How To Use Thecontinuus Provider Portal

Transcription

1 PROVIDER PORTAL USER GUIDE OCTOBER 13, 2014 TOGETHER ADMINISTRATION OFFICE phone: toll free: fax: web:

2 CONTENTS System Requirements... 1 Login Information... 2 Login ID and Password... 2 Additional Staff... 2 Multiple Locations... 2 Login Assistance and Technical Support... 2 How to Log In to the Portal... 3 Welcome Screen... 4 News & Updates... 4 Main Menu... 5 A Note About Portal Menu Items... 5 Home... 6 Home > User Documents... 6 Provider Mgmt... 7 Client Mgmt > Lookup or Create HIPAA ID for Client... 7 Create a HIPAA ID for use in Communications with ContinuUs... 8 Find the Member Associated with a HIPAA ID Care Mgmt Care Mgmt > Search Service Authorizations Checking for New and/or Updated Authorizations 12 Exploring the Service Authorization Search Results 12 Service Authorization Detail 14 Care Mgmt > Search Claim Payments Exploring Claim Payment Search Results 15 Claim Payment Search Criteria 16 Saving Claim Payment Searches 17 Reports Reports > WPS Claim Form ContinuUs Provider Portal User Guide i 10/13/2014

3 Welcome to the ContinuUs Provider Portal, your access to authorization, claim, and other information for services you provide to ContinuUs members, using the MIDAS system. Note: All examples in this guide use fictitious member information. SYSTEM REQUIREMENTS The ContinuUs Provider Portal is a browser-based application, which means you access the Portal like any other website you might visit. However, you must be using the Internet Explorer web browser. Other browsers (such as Chrome, Firefox, and Safari) are not supported. If you do not have the Internet Explorer browser, contact the ContinuUs Provider Help Desk at or providerhelpdesk@continuus.org for assistance. General system requirements for using the Portal include: Internet Explorer (IE) Internet Explorer is the only browser that is supported for the Portal. Other browsers may allow you to log in, but some Portal functions will not work properly, including viewing authorizations. Printer access if you want to print authorization letters or reports. Adobe Acrobat Reader is required to view some reports. (Download Reader for free at get.adobe.com/reader). Internet Explorer 11 is not yet compatible with the Portal. If you have a new computer or if your computer automatically updates to the most current version of IE and you are having difficulty viewing authorizations, try the following: 1. Go to sfca-midas.com and click on Tools at the top of the screen and scroll down and select Compatibility View Settings. The sfca-midas.com will automatically fill in under Add this website. 2. Click Add to make the sfca-midas.com website compatible with your version of IE. 3. Click Close and then log in to the portal. (If you were already logged in, log out and log back in.) ContinuUs Provider Portal User Guide 1 10/13/2014

4 Note: You can see what browser you are using by looking above the menu on the sfca-midas.com login page. In the example below, IE indicates that the browser is Internet Explorer, version 8.0. LOGIN INFORMATION LOGIN ID AND PASSWORD A login ID and password are required in order to access the ContinuUs Provider Portal. These are provided in your contract welcome packet. Existing providers who contracted with ContinuUs before the Portal setup was automatic with new contracts can request to be set up by contacting providerhelpdesk@continuus.org. A signed confidentiality form is required from each staff person who will be accessing the Portal. ADDITIONAL STAFF If you have additional staff that need to access the Portal, have them submit a signed Provider Portal Confidentiality Agreement form. Additional logins and passwords are not required all of your staff will use the same login information. Because of this, it is important that you let us know if someone on your staff who has had access to the Portal ends their employment with your organization, so we can give you a new password. (The confidentiality form is available on our website at ContinuUs.org on the main Providers page, and also on the Portal under Home > User Documents.) MULTIPLE LOCATIONS Providers with multiple locations may have several records in the MIDAS system. In that case, you will receive a separate Portal login and password for each location record. LOGIN ASSISTANCE AND TECHNICAL SUPPORT If you experience any problems with your account information, need a new password, or have technical difficulties with the Portal, please contact the ContinuUs Provider Help Desk at or providerhelpdesk@continuus.org. You can also view the Troubleshooting section of the Provider Portal page in the Providers section of our website at ContinuUs.org for more information. ContinuUs Provider Portal User Guide 2 10/13/2014

5 HOW TO LOG IN TO THE PORTAL To access the ContinuUs Provider Portal: 1. Open Internet Explorer and go to sfca-midas.com. 2. Click the System dropdown arrow and select Provider Portal. 3. Enter your assigned Login (Login ID) and Password. (Leave Environment set at Production. ) 4. Click Login. ContinuUs Provider Portal User Guide 3 10/13/2014

6 WELCOME SCREEN The Welcome screen contains informational items and the main menu. Click Log Out at the top right corner of the screen to end your Portal session. Click the Contract Specialists link above the menu to open an message to ContinuUs Provider Services. TIP: The MIDAS Support link at the top of the screen is for ContinuUs staff users of MIDAS. For technical assistance with the Portal please contact the ContinuUs Provider Help Desk at or NEWS & UPDATES An alert will appear in the News & Updates section of the Welcome Screen if ContinuUs staff have placed a news item for providers on the Portal. Click the category title of the update (e.g., Provider News above) to see the news item. Click the plus and minus signs to expand and condense topics and news items. ContinuUs Provider Portal User Guide 4 10/13/2014

7 MAIN MENU The blue menu bar contains six headings with submenus containing various options. Pause your mouse pointer over the menu name or click on the menu to see the drop down, then click to select the desired menu option. A NOTE ABOUT PORTAL MENU ITEMS There are a variety of items in the Portal that ContinuUs is not using at this time. The Care Mgmt menu shown above is one example ContinuUs has not activated the SHC/PC Assessments feature at this time. This guide will only address the items that apply to ContinuUs providers. You may notice that the menu options in the Portal differ from the options shown in the screen shots in this guide. From time to time the system developers may add new features for other users. This guide will only be updated when items that are options for ContinuUs providers have changed. You may see a Security Error screen if you try to access a menu item that is not set up for ContinuUs providers. If this happens, simply click Click to Continue to return to the main screen. ContinuUs Provider Portal User Guide 5 10/13/2014

8 HOME The Home menu contains two submenus: News (which will take you back to the Welcome Screen) and User Documents. HOME > USER DOCUMENTS Home > User Documents is where you will find a variety of resources and publications for providers. Click the plus/minus sign next to folders in the navigation pane at the left to expand/condense the list. Click [Refresh] to return to the main User Documents Folders. Click [Find in Files] or [Find in Filenames] to search for a word or words in a document, or in document name. ContinuUs Provider Portal User Guide 6 10/13/2014

9 PROVIDER MGMT There are three items on the Provider Mgmt menu currently in use for ContinuUs providers. These items show you the information we have for you in our system: Provider Demographics, Additional Information, and Provider Contacts. The information in these sections is maintained by ContinuUs Provider Services staff. If you notice something that is incorrect or needs to be updated, please contact the ContinuUs Provider Help Desk. It is important that you contact us to make changes, as we will need to update other systems with your new information as well. CLIENT MGMT > LOOKUP OR CREATE HIPAA ID FOR CLIENT The Client Mgmt menu has one option in use by ContinuUs: Lookup or Create HIPAA ID for Client. This feature provides a way to generate a unique member identification number for confidential communications, called a HIPAA ID. ( HIPAA refers to the Health Insurance Portability and Accountability Act of 1996.) Use of a HIPAA ID is a way for you and ContinuUs to be sure we protect our members privacy and also satisfy government HIPAA regulations. These regulations are designed to protect our members, and your contract with ContinuUs requires you to abide by these rules. The HIPAA ID is a temporary member identifier that should be used in place of the client/member ID (social ContinuUs Provider Portal User Guide 7 10/13/2014

10 security number), name, or address when referencing a member in electronic correspondence. The HIPAA ID is valid for eight days and a new HIPAA ID can be generated for new or additional communications when an existing ID expires. A 'Keep Active' option is available to extend a currently active ID so it will not expire until eight days from the current date. You can use this feature to create a HIPAA ID for a member you serve, in order to communicate with ContinuUs staff about that member using your regular system or other non-secure method. You would use the HIPAA ID to refer to the member in your message, rather than the member s name or other information. Note: ContinuUs staff can use the ContinuUs secure system to send member identifying information in messages. For that type of message, you would receive a notification that you have a secure message and would be directed to a secure website to view the message. You could then reply to the secure message from within the secure system. However, as a provider you cannot create and send a new secure message using the ContinuUs secure system you can only reply to a message from ContinuUs staff. Instead, use the Portal to create a HIPAA ID to use to identify the member, and then you can send a message using your regular . Be sure that you do not include any other identifying information in your , just the HIPAA ID. CREATE A HIPAA ID FOR USE IN COMMUNICATIONS WITH CONTINUUS To create a HIPAA ID for a ContinuUs member that you can use in non-secure communications with ContinuUs: 1. Go to the Client Mgmt menu and select Lookup or Create HIPAA ID for Client. 2. In the Client Search screen that comes up, type the Client ID (social security number), Last Name or First Name and click [Search]. Click [Reset] to clear the search fields and start a new search. ContinuUs Provider Portal User Guide 8 10/13/2014

11 3. Click on the member s name or ID in the search results. a. Use an Existing HIPAA ID If the member already has an active HIPAA ID, you will see the current ID and a list of any prior IDs. You do not need to create a new ID if there is a current one still active. (You may want to click Keep Active to extend the expiration date an additional eight days.) You can copy and paste the ID into messages or documents, or click Open with Reference to have the Portal start a new message for you with HIPAA ID already filled in. If you choose Open with Reference, the subject line automatically fills in with the expiration date for the HIPAA ID, and the HIPAA ID is placed in the message body. You can delete the expiration information if you wish and put in a different subject line for your message. b. Create a New HIPAA ID If no HIPAA history exists for the member, click [Generate ID and Open with Reference] to generate the HIPAA ID. ContinuUs Provider Portal User Guide 9 10/13/2014

12 If you do not wish to send an , you can close the message without saving it. When you return to the HIPAA ID screen you will be able to see the ID number and the expiration date. The ID will be valid for eight days. Once a HIPAA ID has been created, you can go back later and use the [Keep Active] and [Open with Reference] options described above. Simply select the Lookup or Create HIPAA ID for Client menu item and search for the member using one of the search options. FIND THE MEMBER ASSOCIATED WITH A HIPAA ID There may be times when a communication is sent to you by ContinuUs that contains a HIPAA ID. Or you may be looking through your own communications that contain a HIPAA ID and need a reminder of who the communication was about. In that case, you would go to the Portal to find out which member the HIPAA ID refers to. To search for a HIPAA ID: 1. Go to the Client Mgmt menu and select Lookup or Create HIPAA ID for Client. 2. Type the HIPAA ID in the HIPAA ID box and click [Search]. Click [Reset] to clear the search fields and start a new search. ContinuUs Provider Portal User Guide 10 10/13/2014

13 The search results will display the social security number and name of the member associated with that HIPAA ID. Click any of the blue underlined items to go to the HIPAA ID detail screen. Click [New Search] to search for a different number or member. CARE MGMT There are two active options on the Care Mgmt menu: Search Service Authorizations and Search Claim Payments. CARE MGMT > SEARCH SERVICE AUTHORIZATIONS This feature allows you to enter multiple criteria for searching service authorizations. You may select Open or Closed authorizations, and also search by a variety of date options, client (type in last name of the member you re searching for), procedure code or authorization number using a single item or a combination of several criteria. Click the Show Notes checkbox to view authorization notes entered by the care manager. Click the Show Date of Birth checkbox to have the member s date of birth added to the search results. After you select your criteria, click [Search] and the results will appear below in the same screen. Click [Reset] to clear the search criteria and start a new search. ContinuUs Provider Portal User Guide 11 10/13/2014

14 CHECKING FOR NEW AND/OR UPDATED AUTHORIZATIONS Many of our providers check the Portal on a regular basis to see if there are new authorizations, or changes to existing authorizations. You can search using these criteria individually, or combine them by selecting New or Revised Date in the Date: dropdown list. Enter the range of dates for which you want to know if anything changed, and click [Search]. Note: Authorizations are not available on the Portal until after 6:00 p.m. on the day the authorization was created and approved in the MIDAS system. Also, authorizations created far in advance of the start date do not become available until five days prior to the start date. EXPLORING THE SERVICE AUTHORIZATION SEARCH RESULTS ContinuUs Provider Portal User Guide 12 10/13/2014

15 The search results will appear below the search criteria. If the list is long, scroll bars will appear at the right side of the window so you can scroll down to see all the results. Click the column title to sort the results on that column. Click the arrow in the yellow circle to change the sort direction. Pause your mouse pointer (hover) over the following items to see a quick information popup: Auth No date authorization was entered Client Name member social security number and MCI number (used on SRSPs for AFH, CBRF, RCAC providers, and others with member-specific rates), and care manager names Procedure procedure (HCPCS/CPT) code Service start message to click to view claims history TIP: On many screens in the Portal, you can right-click and select Print Preview to quickly print the contents of the screen. If the contents extend below the bottom of the active area of the window, you will see a message asking if you want to print the screen as it is or print all the records in the list. Select Yes to print the entire list. Click on the blue authorization number in the left column to view detail for a specific authorization. (See Service Authorization Detail below). Click [Download as CSV file for Excel] to save the search results in a spreadsheet. An asterisk (*) next to the authorization number indicates that there is cancellation information for the authorization. Click on the authorization number to bring up the service authorization detail screen to view the information. Going Green. Paper printing of authorizations has been discontinued. We no longer send copies of the authorizations in the mail. You can always print copies of the letters yourself from the Portal if you wish to do so (see Service Authorization Detail below). Please contact the ContinuUs Provider Help Desk if you have any questions. ContinuUs Provider Portal User Guide 13 10/13/2014

16 SERVICE AUTHORIZATION DETAIL From the Service Authorization detail screen, you can click on the Care Manager or RN name link for contact information. Clicking on the address in the pop up window will open an message in your client and fill in the care manager s address. Click [Print Copy] to view/print the authorization letter. Click [Claim History] to view the claim history for the authorization. Click [Report Problem] to notify the care Manager and supervisor of any authorization issues. This will open an message and fill in the addresses (if your computer is set up to access your from website pages). You may have to click Allow in a pop-up window in order for your mail message to open. Click [Return] to go back to the search results. CARE MGMT > SEARCH CLAIM PAYMENTS This feature allows you to search for claim information using a variety of criteria, and use multiple criteria to refine your search. Once a claim is processed by WPS (ContinuUs s third-party claim administrator) the claim information is uploaded to ContinuUs s MIDAS system. ContinuUs Provider Portal User Guide 14 10/13/2014

17 To view all claims for a range of dates, enter the date range (From and To) and click [Search]. Click [Reset] to clear all search criteria and start a new search. EXPLORING CLAIM PAYMENT SEARCH RESULTS Paid claims data will appear in the results area below the search criteria window. The report results will be wide, and you will need to enlarge your browser window and use the scroll bar at the bottom of the window to see all the data for a particular claim. ContinuUs Provider Portal User Guide 15 10/13/2014

18 If a claim is denied, the reject code will be displayed in the last column, EX Code. Move your mouse over the code to see a description pop up. (For a list of codes and definitions, see the WPS Common Payment-Rejection Codes document under Home > User Documents for a key to the codes.) To export the report results to a spreadsheet file, click EXPORT at the top right corner of the search results area and select CSV (Tab) for a standard spreadsheet. A window will open prompting you to save or open the file. You can then manipulate the data, format, and print as you wish. (You are also welcome to use the other formats if you choose.) To print the results if you do not have spreadsheet software (or if you just want a quick printout of the report results rather than creating a spreadsheet), right click in the report area, select Print Preview in the pop-up menu, change page layout to landscape and print the report. CLAIM PAYMENT SEARCH CRITERIA You can refine your search by choosing a different option on the Search By: list, and by combining options on the main search screen (for example, all claims for a particular year summarized by service). ContinuUs Provider Portal User Guide 16 10/13/2014

19 Select Advanced (Multiple Criteria) for even more flexibility in designing your search: SAVING CLAIM PAYMENT SEARCHES After you run a search with multiple criteria, you have the option of saving that search to your personal Saved Searches list for future use. The search criteria are saved, not the actual results, so each time you run a saved search you get the most up-to-date information in the system. Click on Add To Saved Searches at the bottom of the search criteria window (above the search results). Note: You must run the search first for the criteria to be saved. ContinuUs Provider Portal User Guide 17 10/13/2014

20 Give the search a name in the dialog box that pops up: To run a saved search, select My Saved Searches from the Search By dropdown list, then click on the search name to run the search. This screen is also where you can delete or rename your saved searches. REPORTS REPORTS > WPS CLAIM FORM The WPS paper claim form can be opened from this menu. If you are not currently submitting to WPS electronically, this is a form that you can use to enter claim information, print, and submit via mail (you cannot submit a claim through the MIDAS system). A fillable PDF version of the form is available on our website at ContinuUs.org, in the Providers Section under Claims & Billing Information. Note: The Provider Terminated Enrollment report is not available at this time. ContinuUs Provider Portal User Guide 18 10/13/2014