Useful Websites for Office Managers and Staff
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- Pierce Barnett
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1 VALLEY HOSPITAL Valley Hospital website exclusively our physicians office staff Valley ms, general Hospital info, other internet resources, legal issues info, Medicare internet links, managed care, medical clearance, office manager general info, physician info with NPI numbers, programs and services at Valley, and technical support Disclaimer:The following sites may involve fees to subscribe. These sites are inmation purposes only GOVERNMENT (Helpful with Human Resources, ms, etc.) AARP Health Care Options A free online resource physicians and health care providers serving AARP members through products insured by United HealthCare Insurance Company. This service is available 7 days per week, providing fast and easy access to real-time inmation including: member eligibility; claim status; claim payment inmation; plan descriptions; and check details. Internal Revenue Service EIN (Employer ID number) and Payment plan applications; commonly used ms and publications; operating a business. The State of New Jersey Employment and Unemployment NJ Dept of Labor & Workce Development Employer Poster packet ms ms.html Page 1 of 7
2 INSURANCE (Helpful with eligibility, claims, provider info, etc.) Aetna Medical Plans Application Request Health Professionals Recent Medical Claim Payment Policy Updates Aetna Billing Tips, Policies and Processes Aetna Participating providers Directory Online Claims Explanation of Benefits (EOB) Practioner/Provider Appeal Process Quick Reference Guide Precertification List Cigna Answers questions about fee schedules, covered services, benefit plans and features, member health & wellness. Cortex EDI This website is FREE Medicare eligibility. Provides a complete answer DME and Medical Electronic billing free software, installation, and initial training. Receive payments within an average of 14 days instead of 45 days. (Nominal monthly fee software support and version updates). Empire BlueCross BlueShield Access benefits, NPI Inmation, Contact info. Empire Medicare Services Inmation about Medicare Part A (New York) and Medicare Part B (New Jersey & New York) Page 2 of 7
3 INSURANCE cont. GHI View eligibility; check claim status; view patients benefits; submit treatment plans; manage billing, check reimbursement rates; pre-certification and status, a stand-alone Medicare Part D drug plan; daily updated health inmation; diagnosis-specific health programs; member discounts to fitness clubs, weight watchers, and more. Horizon Blue Cross Blue Shield of NJ Check claim status, eligibility, premium billing, programs to help your patients manage chronic conditions; send electronic prescriptions directly to the pharmacy; submit and check patient referrals. MagnaCare Check eligibility, claim status, fee schedule info, NPI info. New Jersey Medicaid Correct claims; submit Judge Run requests online; view and download Judge Run reports; view FFS and Charity Care remittance advice reports; provider directory access; emevs. Oxd Health Plans Oxd Medicare info; in-network provider benefits Lab Services - locate a lab, order tests, get lab results; in-office Lab testing list; lab network list Reimbursement policies Rx drug inmation Radiology info procedures requiring pre-cert, precert request m, bundling rules Clinical & preventative guidelines Free online CME programs United Healthcare Online Claim estimator, submission, re-submission; check claim status, patient eligibility; referral status, fee schedules; news and inmation on prescription drugs. Page 3 of 7
4 PRACTICE SUPPORT (Helpful with group purchasing, lab info, guidelines, etc.) CareCore Guidelines to Radiology, Cardiology, and Oncology Detailed assessment of professional physician/practice sites to ensure that contracted imaging centers are meeting professional and technical permance quality standards. Access to Group Purchasing Programs CDC Vaccine Inmation Vaccine Inmation Sheets(VIS); guidelines, brochures. ecare online A powerful resource designed to assist healthcare professionals with a wide range of everyday administrative tasks such as insurance eligibility & verification; claim status; pre-certification; medical necessity tools; and UPIN search. emedny Offers you a wealth of inmation about Medicaid, as well as specific instructions on how to submit a claim rendered services. Gives specific rules governing the provision of your care and service to Medicaid recipients. Contains billing instructions, as well as pertinent procedure codes and fee schedules. Health Fusion A service that offers eligibility verification and electronically tracked referral authorizations, edits claims to reduce error rates and resubmission expenses; processes claims electronically. Immunization Action Coalition Vaccine info healthcare professionals Page 4 of 7
5 PRACTICE SUPPORT cont. MedicineNet.com Medical terms dictionary; diseases and conditions, medications, procedures and tests. Navinet A free web-based solution that links providers with health plans to access various transactions such as: Eligibility and benefits verification; claim status, procedure and diagnosis code, network provider inquiries; and pre-certifications. Quest Diagnostics A provider of diagnostic testing, inmation, and services to help physicians diagnose, treat, and monitor disease. Quest Diagnostics Care360 Lab orders and results. Page 5 of 7
6 PHYSICIAN CREDENTIALING (Helpful with licenses, NPI s, CME credits, etc.) AMA Physician Recognition Award Application the Physician s Recognition Award from the AMA; also good CME CAQH (Council Afdable Quality Healthcare) Credentialing a free online service that enables providers to complete one standardized application to meet the needs of all participating health plans and other healthcare organizations. This credentialing process is supported by The American College of Physicians (ACP) and is endorsed by the American Academy of Family Physicians (AAFP). Access to mulary inmation Center Disease Control & Prevention (CDC) Department of Health site - Health and safety topics diseases and conditions, injury, violence and safety, emergency preparedness, healthy living, environmental and travelers health, workplace safety, life stages and populations, data, statistics. Council Afdable Quality Healthcare Credentialing database insurances. Drug Encement Administration's (DEA) Office of Diversion Control DEA website renewals; DEA Form 106 to report theft or loss of controlled substances; controlled substance schedules; regulations and codified CSA.. Medical Society of New Jersey Provides practice resources CME opportunities, medical news, and practice management advice Page 6 of 7
7 PHYSICIAN CREDENTIALING cont. National Plan and Provider Enumeration System (NPPES) NPPES collects identifying inmation on health care providers and assigns each a unique National Provider Identifier (NPI). New Jersey Division of Consumer Affairs (Office of the Attorney General) NJ State Board of Medical Examiners M.D. and D.O. license renewal. Office of the Professions, New York State Education Department Provides a summary of the requirements licensure or certification, as well as links to one or more required application ms; listing of employment opportunities; online verification searches. or For more inmation on other internet resources, please go to: Q:\Office Manager Quarterly\2007 MEETINGS\July 25, 2007\Useful Websites Categorized.doc Page 7 of 7
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