management Services User Guide 5

7 Log In To access secure information and services: Select the Log In link At the Log In page, enter: Your User ID Your Password Not registered yet? Choose the Register link You will be guided through online registration and will need to have your PIN letter available. If you have not received your PIN letter please call Online Management Services User Guide 6

8 Register Using your PIN number you will create a specific user ID and password for yourself Online Management Services User Guide 7

9 Message Center This landing page offers you important benefit administration information and links to benefit management tools. Online Management Services User Guide 8

10 Message Center Access Quick Links New Feature Highlights Screen continues on next page Online Management Services User Guide 9

11 Message Center Screen continued from previous page Payment Information Reset Password Online Management Services User Guide 10

12 Enroll/Terminate Enroll a new eligible employee and his/her family Add a spouse or domestic partner to an existing employee Add dependents to an existing employee Edit subgroup information (if you have more than one subgroup) Change Class (if applicable) Change Plan (if applicable) Terminate an employee and/or dependent from the plan Online Management Services User Guide 11

13 Enroll/Terminate Add a new employee or dependents to your plan. Note: Employees or dependents who are not enrolled when first eligible, will be eligible during the group s next open enrollment period. Rehires or re-enrollments need to be processed by your Billing Representative not via the web. *If you are having difficulty completing enrollments or receiving an error message please contact our Technical Help Desk at Online Management Services User Guide 12

14 Enroll/Terminate Add a Spouse or Domestic Partner (if applicable) to an existing employee HIPAA qualifying events need to be processed by your Billing Representative (i.e. loss of coverage) Screen continues on next page Online Management Services User Guide 13

15 Enroll/Terminate Screen continued from previous page Add a Spouse or Domestic Partner (if applicable) to an existing employee Online Management Services User Guide 14

16 Enroll/Terminate Add a newborn or dependent to an existing employee For the following additions please contact your Billing Representative Adoption To qualify dependent as disabled status Guardianship Court orders Supported orders Dependents with different addresses then the employee Online Management Services User Guide 15

17 Enroll/Terminate Add a newborn or dependent to an existing subscriber Note: Please search to ensure the newborn has not already been added to the Subscriber's Policy based on a claim that was received by Premera. If the newborn has already been added, do not add a duplicate. Please contact your Membership Analyst to have the newborn added permanently. Online Management Services User Guide 16

18 Enroll/Terminate Change Subgroup (if applicable) Note: This excludes transfers to a COBRA subgroup Online Management Services User Guide 17

19 Enroll/Terminate Change Class or Plan (if applicable) Online Management Services User Guide 18

20 Enroll/Terminate Terminate Member Terminations should be completed within 30 days of receiving notice from your employee. Note: Terminations must be dated with the last day of the month for which coverage ends. You can terminate at the employee level if you want to terminate the entire family. Or you can terminate by individual. Note: To terminate a COBRA member contact your Billing Representative. Online Management Services User Guide 19

21 Member Management View and edit member information Search past and current eligibility up to two years Conduct routine member maintenance Order ID cards View other insurance Update address Online Management Services User Guide 20

22 Member Management Search for a member by Member ID or Last name Online Management Services User Guide 21

23 Member Management View or change employee/member information Demographics Personal Info Online Management Services User Guide 22

24 Member Management View benefit eligibility up to two years from today s date Online Management Services User Guide 23

25 Member Management View eligibility information Note: Benefits displayed are Group level and not Member level. Online Management Services User Guide 24

26 Member Management Order ID cards for a specific member or the entire family ID cards are auto-generated for the following transactions: Employee Enroll Member Enroll Employee Change Event Member Change Event Employee Name Change Member Name Change Online Management Services User Guide 25

27 Member Management View other insurance for a member (if applicable) Online Management Services User Guide 26

28 Member Management Cancel specific benefit coverage for a employee of member Note: This is not a complete termination of coverage. Online Management Services User Guide 27

29 Billing Management In the Billing Management section you can: View billing invoices for the last 6 months View summary information for each invoice Review next invoice generation date Online Management Services User Guide 28

30 Billing Management Displays six months worth of bills Download bills to either Excel or PDF by subgroup Review next invoice generation date To view an invoice: Select the Request PDF link Select refresh while the invoice is pending and processing Select View PDF to open the invoice Screen continues on next page Online Management Services User Guide 29

31 Billing Management Screen continued from previous page Remitting your payment information Payment policy review Online Management Services User Guide 30

32 Billing Management Invoice PDF output Group Invoice Summary Group Invoice Detail Online Management Services User Guide 31

33 Transaction Status Track activities completed on the web for 30 days or 50 transactions, whichever occurs first. Online Management Services User Guide 32

34 Transaction Status View your transactions Online Management Services User Guide 33

35 Reports Reports available (in Excel or PDF format): Active Members Member Adds and Terminations Employee Roster Address Changes Online Data Changes Subgroup, Class and Plan Changes ID Cards Ordered Online Management Services User Guide 34

36 Reports Access Audit Reports or DataWise Reporter Note: DataWise Reporter is available for groups of 150+ enrolled. Please contact your Marketing Representative for more information. Online Management Services User Guide 35

37 Reports Request a report Online Management Services User Guide 36

38 Reports Download and view the report you requested *If you are having difficulty viewing reports or receiving an error message please contact our Technical Help Desk at Online Management Services User Guide 37

39 Employer Management View your: Business Profile Employee Roster Employer Contact Information Online Management Services User Guide 38

40 Employer Management View all active and inactive employees To view member specific information click on employee name Download your employee roster to Excel or PDF Online Management Services User Guide 39

41 Employer Management Employee roster PDF output Online Management Services User Guide 40

42 Employer Management View your group s and your Billing Representative contact information Online Management Services User Guide 41

43 Health Tools Find helpful tools to assist your member in making benefit selection and health decisions. This page provides links to important benefit information and supporting features. Online Management Services User Guide 42

44 Health Tools Compare Health Plans Coverage Advisor Staying Healthy Toolkits and Resources Preferred Drug Search Generics Yes! A Smart Choice MyPharmacyPlus Online Management Services User Guide 43

45 Contact Information Group Sales Claims Submission LifeWise Health Plan of Oregon P. O. Box 7709 Bend, OR Help Desk for Online Management Services To report technical problems or for help with Web applications: Business Office 2020 SW Fourth - Suite 1000 Portland, OR Online Management Services User Guide 44