Physician Online Data System - MedNetOnePhysician Online Data System Medical Network One, PC 4986...
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Physician Online Data System Medical Network One, PC 4986 Adams Rd., Suite D Rochester, MI 48306
Transcript of Physician Online Data System - MedNetOnePhysician Online Data System Medical Network One, PC 4986...
Physician Online Data System
MedicalNetworkOne,PC4986AdamsRd.,SuiteD
Rochester,MI48306
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PhysicianOnlineDataSystem(PODS)
RegisterforPODS...........................................................................................4Usernameandpassword..........................................................................7Login....................................................................................................................8MemberSearch...............................................................................................9AuthorizationSearch.................................................................................10ReferralRequest..........................................................................................11AuthorizationRequest..............................................................................14AuthorizationTips......................................................................................16Referral/AuthorizationStatus..............................................................17Misc.Information........................................................................................18SupportIcons................................................................................................19
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OVERVIEW
• PODSisanonlinereferralsystemforBlueCareNetworkreferralsandpre-certification
• PODSisaquickandeasywayofissuingreferralsandrequestingauthorizations
• RefertoMNOGuidelinesforproceduresrequiringreferralsandpre-certification
• AllPCPofficesthatareinMedicalNetworkOnearerequiredtousePODS
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REGISTERFORPODS
• PCPandspecialistofficestaffcanregisterforPODS
• AccessapplicationatWWW.MedNetOne.Net
• GotoQuickLinks,PODSlogin
• UnderLoginbox,clickon“Requestanaccount…”
RequestanAccount…
• Enterpracticeinformation
EnterPracticeInformation…
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• Entertheuser’sinformation
EnterUserInformation…
• Indicatetheeligiblephysicians
EntertheEligiblePhysicians…
• FilloutOfficeManagersectionPleaseNote:Uponcompletion,theofficemanagerwillbecontactedtoverifyyourrequest.
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EntertheOfficeManagersection…
• AcceptTermsOfAgreement
AcceptTermsofAgreement…
• SubmitforprocessingandapprovalPleaseNote:Youandyourofficemanagerwillbecontactedviatheprovidedemailaddresses.Pleasebeaccurate.
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USERNAMEANDPASSWORD
• Passwordandloginnamewillbegiventoapplicantafterapplicationisprocessed
• EachpersonrequiringaccesstoPODSisrequiredtosubmitanapplication.
• Passwordsarenottobesharedbyofficestaff
• Passwordsaretobechangedonamonthlybasisforsecuritypurposes
• Thereisnolimitonthenumberofusersperoffice
• NotifyMNOwhenuserterminatesemploymentsothataccesscanbedisabled.
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LOGIN
• Gotowww.mednetone.net
• SelectPODSloginunderquicklinks
• Enterusernameandpassword
• AccepttheTermsofService
AcceptTermsofServicetoLogin
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MEMBERSEARCH
• YoucanperformMembersearchesonanysearchcriteria.PleaseNotice:Besuretoselect“IncludeInactivePlans”ifyouarelookingforolderinformation.
PerformingaMembersearch
• Referrals,Authorizations,BenefitPlansandadditionalDemographics,aswellasmember,physicianandfacilityinformationcanallbeviewedinthemembersearchresults,withadefaultviewofBenefitPlans.
MemberSearchResults
• ClickthePlusiconattherighttoview/hidedemographicinformation,orthePlansorAuthorizationslinkstoviewthosetabs.
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AUTHORIZATIONSEARCH
• YoucanperformAuthorizationsearchesonanycriteria.PleaseNotice:Besuretoselect“IncludeInactivePlans”ifyouarelookingforolderinformation.
• Referrals,Authorizations,BenefitPlansandadditionalDemographics,aswellasmember,physicianandfacilityinformationcanallbeviewedinthemembersearchresults,withadefaultviewofAuthorizations.
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REFERRALREQUEST
• ClickthelinkforRequestReferral…
• Ifthereismorethan(1)activebenefitplan,selectthePlanyouwouldliketouseforthisrequest
• Locateaspecialistorproviderbyusingthein-linesearchunderRequestedProvider.PleaseNote:Referralsmustbeissuedtoaprovider
• FillorselecttheremainingfieldDonotchangethetypeofservice
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• Fieldsthatdonotrequireinterventionwillpre-populateautomatically.
• Requestedvisitsdefaultsto99toindicateglobalreferral
• Referralstartdatedefaultstotoday'sdateandcanbechangedtoafuturedate(issuereferralsforaminimumof90days).
• Referralenddatedefaultsto90daysfromstartdateandcanbechangedtofuturedate.
• EnteroneormoreDiagnoses…
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• Submitwhencomplete
• CheckbackbyperforminganAuthorizationSearch
• YoucanprinttheauthorizationwhenithasastatusofAPPROVED.
• DonotprintifthestatusisPCP-APPROVED,asitisnotyetcomplete.
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AUTHORIZATIONREQUEST
• ClickthelinkforRequestAuthorization…
• Locateaspecialistorproviderbyusingthein-linesearchunderRequestedProvider.PleaseNote:Referralsmustbeissuedtoaprovider
• Searchforadesiredfacility
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• SelectappropriateTypeofServiceandPlaceofService
• IndicatespecificrequestedVisits(NOTICE:SurgicalProceduresare“1”)
• EnterStartDateandEndDate(NOTICE:SurgicalProcedures,orSleepStudiesshouldnotbespannedformorethanoneday)
• EnteroneormoreDiagnoses…
• EnteroneormoreProcedures…
• Submittheformwhenitiscomplete.
• Toexpediteprocessclinicalinformationcanbetypedunderauthorizationdescription
• Authorizationrequestsarependedformedicalnecessityandbenefits
• CheckforstatusofAPPROVEDfromtheAuthorizationSearch
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AUTHORIZATIONTIPS
• Physicaltherapy-selectfromthefacilityboxifdoneinafreestandingcenterorhospital
• Physicaltherapy-selectoutpatientplaceofserviceifdoneinfreestandingcenterorhospitalsetting
• Physicaltherapy-selectproviderfromproviderboxifdoneinaprovidersoffice
• Physicaltherapy-selectplaceofservicedoctorsofficeifdoneinprovidersoffice
• Physicaltherapy-weonlyprocessesthemfor2visits,toincludeanevaluationandthefirstvisit.TheactualtherapywillbesubmittedtoLandmark.
• SleepStudies-Theserequireauthorization.Pleasesubmitwiththeactualdateofservice.
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REFERRAL/AUTHORIZATIONSTATUS
• PCP-Approved:PCPofficehassubmittedandapprovedareferralforprocessing.
• MNO-A:Therequesthasbeenreviewedbyournursesandmeetscriteria;itisnowwaitingtobesubmittedtoBCN.
• Pending:Thisisarequestthathasbeensubmitted,butnotyetreviewed.
• MoreInformation:ThisindicateswecannotbegintoprocessthereferraluntilmoreinformationfromPCPofficeisgiven.
• AwaitingInformation:ThisisforaPre-Certificationthatthenurseshavereviewedandhaverequestedmoreclinicalinformationand/orBCNforms.
• PendingBCNReview:ThisindicatesthatwehavesubmittedthistoBCNandarewaitingforthemtoreviewit.Itmaytakeaweekormoretoobtainadecision.
• NewCase:Wehavereceivedthiscaseanditisawaitingthenursestoreviewit.
• FileClosed:Thiswillnotbeprocessed;referralisunnecessaryornotappropriate.
• Approved:Approved
• Denied:ThishasbeenreviewedbyBCNandtheyhavedeniedit.Youmayappealthecaseifsodesired.
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MISC.INFORMATION
• Ifunabletofindamember,contactMNOafterverifyingeligibilityonDENIS
• IfunabletosearchproviderorfacilitycontactMNOafterverifyingcontractonMIBCN.COM
• RememberALLreferralsareGLOBAL.Youcannotissuethemfor1day.Theyaregoodforaminimumof90days,andamaximumof1year.
• PleaserefertotheBCNGuidelinestomakesureyouarerequestingAuthorizationswhennecessary.Thesecanchangeonaquarterlybasis,pleasekeepyourselfupdated.
• Donotsendelectronicprotectedhealthinformationbylinksoremail
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SUPPORTICONS
• Home:BringsyoutoPODShomepage
• Alerts:Thiswilltakeyoutothelistofallactivealertmessages
• HelpisalinktothisTrainingManual
• E-Mail:toinquireaboutPODSissuesNOTICE:DONOTSENDPATIENTINFORMATION.THISISNOTSECURE.
• Logout:logsyououtofPODS
• YourName:Thiswilltakeyoutoyourprofilepagewhereyoucanchangeyourpassword
• Timer:Thesystemwillautomaticallylogyououtifyouarenotactivefor15minutes.Thetimerwillreseteachtimeanewpageisloaded.Youcanalsomanuallyclickthetimertoresetit.
