A Day In The Life Of VP Claims Operations - An Availity eGuide
For AMA Review - Setting Up Your Account and Getting Started · © 2021 Availity, LLC. All rights...
Transcript of For AMA Review - Setting Up Your Account and Getting Started · © 2021 Availity, LLC. All rights...
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Setting Up Your Account and Getting Started with AvailityFor Aetna Better Health and Mercy Care providers
Setting Up Your Account and Getting Started with AvailityFor Aetna Better Health and Mercy Care providers
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What we’ll cover
Availity IntroductionFinding Help and TrainingAvaility Customer SupportPayer Apps and ResourcesPayer Space
Account Setup – For AdminsAdd and maintain usersExpress Entry setupProvider Data ManagementReporting
Want more training?Availity offers free on-demand and live training in the Availity Learning Center (ALC). Log in and select Help & Training > Get Trained to search the ALC catalog.For trainings applicable to Aetna Better Health and Mercy Care just us keyword search “ABHMC” in the ALC.
© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.2
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Important Notes About Using Availity
When you use Availity Portal, results and data come from payer systems. Information can vary by payer, plan, product, member, your organization, user account permissions, etc.
© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.3
Information and images were current at the time this presentation was developed. Screen images and demonstrations are from a demo environment containing pre-loaded generic, de-identified information. Information might also be redacted or blurred.
It is a violation of HIPAA regulations to share credentials to a system that contains PII/ PHI. Do not share an Availity user ID with others. Your organization’s Availity administrator sets up user IDs and assigns roles.
YOU SHOULD KNOW…Availity supports Google Chrome, Firefox ®, Microsoft Edge v79, and
Internet Explorer 11® .
Be sure to allow pop-ups from:
www.apps.availity.com,www.availity.com, or
any third-party websites accessed from the Availity Portal, such as a payer's website.
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Availity Portal
Secure
Compliant
Multi-payer
Availity Portal offers secure online access to multiple health plans, and the ability to manage business transactions through a single, easy-to-use website. Registering for the Portal also gives you options to set up EDI Gateway, batch, and FTP services (or transactions).
© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.4
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Sample List of Availity Services and Tools
© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.5
+ Eligibility and benefits inquiry+ Patient cost estimator
+ Claim status + Claim reconsideration+ Add attachments
+ Authorization requests and inquiry+ Provider data management+ Payer spaces
+ Contact Us – Messaging+ Claim submission+ And more…
GET TRAINEDIn Availity Portal, click Help & Training > Get Trained to open the Availity Learning Center (ALC) in a new browser tab. Filter the ALC catalog by category to explore your options.
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Eligibility & Benefits Inquiry © 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.6
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Claims & Payments menu© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.7
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Authorizations and follow-up options© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.8
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Authorizations & Referrals landing page© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.9
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.
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Tip:
Select Help & Training > Find Help to access help topics.
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Availity Help
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Tip:
Some topic ideas for new users• Administrator (for admins)• Getting Started• Glossary• Payer Tools• Troubleshooting
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Crosswalk in Availity Help
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1. Select Help & Training > Find Help.
2. Select Payer Tools.
3. Select the payer’s name: Aetna Medicaid.
4. Select the topic to review the crosswalk.
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.15
Tip:
Select Help & Training > Get Trained to access free Availity Portal training demos and webinars.
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.16
Tip: For training options applicable to Aetna Better Health and Mercy Care, search by keyword, “ABHMC”.
ALC Catalog
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ALC Catalog, continued© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.17
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.18
Tip:
Select the View Course link to go to the course and enroll.
ALC Sessions tab
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Menu options© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.19
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.22
Sort SearchSwitch to list view Filter
ALC Forum, All Posts
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Availity Client Services Call 1.800.AVAILITY (282.4548)
Monday-Friday 8:00 a.m. to 8:00 p.m. Eastern time
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.25
Need to submit a support ticket?
You can open a new ticket on your My Account page or under Help & Training.
Need To Open A Support Ticket?
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Aetna Better Health and Mercy Care’s Payer Space
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Tip for Arizona providers:
Select Mercy Care as the payer in your payer list.
Payer Spaces
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.28
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29
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.31
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Frequently asked questions
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QCan I add payers to the payer drop down list?
ANo. All payers that are available for each app in your region will already be listed in the drop down.
QHow do I get access to additional tools or apps?
AContact an Availity user administrator for your organization. They can grant you access by editing your user roles.
QHow can I find the name(s) of our organization’s Availity user administrator(s)?
AIn Availity Portal, select your name in the top-right and then My Administrators.
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For Availity and Aetna Better Health / Mercy Care
© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.33
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On-demand resources and trainingSelect Help & Training > Get Trained to open the Availity Learning Center (ALC).
ALC
ALC CatalogTraining demos
Availity Portal Onboarding – Training Program
My Account Dashboard - Online Course Payer Spaces Overview - Training Demo
ForumSuggested posts
Quick Tips for Getting Started with Availity Portal
Setting Up Your Web Browser for Availity Portal Success
Availity Keyword Search Helps to Save My Brain Cells
© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.34
For training options applicable to Aetna Better Health and Mercy Care, use keyword search “ABHMC” in the ALC.
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Tips for Availity Administrators
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First Steps for the Administrator
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Add User (Single or Bulk Upload)
My Account Dashboard > Add User
User and Transaction Reporting
Reporting
Set up for provider express entry
My Providers > Express Entry
Manage User Access (Change/Revoke)
My Account Dashboard > Maintain User
Manage Organization Information
My Account Dashboard > Manage My Organization
Additional enrollments
My Providers > Enrollments Center > Additional Enrollments
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.37 Admin tasks on My Account Dashboard
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.38 Adding users
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.39 Roles and Permissions
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.40 Administrator Roles
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.41 Review and Submit new user
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.42 Admin tasks on My Account Dashboard
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.43 Maintain Users
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.44 Maintain Users
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.45 Set up provider in Express Entry
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.46 Manage Express Entry
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Tip:
Select Edit to make necessary changes.
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.48 Access to PDM
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.49 Business Profiles
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Demo link
Manage Business
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.51 Manage Practitioners
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.52
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.53 Accessing Reporting
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© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.55 Administrator Help
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On-demand resources and trainingSelect Help & Training > Get Trained to open the Availity Learning Center (ALC).
ALC
ALC CatalogTraining demos
Availity Portal Administrator Onboarding –Training Program
Register a New Organization from within Availity Portal - Training Demo
Using Availity Support Tools for Self-Service - Training Demo
ForumSuggested posts
Express Entry: What is it and How Does it Help Me?
Quick Access to the New User Guide What are Availity Roles and Why Do They
Matter? Find Out More in This Post!
© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.56
For training options applicable to Aetna Better Health and Mercy Care, use keyword search “ABHMC” in the ALC.
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For Availity and Aetna Better Health / Mercy Care
© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.57
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For Availity customer support, contact 1.800.282.4548, or select Help & Training > My Support Tickets. For more training, select Help & Training > Get Trained. The Availity Learning Center (ALC) opens in a new browser tab.
© 2021 Availity, LLC. All rights reserved. Confidential and proprietary—do not distribute.58