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1 1
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4 Complete the Fields as indicated 4
5 Complete the Fields as indicated click submit 5
6 6
7 Security Questions 7
8 sent to Activate Account 8
9 Close out previous browser and sign in to new browser 9
10 Select Task and the Log In page will come up, sign in 10
11 11
12 Provider and Patient Specific Benefits Provider In Network Enrollment information Service History Tabs for Benefits, Claim Status and Ortho treatment Out of Network 12
13 Initial view of Benefits screen Procedure categories sorted by ADA code ranges To see additional benefits available if medical condition reported click See Medical Condition Benefits 13
14 Display of additional benefits member would have if a medical condition was reported 14
15 Deductible & Maximum information will remain as a graphic and as text at top of benefits section + and allow user to expand to the details under the procedure category Click on procedure row to get to additional details 15
16 Procedure history relative to selected procedure is displayed to assist the office in determining patient eligibility for service 16
17 Patient full procedure history is available in the procedure look or from the View Service History Link in Benefit section 17
18 Waiting Periods shown when applicable Shows the % of benefit after the waiting period Provides the date the waiting period is over 18
19 Patient specific benefit information. Sealant not covered for due to age Not covered, 0% and limitation Covered by plan but not covered for patient 19
20 Change patient to child Andrew Expand sealant coverage Benefits specific to Andrew and now shows covered 20
21 Not covered by plan Alternate Benefit 21
22 PDF Print / Save capability Select sections the provider is interested in details for Select all sections if needed 22
23 Print 23
24 View / Print Coverage Summary 24
25 Claim Status recent claim alert View Details 25
26 26
27 27
28 Add a date of service to predeterminations Implemented July
29 Reimbursements 29
30 Reimbursements After logging in, Enter Provider & ID Tax ID Enter date range to search provider check information Select Search Date Range 30
31 31
32 Summary of recent provider payments and EOBs displayed 32
33 Check Detail or EOB available online 33
34 Speed eclaim 34
35 Speed eclaim quick entry used when no attachments; COB information or any special comment needs to be entered 35
36 3 options for Type of Transaction 36
37 Expanded Form to enter specific information such as COB, Attachments, Select patient for twins 37
38 Claim Tab 38
39 Provider Tab 39
40 Subscriber / Patient Tab Select specific patient (twins); enter any Attachment information such as NEA# containing images of x-rays; diagnostics or COB 40
41 Attachment Drop Downs 41
42 Other Insurance Tab 42
43 Services Tab enter additional information for the Services such as initial placement 43
44 Summary & submit Tab Review for changes or corrections and submit 5 slides 44
45 45
46 46
47 47
48 48
49 Notification Claim Submission Successful will receive claim number 49
50 EFT Electronic Funds Transfer Must request a PIN which is mailed to your office. Once PIN is received, can sign in and go to this tab to add the banking information and be set up to receive Direct Deposits 50
51 51
52 Schedule of Allowances can receive schedules for different networks 52
53 53
54 Questions? 54
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