Anthem Blue Cross and Blue Shield (Anthem)

Transcription

1 Serving Hoosier Healthwise, Healthy Indiana Plan Anthem Blue Cross and Blue Shield (Anthem) The Availity multi payer Web Portal presented by Anthem and Availity 2017 Annual Workshop

2 Agenda Healthy Indiana Plan (HIP) overview POWER Account Estimator Tool (screens and stops) Eligibility and Benefits Inquiry Availity navigation bar Administrator dashboard Payer spaces Availity Online PMP Member Listing Reports Additional training Anthem portal/crossover Availity Web Portal support 2 2

3 HIP overview HIP was created to help fund health care benefits for adults who have traditionally been uninsured. It is an affordable health insurance program from the State of Indiana for uninsured low-income Indiana residents (ages 19 to 64). In the HIP program, the first $2,500 of medical expenses for covered benefits (excluding preventive care) is paid with a special savings account called the Personal Wellness and Responsibility (POWER) Account. The state pays most of this amount, but participants are responsible for paying a small portion of their initial health care costs, based on their income. Source: [in.gov/fssa/hip/] 3 3

4 POWER Account Estimator Tool Effective [July 2017], Anthem introduces the POWER Account Estimator Tool. Available through the Availity Web Portal, this new tool allows primary medical providers the capability to provide HIP members with an estimate for rendered medical services. This tool helps your HIP patients keep track of their POWER Account dollars and take personal responsibility for their wellness key components of the HIP program. 4 4

5 Accessing the POWER Account Estimator Tool The POWER Account Estimator Tool is accessed through the Availity Web Portal. Simply log in as you normally would to access Availity. 5 5

6 First step eligibility verification As always, the first step is ensuring your patients are eligible for HIP benefits. In Availity, select Patient Registration from the top menu bar, then Eligibility and Benefits Inquiry from the drop-down menu. 6 6

7 Eligibility verification Once you select the Eligibility and Benefits Inquiry link, the New Request screen will appear, prompting you to input provider and patient information. For Patient ID, you can input the Anthem ID number or the state recipient identification number (RID) to verify eligibility. The HCID prefix or YRK must be entered with the member ID or as a prefix to the RID. Select Submit. 7 7

8 Eligibility and Benefits Results screen When eligibility is verified, the Eligibility and Benefits Results screen will appear with your patient s information and POWER Account balance. Select Create Healthy Indiana POWER Account Service Estimate. 8 8

9 Provider screen To start the process of creating a service estimate, input the servicing provider information. When done, select the Services button. 9 9

10 Services screen The Services screen provides a simplified list of office visit and diagnosis categories to choose from with a description to streamline the selection process. Select one office visit category and any diagnosis categories that apply. When finished, select the Estimate button

11 POWER Account Service Estimate The POWER Account Service Estimate provides your patients with an estimate of the services rendered and a new POWER Account balance. The estimate also shows what services were provided and how the service estimate process works. Remember! Select Print and present the estimate to your patients for their records

12 Availity navigation bar My Top Applications are the ones you use most frequently. Your favorite tools

13 Availity navigation bar (cont.) Select the heart symbol to choose as one of your favorite tools

14 Availity navigation bar (cont.) 14 14

15 Availity navigation bar (cont.) 15 15

16 Administrator dashboard 16 16

17 Administrator dashboard (cont.) 17 17

18 Payer spaces 18 18

19 Payer spaces (cont.) Toggle between Applications and Resources to see all available tools

20 Payer spaces (cont.) With Resources, you have Anthem-specific resources such as companion guides and links

21 Anthem portal/crossover 21 21

22 Operational updates Availity online PMP Member Listing Reports o PCP member: Listing_Indiana o New program for provider online reporting HIP, Hoosier Care Connect and Hoosier Healthwise reports will be combined into the PMP Member Listing Report

23 Operational updates (cont.) Availity online PMP Member Listing Reports o PCP member: Listing_Indiana o New program for provider online reporting Program name: Member Panel Listing Description: The PMP Member Listing Report is available to providers to view and download a complete list of past and current Medicaid members that have been assigned to a specific provider or group

24 Operational updates (cont.) Member Panel Listing: Description will be added to home and program pages

25 Operational updates (cont.) Report Search 25 25

26 Operational updates (cont.) If you have any questions about the program, all inquiries can be directed through our Contact Us page

27 Additional training To find helpful Availity training, go to the top navigation bar and select Help then Get Trained. You will be redirected to our Availity Learning Center. Training options: Live webinars Recorded webinars Quick demonstrations Quick reference guides 27 27

28 Availity Web Portal support Availity client services [ ] Up to 24-hour response time Worked internally by our ACS team Anthem providers can: Update with additional information Change main contact person for ACS to reply Ask for multiple addresses to be notified of response Attach files to support cases Reopen a closed support case within 14 days of it being closed (after 14 days, resubmit a new one)

29 Thank you Thank you for your partnership and serving our Hoosier Healthwise, HIP members. is the trade name of Anthem Insurance Companies, Inc., independent licensee of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. AINPEC [rdate] 29 29