October 2012 IHCP Annual Workshop Hoosier Healthwise - MDwise
Anthem Blue Cross and Blue Shield Serving Hoosier Healthwise, … · 2017. 10. 13. · Anthem Blue...
Transcript of Anthem Blue Cross and Blue Shield Serving Hoosier Healthwise, … · 2017. 10. 13. · Anthem Blue...
Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana
Plan and Hoosier Care Connect
The Availity multi payer Web Portal
presented by Anthem and Availity
2017 Annual Workshop
Anthem Blue Cross and Blue Shield (Anthem)
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
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
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
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/
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
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.
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
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.
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
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.
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
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.
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
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.
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Provider screen
To start the process of creating a service estimate, input the servicing
provider information. When done, select the Services button.
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and Hoosier Care Connect
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.
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
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.
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Availity navigation bar
Your
favorite
tools.
My Top Applications
are the ones you use
most frequently.
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Availity navigation bar (cont.)
Select the heart
symbol to choose
as one of your
favorite tools.
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Availity navigation bar (cont.)
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Availity navigation bar (cont.)
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Administrator dashboard
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Administrator dashboard (cont.)
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Payer spaces
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Payer spaces (cont.)
Toggle between
Applications
and Resources
to see all
available tools.
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Payer spaces (cont.)
With Resources,
you have
Anthem-specific
resources such
as companion
guides and links.
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and Hoosier Care Connect
Anthem portal/crossover
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
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.
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
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.
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Operational updates (cont.)
Member Panel Listing: Description will be added to home
and program pages.
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Operational updates (cont.)
Report Search
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Operational updates (cont.)
If you have any
questions about the
program, all inquiries
can be directed
through our Contact
Us page.
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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
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Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Availity Web Portal support
Anthem providers can:
• Update with additional information
• Change main contact person for ACS
to reply
• Ask for multiple email 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).
Availity client services
1-800-282-4548• Up to 24-hour response time
• Worked internally by our ACS team
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Anthem Blue Cross and Blue Shield
Serving Hoosier Healthwise, Healthy Indiana Plan
and Hoosier Care Connect
Thank you
www.anthem.com/inmedicaiddoc
Anthem Blue Cross and Blue Shield 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-1484-17 September 2017
Thank you for your partnership and serving our Hoosier Healthwise,
HIP and Hoosier Care Connect members.