authorizations in providerconnect
TRANSCRIPT
Authorizations in ProviderConnect
February 2016
Agenda
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E-Commerce
Demonstration of inpatient or higher levels of care authorizations
Demonstration of outpatient authorizations
Viewing authorizations and letters
Helpful resources
How to Access ProviderConnect
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Go to www.ValueOptions.com, choose “Providers”
Click on Login under “ProviderConnect” on the right
side of the screen
Unregistered providers can self register using a
provider ID number and clicking “Register” on the login
screen
Multiple logons from same provider ID number
available
Contact Information:
EDI Helpdesk
Phone: 888.247.9311 (Mon-Fri, 8 a.m. - 6 p.m. ET)
Email: [email protected]
Services
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• Verify member benefits and
eligibility
• View and print forms
• Request and view
authorizations
• Download and print
authorization letters
• Submit claims and view status • Access Provider Summary
Vouchers (PSV)
• Request payment for EAP
services
• Submit EAP case activity forms
(CAF)
• Submit updates to provider
demographic information
• Submit recredentialing
applications
• Submit customer service
inquiries
• Access ProviderConnect
message center
Benefits
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Free and secure online
application, available 24 / 7Reduces paper files
Mobile Device friendlyReduces the need to call
for routine information
Quicker PaymentMac and Windows
compatible
INCREASED CONVENIENCE, DECREASED ADMINISTRATIVE PROCESSES
Disclaimer: Please note that ProviderConnect may look different and have
different functionalities based on individual contract needs, therefore some
functions may not be available or may look different for your
specific contract.
E-Commerce
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Providers in the Beacon Health Options network are expected to
electronically conduct all routine transactions, including:
• Submission of claims
• Submission of authorization requests
• Verification of eligibility inquiries
• Submission of re-credentialing applications
• Updating of provider information
• Electronic fund transfer
ProviderConnect’s New Look
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ProviderConnect new look
• Current functionality remains the same
Ready to take your office to the next level?
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“Everything a provider needs or may want is
available on one website. Impressive!”
“Having the
remittance advice
online is a real
timesaver as well as
being able to check
claim status and
benefits. I would
recommend them to
other providers.”
Demonstration of
Outpatient
Authorizations
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Requested Services Header
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Type of Service
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Diagnosis
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Diagnosis
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Social Elements
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Current Risks and Impairments
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Psychotropic Medications
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Psychotropic Medications
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Psychotropic Medications
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Approval
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Disclaimer: The number of approved visits may vary based on
contract and medical necessity.
Requested Services
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Results
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Demonstration of
Inpatient or Higher
Levels of Care
Authorizations
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Enter an Authorization Request
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Disclaimer
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Search a Member
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Member Information
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Service Address
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Requested Services Header
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Level of Care
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Diagnosis
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Diagnosis
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Social Elements
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Medical Implications and Metabolic Assessment
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Symptomatology
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Primary Issues/Symptoms Addressed in Treatment
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ASAM and Recovery and Resiliency
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Medications
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Medications
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Medications
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Best Practices Endorsement and Discharge Information
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Best Practices Endorsement
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Best Practices Endorsement
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Best Practices Endorsement
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Best Practices Endorsement
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Results
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Viewing
Authorization
Listings and
Letters
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Review an Authorization
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Search Authorizations
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Authorization Search Results
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Authorization Summary
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Authorization Detail
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Authorization Letters
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Authorization Letter Sample
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Additional
Training Options
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Helpful Resources
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On Valueoptions.com choose “Providers”
Click on “Helpful Resources” under
ProviderConnect on the right
Training Webinars
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Scheduled monthly
Topics include: High level overview of ProviderConnect, claim
submission, enhancements to ProviderConnect, etc.
Registration available by clicking “Education Center” from the
provider homepage or through the newsletter
Webinars are offered on the webinar page in the education center
and on the network specific page for your contract
Next webinar scheduled for Tuesday 2/16/16 at 2:00 p.m. ET and
will be titled “ProviderConnect Claims”
Customized Training
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Scheduled at your convenience
Available to just one employee or your entire office
Training topics are customized based on your needs, timeframes,
etc.
How-To Video Tutorials
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Short Video Tutorials:
Contact Information
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EDI Helpdesk
(ProviderConnect Technical Questions)
Monday through Friday, 8:00 a.m. - 6:00 p.m. ET
Phone: 888.247.9311
Email: [email protected]
Provider Service Line
(Training Requests)
Monday through Friday, 8:00 a.m. – 8:00 p.m. ET
Phone: 800.397.1630