Anthem Secure Mailbox Setup

Transcription

1 Anthem Secure Mailbox Setup

2 What is Secure e-review Secure e-review is a way for providers and facilities to relay information electronically to Anthem for pre-authorizations No need to fax or phone. The user just needs internet access and a work address Replies from the Anthem Utilization Management area will also be returned electronically (Hard copy decision letters are still mailed) Secure e-review is HIPAA compliant It is free no cost to the provider Anthem e-review is only for certain Anthem member s. It CAN NOT be used for BlueCard member s. (If the member s card does not state Anthem then it is probably not ours.) Outpatient radiology requests are out of scope for e-review. To receive more information on getting connected to the Anthem web portal for outpatient radiology requests, please send an to: Central.eprovider.rep@Anthem.com. In the , outline your wish to get connected to the webportal for outpatient radiology requests and provide your group name / tax ID.

3 How To Get Connected to Secure e-review In the Internet Explorer window type in & it will bring you to the page below. Save this site to your favorites.

4 Registering Your Account For first time registration, please click here:

5 Registering Your Account Set up your account by entering your address, password (8 or more alphanumeric characters & case sensitive) password reminder phrase and click on Submit Password.

6 Registering Your Account You should receive a confirmation response. Minimize this screen and go to the in-box of your

7 Registering Your Account In a moment or two, you should see a confirmation come into the e- mail account you had set that reads: Notification@messages.wellpointsecure .com

8 Registering Your Account Open the and click on the link that states: To ACTIVATE your new password, click the link below

9 Registering Your Account You should then receive the following screen. Please click on Continue.

10 System Log In You are now back at the home log in screen. Log in using your address, enter the password you just established & click Sign In. Your password should never need to be changed unless you would lock up your account. To change your password, click on the link that states Change Your Password

11 Set Anthem e-review Addresses After you log in, you will see the following format. Let s set the Anthem e- mail addresses you may want to preauthorize requests. Click on the Address tab.

12 Set Anthem e-review Addresses Now you are in the Address section. To set the addresses click on Add Contact

13 Set Anthem e-review Addresses Enter the addresses provided later in this presentation (one by one) based on your state and type of request you plan on sending. After you enter an address, click on Save

14 Set Anthem e-review Addresses Again, Anthem e-review is only for certain Anthem member s. It can not be used for Blue Card member s. (If the member s card does not state Anthem then it is probably not ours.) You are able to do preauthorizations for Anthem Local Commercial accounts (by state), certain National accounts, Federal accounts, and Managed Medicare accounts. Enter the name of the Anthem department as the First Name / Last Name and the appropriate E-Review Address for that department.

15 Set Anthem e-review Addresses: Federal Accounts Prior approvals for Federal accounts are in scope. SNF, LTAC, Rehab requests are out of scope. If the member s ID prefix is a R - this indicates a Federal plan and the preauth can be sent to the Federal shared mailbox for e-review. (example = R ) Federal Prior Approval Address: First Name = Prior Approval Last Name = Federal Address = FEPE-Reviews@Anthem.com This address is for any initial demographics as well as clinical information (initial clinical and updates)

16 Set Anthem e-review Addresses: National Accounts For National accounts you can complete precertifications for surgery requests, inpatient stays, SNF/LTAC/Rehab, Specialty Pharmacy, DME, etc. You can also submit your predetermination requests in this manner. If the member s ID prefix is an AN this indicates a National plan and the precert can be sent to a National shared mailbox for e-review. Example AN or PGRAN (This rule applies to a majority of the National accounts. There are a few that they may not be able to handle) National e-review Addresses: 1. First Name = Demographics Last Name = National Address = INAdmittingNational-Anthem@Anthem.com This address is for the initial demographic submission 2. First Name = Clinical Last Name = National Address = UMNationalUnit@Anthem.com This address is for any clinical updates after the initial demographic submission of information

17 Set Anthem e-review Addresses: Local Commercial Accounts For Local Commercial accounts you can complete precertifications for surgery requests, inpatient stays, SNF/LTAC/Rehab, Specialty Pharmacy, DME, etc. You can also submit your predetermination requests in this manner. Local Commercial accounts generally have a M or A in the middle of the ID number. Example YRP000M00000 The Local Commercial Addresses in the Anthem Central Region are separated by state (OH, IN, KY, MO, WI). Please see the following pages for your state addresses.

18 Local Commercial Accounts -- Ohio Addresses Ohio Local Commercial e-review Addresses: 1. First Name = Precert - Demographics Last Name = OH Local Address = Anthem.OhioAdmitting@Anthem.com This address is for the initial demographic submission 2. First Name = Precert - Clinical Last Name = OH Local Address = OHConcurrentClinicalReview@Anthem.com This address is for any clinical updates after the initial demographic submission of information 3. First Name = SNF/LTAC/Rehab Last Name = OH Local Address = SNF-LTAC-InptrehabReview@Anthem.com This address is for any demographic and /or clinical submission of information for SNF, LTAC or Rehab stays 4. First Name = Predeterminations Last Name = OH Local Address = OHPredSpecServUM@Anthem.com This address is for any demographic and /or clinical submission of information for predeterminations 5. First Name = Specialty Pharmacy Last Name = OH Local Address = SpecialtyMeds@Anthem.com This address is for any demographic and /or clinical submission of information for specialty med requests

19 Local Commercial Accounts Indiana Addresses Indiana Local Commercial e-review Addresses: 1. First Name = Precert - Demographics Last Name = IN Local Address = INAdmittingLocal-Anthem@Anthem.com This address is for the initial demographic submission 2. First Name/Last Name = IN Local Precert - Clinical Last Name = IN Local Address = INConcurrentClinicalReview@Anthem.com This address is for any clinical updates after the initial demographic submission of information 3. First Name = SNF/LTAC/Rehab Last Name = IN Local Address = SNF-LTAC-InptrehabReview@Anthem.com This address is for any demographic and /or clinical submission of information for SNF, LTAC or Rehab stays 4. First Name = Predeterminations Last Name = IN Local Address = OHPredSpecServUM@Anthem.com This address is for any demographic and /or clinical submission of information for predeterminations 5. First Name = Specialty Pharmacy Last Name = IN Local Address = SpecialtyMeds@Anthem.com This address is for any demographic and /or clinical submission of information for specialty med requests

20 Local Commercial Accounts Kentucky Addresses Kentucky Local Commercial e-review Addresses: 1. First Name = Precert Demographics Last Name = KY Local Address = KY.Group.Utilization@Wellpoint.com This address is for the initial demographic submission 2. First Name = Precert - Clinical Last Name = KY Local Address = KYConcurrentClinicalReview@Anthem.com This address is for any clinical updates after the initial demographic submission of information 3. First Name = SNF/LTAC/Rehab Last Name = KY Local Address = SNF-LTAC-InptrehabReview@Anthem.com This address is for any demographic and /or clinical submission of information for SNF, LTAC or Rehab stays 4. First Name = Predeterminations Last Name = KY Local Address = OHPredSpecServUM@Anthem.com This address is for any demographic and /or clinical submission of information for predeterminations 5. First Name = Specialty Pharmacy Last Name = KY Local Address = SpecialtyMeds@Anthem.com This address is for any demographic and /or clinical submission of information for specialty med requests

21 Local Commercial Accounts Missouri Addresses Missouri Local Commercial e-review Addresses: 1. First Name = Precert Demographics Last Name = MO Local Address = CertificationCenter-MO@Wellpoint.com This address is for the initial demographic submission 2. First Name = Precert - Clinical Last Name = MO Local Address = MOConcurrentClinicalReview@Anthem.com This address is for any clinical updates after the initial demographic submission of information 3. First Name = SNF/LTAC/Rehab Last Name = MO Local Address = SNF-LTAC-InptrehabReview@Anthem.com This address is for any demographic and /or clinical submission of information for SNF, LTAC or Rehab stays 4. First Name = Predeterminations Last Name = MO Local Address = OHPredSpecServUM@Anthem.com This address is for any demographic and /or clinical submission of information for predeterminations 5. First Name = Specialty Pharmacy Last Name = MO Local Address = SpecialtyMeds@Anthem.com This address is for any demographic and /or clinical submission of information for specialty med requests

22 Local Commercial Accounts Wisconsin Addresses Wisconsin Local Commercial e-review Addresses: 1. First Name = Precert - Demographics Last Name = WI Local Address = WIPrecert.EReview@Wellpoint.com This address is for the initial demographic submission 2. First Name = Precert - Clinical Last Name = WI Local Address = WIConcurrentClinicalReview@Anthem.com This address is for any clinical updates after the initial demographic submission of information 3. First Name = SNF/LTAC/Rehab Last Name = WI Local Address = SNF-LTAC-InptrehabReview@Anthem.com This address is for any demographic and /or clinical submission of information for SNF, LTAC or Rehab stays 4. First Name = Predeterminations Last Name = WI Local Address = OHPredSpecServUM@Anthem.com This address is for any demographic and /or clinical submission of information for predeterminations 5. First Name = Specialty Pharmacy Last Name = WI Local Address = SpecialtyMeds@Anthem.com This address is for any demographic and /or clinical submission of information for specialty med requests

23 Set Anthem e-review Addresses: Managed Medicare Accounts For Medicare Advantage accounts you can complete precertifications for surgery requests, inpatient stays, SNF/LTAC/Rehab, Specialty Pharmacy, DME, etc. You can also submit your predetermination requests in this manner. Medicare Advantage accounts generally start with the prefix of YRA, YRE, YRS, JWM, VZM or YRF. Please see next page for your Managed Medicare addresses.

24 Set Anthem e-review Addresses: Managed Medicare e-review Addresses: Managed Medicare Accounts 1. First Name = Precert Demographics & Clinical Last Name = Managed Medicare Address = Anthem.Ohio.Medicare@Anthem.com This address is for any initial demographics as well as clinical information (initial clinical and updates) 2. First Name = SNF/LTAC/Rehab Last Name = Managed Medicare Address = OHDischargePlanning@Anthem.com This address is for any demographic and /or clinical submission of information for SNF, LTAC or Rehab stays 3. First Name = Predeterminations Last Name = Managed Medicare Address = Medicarepre-De-Review@Anthem.com This address is for any demographic and /or clinical submission of information for predeterminations 4. First Name = Specialty Pharmacy Last Name = Managed Medicare Address = MASpecialtyPharm@Wellpoint.com This address is for any demographic and /or clinical submission of information for specialty med requests

25 Set Anthem e-review Addresses Once you enter all the addresses that you need, your address tab should look something like this.

26 You Are Now Ready to Send An Choose the you would like to send your information to by doulble clicking on the specific address in the Contact Details column

27 Composing an After you click on the address you want it should bring you to the Compose screen. The address you are sending to will be listed.

28 Composing Request Its just like a regular you send from your home personal computer. Never enter anything into the CC line In Subject Line always enter: Secure your facility name In the Message Area please provide the following plus any clinical information you would like to add: Requesting Provider / Facility Name: Tax ID: Contact Name and Phone Number: Patient Name: Insurance ID: Date of Birth: Admitting Physician Name: Address: Tax ID: Facility Name: Address: Tax ID: Date of Service: Admit Type: Diagnosis (Code/Description): Procedure (Code/Description

29 Composing Request Continued You may click Attach button to attach: File or document with additional information Precert Clinical Review Template Clinical Data Submission Tools for Predeterminations Great for photos / scanned documents Click Send to transfer the information to Anthem.

30 Sample of Composed

31 Sent Mail For your tracking purposes, all sent s will be stored under the Sent Mail tab for 60 days (unless you manually delete).

32 Processing Request Anthem associates process information & respond to sender via secured link. In general, Precertification requests are handled in 1-2 business days and pre-determination requests are handled within 15 business days When the Anthem associate replies to the request, the Provider will receive a notice in the account used to setup account informing of message on the secure site. At the bottom of this notification there is a link that can be clicked on that will take the Provider to the log-in screen. Log into the system to access the response. For your tracking, all replies will be stored in the Inbox tab for 60 days (unless manually deleted).

33 Types of Responses Not Our Member: reply via secure notifying the Provider if they have sent in information on a member that is not managed by Anthem. Approvals: reply via secure advising of approval, authorization number & appropriate disclaimer. Denials: reply via phone call advising of denial. Provider will still receive mailed notification letter. In Process: if case is being sent for a RN or MD review, an is sent back advising the status that the case is being reviewed.

34 Thank You Anthem Blue Cross and Blue Shield is the trade name of: In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-hmo benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Ohio: Community Insurance Company. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation (Compcare), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are the registered marks of the Blue Cross and Blue Shield Association.