ProviderConnect Claims - Beacon Health Options

1 ProviderConnectClaimsNovember20162 Services and Benefits Direct claim Submission Batch claim Submission claim Search Reprocessing a claim EAP Case Activity Form Submission Viewing Provider Summary VouchersAgendaServices3 Verifymember benefits and eligibility View and printforms Request and view authorizations Downloadand print authorization letters Submit claimsand view status Access Provider Summary Vouchers(PSV) Request payment for EAP services Submit EAP case activity forms(CAF) Submit updates to provider demographic information Submitrecredentialing applications Submit customerservice inquiries Access ProviderConnect message centerBenefits4 Free and secure online application, available 24 / 7 Reduces paper filesMobile Device friendlyReduces the need to call for routine informationQuicker PaymentMac and Windows compatibleINCREASED CONVENIENCE, DECREASED ADMINISTRATIVE PROCESSESD isclaimer.

2 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 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 recredentialingapplications Updating of provider information Electronic fund transferE-Commerce6 Nine out of ten providers are satisfied with the functions they use in ProviderConnect 95% of providers submitting Claims electronically are satisfied with the processProviderConnect Stats ProviderConnect website is one of the best insurance based websites that I have ever a provider needs or may want is available on the one web site.

3 Impressive! -Provider Testimonial How to Access ProviderConnect7 Go to , 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 availableContact Information:EDI Helpdesk Monday through Friday, 8 6 ETPhone: 888-247-9311 Email: Better, faster, and cheaper Reduces paper files Reduces labor and postage expenses Reduces potential of error or mishandling Faster Claims processing improves cash flow Accepts claim files from any Practice Management System outputting HIPAA formatted 837p or 837i batch files and from EDI Claims submission vendorsElectronic claim Submission.

4 AdvantagesDirect claim Submission910 Provides ability to enter a claim directly into ProviderConnect portal without using special software Expedites processing of the claim and payment Available for professional services only, not higher levels of care Recommended for providers submitting a lower volume of outpatient claimsDirect claim SubmissionDirect claim Submission11 Direct claim Submission12 Direct claim Submission13 Direct claim Submission14 Direct claim Submission -COB15 Direct claim Submission16 Direct claim Submission17 Summary Page18 Batch claim Submission1920 Allows you to upload HIPAA 5010 compliant files directly to Beacon Expedites processing of the claim and payment Available for all levels of care Recommended for facilities and providers submitting a higher volume of Claims Payer ID is FHC &Affiliates Note.

5 Some clearinghouses may assign a separate payer IDBatch claim SubmissionBatch claim Submission21 Batch claim Submission22 Batch claim Submission23 Batch claim Submission24 Batch claim Submission25 Batch claim Submission2627 Free Beacon Health Options software that submits HIPAA 5010 compliant files Used only for Claims submitted directly to Beacon Health Options Available for download in our Helpful Resources under ProviderConnect Only available for Windows platformEDI Claims Link28 Beacon Health Options Companion Guide Located on the Helpful Resourcespage Shows Beacon s specific batch file requirements Reprocess and Voids Beacon accepts frequency indicators of original (1), replacement (7), and void (8) Corrected Claims can be completed as a replacement claim Replacement and Voided Claims require original claim number Payer ID FHC &Affiliates Clearinghouses may provide their own 5 digit payer ID for Beacon Health Options Contact your clearinghouse to see what payer ID is neededAdditional EDI InformationClaim Search29 Review a Claim30 Search Claims31 Searching a Specific Member32 Searching a Specific Member33 Viewing Member Claims34 claim Search Results35 Claims Summary36 Service Line Detail37 Correcting a Claim38 Reasons to Correct a Claim39 Change claim Data Incorrect diagnosis code, service date, etc.

6 Incorrect service address Voiding one line of the claimResubmit Previously Denied Charge Member eligibility was updated Authorization was updatedVoid Entire claim claim was entered for incorrect member Entire claim was incorrect and a new claim is needed or requestedChange/Reprocess Claim40 Disclaimer41 Type of Adjustment42 Select Service Address43 Member Search44 Coordination of Benefits45 Service Line Entry46 Attaching an EOB47 Summary Page48 EAP Case Activity Form Submission49 EAP Case Activity Form Submission50 Authorization Search51 Enter EAP CAF5253 Select a Billing Type Complete all case opening questions for both interim and final billing type If Final was selected for billing type, complete all case closing questionsOnline CAF Key PointsSummary Page54 Viewing Provider Summary Vouchers55 Provider Summary Vouchers56 Search by Provider57 Search by Check58 Provider Summary Voucher Results59 PaySpan Health : Electronic Funds Transfer (EFT)60A tool that enables you to.

7 Receive payments automatically Receive email notifications immediately upon payment View your remittance advice online Download an 835 file to use for auto-posting purposesPayment Stub Example61 Giving Value Back to the Provider 2015 PaySpanRegistration62 To register online for Electronic Funds Transfer (EFT), either Click the PaySpanlink in ProviderConnect , or Visit the PaySpanHealth website directly at call Have registration code and PIN from the payment stub of a paper check handy Until successful registration with PaySpanis complete, physical checks will continue be generated Unable to locate your registration code?Email: will be received within three (3) business daysAdditional Training Options6364 On choose Providers Click on Helpful Resources under ProviderConnect on the rightHelpful Resources65 Scheduled monthly Topics include: High level overview, authorizations, enhancements, etc.

8 Registration available by clicking Education Center from the provider homepage Upcoming webinars schedule: Authorizations on ProviderConnect Tuesday, 12/13/16 from 11 :30 ETTraining Webinars66 Scheduled at your convenience Available to just one employee or your entire office Training topics are customized based on your needs, timeframes, Training67 Short Video Tutorials: Viewing Member s Eligibility Viewing and Submitting Authorizations Direct claim Submission Process Batch claim Submission Process Re-credentialingHow-To Video Tutorials68 Contact InformationBeacon Health StrategiesBeacon Health Options (formerly ValueOptions)Website and Data Helpdesk Monday through Friday,8 -6 ETPhone: 888-247-9311 RelationsProvider Service Line Monday through Friday, 8 8 ETPhone: 800-397-1630 Regional Provider Relations Team69 Thank You