Transcription

1 1

2 2

3 3

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