MI Health Plan Benefits: Users and Applications Application User Guide

Transcription

1 MI Health Plan Benefits: Users and Applications Application User Guide August 28, 2017 MI Health Plan Benefits User Guide Page 1 of 17

2 Table of Contents 1 MI Health Plan Benefits Overview Accessing MI Health Plan Benefits Logging In Forgotten Username Forgotten Password Applying for Access to MI Health Plan Benefits Filling Out the Application Application Approval/Denial Setting Up Your Account User Profile User Profile Pages Change Password Organization Management Creating a New User/Editing an Existing User Editing Your Organization Confirming Users...16 August 28, 2017 MI Health Plan Benefits User Guide Page 2 of 17

3 1 MI Health Plan Benefits Overview MI Health Plan Benefits is a web application built by and hosted by Michigan Public Health Institute (MPHI) that allows registered providers to query for Medicaid eligibility. Providers can have a combination of any of the following roles: User Allows the user to perform Individual and Multiple Eligibility lookups. Batch EDI Allows the user to submit a batch file and retrieve batch results. ISD Allows the user to submit a batch file to determine the eligibility of students in their school. Organization Administrator Role for an organization s Domain Administrator. Users with the Organization Administrator role manage the organization s list of users. MPHI Reviewer Allows users to perform the MPHI Review step of the application review process. Application Reviewer Allows users to perform the final review and approval of applications for access. Administrator Users who are able to perform administrative functions, such as assisting with organization management or resetting passwords for users. 2 Accessing MI Health Plan Benefits The MI Health Plan Benefits application can be accessed at Logging In You can log into the MI Health Plan Benefits application from the Login page. Enter a valid Username and Password combination and select the Log In button to log in to the application. When you successfully log in to the application, you will be taken to the Home page. If your attempts to log in fail 3 or more times, your account will be temporarily locked. After 10 minutes, your account will be unlocked and you may make another attempt to log in. August 28, 2017 MI Health Plan Benefits User Guide Page 3 of 17

4 2.2 Forgotten Username If you have forgotten your MI Health Plan Benefits account username, you can recover it by following the steps below. Step 1: Select the Forgot your username? button on the Login page. Step 2: Enter the address associated with your MI Health Plan Benefits account and select the Send button. Step 3: MI Health Plan Benefits will send an to the provided address. The will contain a list of all of the usernames associated to the provided address in MI Health Plan Benefits. 2.3 Forgotten Password If you have forgotten your MI Health Plan Benefits account password, you can reset it by following the steps below. Step 1: Select the Forgot your password? button on the Login page. August 28, 2017 MI Health Plan Benefits User Guide Page 4 of 17

5 Step 2: Enter the username associated with your MI Health Plan Benefits account. Step 3: An will be sent to the address associated with the entered username. Follow the link provided in the address to navigate to the Reset Password page. Step 4: Enter the username for your account along with your new password in the Password and Confirm Password fields. Then select the Reset button to save the new password. 3 Applying for Access to MI Health Plan Benefits To use the MI Health Plan Benefits application, an organization must first submit an application for access. To do so, select the Apply for Access button on the Login page then fill out and submit the application. August 28, 2017 MI Health Plan Benefits User Guide Page 5 of 17

6 3.1 Filling Out the Application There are 5 main sections to the Application: 1. Terms and Conditions 2. Organization Details 3. Domain Administrators 4. X12 (270/271) and Batch Processing 5. Application Submission Terms and Conditions Before you can fill out the MI Health Plan Benefits application, you must first agree to the terms and conditions shown on the Terms and Conditions page. Check the I agree to the terms and conditions checkbox and select the Continue button to agree to the terms and conditions. Please Note: The terms and conditions for use of the Real-Time and Batch Transactions are different than the terms and conditions for use of the X12 270/271 Real-time and Batch Transactions. Both sets of terms and conditions are included on the Terms and Conditions page Organization Details The following fields are required in the Organization Details section of the application: August 28, 2017 MI Health Plan Benefits User Guide Page 6 of 17

7 Organization Name The name of your organization. This value need to match the name of the organization recorded in CHAMPS. Organization Type The organization s type. Possible values include: o ABW County Health Plan o Community Mental Health o DHS County Office o Long-Term Care Provider o Medicaid Health Plan o Out-of-State Provider o Pharmacy o School-Based Healthcare o WIC o Other Federal Tax ID The organization s federal tax ID The National Provider Identifier (NPI) The organization s NPI. Only required if a CHAMPS ID is not provided. CHAMPS ID The organization s CHAMPS ID. Only required if a NPI is not provided Domain Administrators To submit the application, you will be required to provide information for two Domain Administrators. Domain Administrators are responsible for maintaining the organization s user accounts and for ensuring that HIPAA privacy regulations are enforced. At least one of the Domain Administrators must be set as the organization s Domain Administrator in CHAMPS for the application to be approved. The following fields are required for both Domain Administrators: First Name The Domain Administrator s first name. Last Name The Domain Administrator s last name. Job Title The Domain Administrator s job title. Address The Domain Administrator s address. Upon application approval, the Domain Administrator s account setup s will be sent to this address. Phone Number The Domain Administrator s phone number. If needed, a phone number extension can be entered in the Extension field. August 28, 2017 MI Health Plan Benefits User Guide Page 7 of 17

8 3.1.4 X12 (270/271) and Batch Processing In the X12 (270/271) and Batch Processing section of the application for access, you must indicate whether your organization will need access to MPHI s X12 (270/271) system. The X12 (270/271) system allows providers and clearinghouses own applications to interface with the MI Health Plan Benefits application to make eligibility requests. To makes use of the X12 (270/271) functionality, your organization will need to create or obtain a software product capable of making X12 (270/271) requests. To request access to MPHI s X12 (270/271) system, select Yes in response to the Will your organization need access to MPHI s X12 (270/271) system? question. You will be required to provide the Public IP Addresses that will be making the X12 (270/271) requests. August 28, 2017 MI Health Plan Benefits User Guide Page 8 of 17

9 If you have indicated that your organization will need access to MPHI s X12 (270/271) system, you will also need to indicate whether your organization needs to submit inquiries on behalf of other providers. When the Yes response is selected, you will be required to enter the following information for each of your organization s clients: The client s Name/Organization The client s Federal Tax ID The client s National Provider ID (NPI) or the client s CHAMPS ID Submitting the Application The last field on the application for access is the Additional Comments field. Here you can provide other information that you believe will assist with the application review and approval. Once you have finished filling in all of the required fields, select the Submit button to submit your application for review. Upon submission, both Domain Administrators and the review team will be informed of the application. August 28, 2017 MI Health Plan Benefits User Guide Page 9 of 17

10 3.2 Application Approval/Denial Your organization s application for access to the MI Health Plan Benefits site will be reviewed within 10 days of your submission Application Approval When your application has been approved, both Domain Administrators will be sent 3 s: An that informs the Domain Administrator of the application s approval. This may also contain attached instructions for how to associate MPHI as a billing agent in CHAMPS. The two account setup s (see 4 Setting Up Your Account) Application Denial When your application has been denied, both Domain Administrators will be sent an informing them of the denial. This will contain the reason for the denial. 4 Setting Up Your Account When your account is initially created, you will receive two s from MI Health Plan Benefits. The first will contain your new username, which is generated using your first name and last name. The second will contain a link to the Setup Account page. To complete your account setup, select the Confirm button on the Setup Account page after you agree to the terms and conditions, enter the username you were provided via , and enter your desired password in the Password and Confirm Password fields. August 28, 2017 MI Health Plan Benefits User Guide Page 10 of 17

11 5 User Profile 5.1 User Profile Pages You can update your account details on the User Profile page. To access the User Profile page, select the Update User Profile link on the Home page. Once on the User Profile page, you can view or update the following information about your account. A red asterisk (*) indicates a required field. * First Name Your first name. * Last Name Your last name. Username Your account username. This field is read-only. * Job Title Your job title. * Address Your address. MI Health Plan Benefits related s, such as password reset, will be sent to this address. * Phone Number Your phone number. Extension Your phone number extension. * Current Identifier Your currently selected provider ID. This can be either a National Provider ID or a CHAMPS ID. You can only select provider IDs that you have been given access to by your Domain Administrator. August 28, 2017 MI Health Plan Benefits User Guide Page 11 of 17

12 5.2 Change Password You can change your account password on the Change Password page. To access the Change Password page, select the Change Password link on the Home page. Once on the page, enter your current password in the Current Password field and enter your new password in the New Password and Confirm New Password fields. Select the Change Password button to save your new password. August 28, 2017 MI Health Plan Benefits User Guide Page 12 of 17

13 6 Organization Management Domain Administrators are able to view and manage the details and users for their organization on the Manage Organization page. To access the Manage Organization page, select the Manage Organization link on the Home page. 6.1 Creating a New User/Editing an Existing User As a Domain Administrator, you can create new users for your organization from the Organization Management page. To create a new user, follow the steps listed below. Step 1: Select the Create User button on the Manage Organizations page or select the user s username from the list of existing users. Step 2: Fill in the following for the new user. A red asterisk (*) indicates a required field: * First Name The new user s first name. * Last Name The new user s last name. * Job Title The new user s job title. * Address The new user s address. Account creation s will be sent to this address. * Phone Number The new user s phone number. Extension The new user s phone number extension. August 28, 2017 MI Health Plan Benefits User Guide Page 13 of 17

14 Step 3: Select which provider IDs the new user will have access to in the Has Access column and which will initially be set as their current ID in the Current column. A user s current provider ID will be used for Eligibility Lookups. Step 4: Select the Create button to create the new user account or the Save button to save changes to an existing account. Once the account has been successfully created, s will be sent to the new user s address with the user s new username (which is automatically generated using the user s first and last name) and instructions for setting a password. When editing an existing user, there are a few additional actions you can perform. If the selected user needs to be resent their account creation s, you can select the Resend Confirmation button. Once the user s account is set up, you can send password reset s to the user by selecting the Reset Password button. You can also deactivate the user by selecting the Deactivate User button. Finally, users with the Administrator role can impersonate the selected user by selecting the Impersonate User button. This allows the Administrator to assist users with issues by providing them with the ability to see MI Health Plan Benefits from the perspective of the impersonated user. August 28, 2017 MI Health Plan Benefits User Guide Page 14 of 17

15 6.2 Editing Your Organization Domain Administrators can make changes to their organization s details on the Edit Organization page. To access the Edit Organization page, select the Edit link at the top of the Manage Organization page. The Edit Organization page allows Domain Administrators to make select changes to their organization s details. One or more of the following organization details may be updated: Organization Name Change the prefilled value in the Organization Name field to update the name of your organization. Federal Tax ID Change the prefilled value in the Federal Tax ID field to update the tax ID of your organization. Organization Type Choose a different value from the Organization Type list to change your organization s type. National Provider ID Entering a value in the New National Provider ID field will add a new National Provider ID (NPI) to your organization. This is in addition to your organization s existing list of Provider IDs. CHAMPS ID Entering a value in the CHAMPS ID field will add a new CHAMPS ID to your organization. This is in addition to your organization s existing list of Provider IDs. Primary Domain Administrator Choose a different user from your organization to be the Primary Domain Administrator for your organization. If the person you would like to make the new Primary Domain Administrator is not shown in the list, please add them as a user for your organization on the Manage Organization page first. Secondary Domain Administrator Choose a different user from your organization to be the Secondary Domain Administrator for your organization. If the person you would like to make the new Secondary Domain Administrator is not shown in the list, please add them as a user for your organization on the Manage Organization page first. August 28, 2017 MI Health Plan Benefits User Guide Page 15 of 17

16 6.3 Confirming Users MI Health Plan Benefits requires each organization to confirm that the users in their organization still have a valid business need to use the site every 6 months. To remind them of this August 28, 2017 MI Health Plan Benefits User Guide Page 16 of 17

17 requirement, an organization s Domain Administrators will be sent s 60 days, 30 days, 10 days, and each of the last 5 days before the 6 month deadline. Steps for confirming users: Step 1: Navigate to the Manage Organization page by selecting the Manage Organization link on the Home page. Step 2: Review your organization s list of users and deactivate any accounts that are no longer needed by selecting the Deactivate link at the far right of their account record. Step 3: Select the Confirm Users button to indicate that you have reviewed the user accounts for your organization and confirm that all active accounts still have a valid business need to access the MI Health Plan Benefits application. If a Domain Administrator does not confirm their users need for access by the deadline, the organization will be temporarily deactivated. When deactivated, the Domain Administrator will have an option near the top of the Manage Organization page to reactivate the organization. Doing so will restore access to the organization s user accounts and allow one more day to confirm the organization s users. August 28, 2017 MI Health Plan Benefits User Guide Page 17 of 17