Online Tools Administration electronic access to Blue Cross services

Transcription

1 Online Tools Administration electronic access to Blue Cross services A Provider E-services Webinar July 14, 2015 Presented by Anna Granen and Marie Davis, Provider Relations Department, BCBSLA 1 Blue Cross and Blue Shield of Louisiana incorporated as Louisiana Health Service & Indemnity Company welcome! Blue Cross now offers our network facilities the option to request authorizations electronically through ilinkblue ( As part of this access, Blue Cross requires organizations to designate an administrative representative to manage and delegate access for this electronic option This webinar is for persons who have been either designated as an administrative representative or who must designate an administrative representative for their organization This webinar is to help you learn more about the role of being an administrative representative 2 For 2016, we are expanding our electronic options to include: behavioral health services Medicare Advantage services 1

2 the ADMINISTRATIVE REPRESENTATIVE is A person designated by their employer to serve as the organization s key person for delegating access to appropriate users within the organization A person who is responsible for ensuring that the appropriate users within the organization adhere to BCBSLA s guidelines A person who will only grant access to those employees who legitimately must have access in order to fulfill their job responsibilities as well as promptly terminate employee access at such time as an employee changes roles or terminates employment with the organization 3 the ADMINISTRATIVE REPRESENTATIVE is A person who will notify BCBSLA immediately of any breach of confidentiality as this person is obligated to maintain complete secrecy over his/her Login ID and Password. Under no conditions can it be revealed to anyone or allow anyone else use of the system under the Login ID. A person who will notify BCBSLA immediately of any fraud, suspected fraud or abuse, or privacy or confidentiality concerns in addition to notifying his/her organization 4 2

3 today Providers can access ilinkblue for: Eligibility Benefits Claim Status Medical Policies Manuals Authorizations Inpatient Outpatient Imaging And more 5 Blue Cross requires providers to designate one (or more) administrative representative to manage the delegation of access to our authorization portal. coming soon Beginning January 1, 2016, our ilinkblue Provider Suite will include online applications that require a separate sign-in process for: Behavioral health services behavioral health providers must access and manage authorizations and more through ilinkblue Medicare Advantage services Providers in our Blue Advantage network (our Medicare Advantage network) must access and manage eligibility, benefits, claims and more through ilinkblue. Having a designated administrative representative now enables your organization the ability to delegate online responsibilities for these services once they are available. 6 If a person delegated for authorizations is also delegated for the behavioral health and/or Blue Advantage applications, they will use the same sign-in information for all. 3

4 administrative representative SETUP Each person designated as an administrative representative must complete the Administrative Representative Acknowledgment form and to Blue Cross Provider Relations department. 7 If you still have not completed this form, please to receive a copy. administrative representative SETUP In addition to completing the Administrative Representative Acknowledgment Form, your organization must also submit a spreadsheet with your designated administrative representative s key information. Blue Cross will provide a standard template of this spreadsheet to your organization for use. Sample Spreadsheet: BCBSLA Administrative Representative (AR) Set Up Request Administrative SPECIALITY ilinkblue 5- Representative Enter the Specialty for digit ID (AR) Name the Facility Name Enter the 5 Enter the First and (Example Acute Care digit number Needs Auth Last name of the AR Address Rehab, Skilled Nursing assigned to Portal Access? person selected as Enter the work address AR Phone # AR Date of Facility) Behavioral this speciality Enter Yes or No the AR. Must for the AR. addresses Enter the phone Birth Enter the FACILITY NAME Health (Psy) and as found on to indicate if this enter name for cannot exceed 100 positions. number and ext AR's offical date Enter the Facility Name as Chemical Dependency your BCBSLA AR will need each different ilb 5 AR Title (Enter the Job title of the Refer to Security Set Up Guide (if applicable) for of birth it appear on your BCBSLA (CDU) CANNOT BE payment access into the digit ID) AR) for more informaiton. the AR. (MMDDYY) Payment Register CITY SUBMITTED. Register. NPI AP in ilinkblue ROUGE Jane Doe Manager Business Services jane.doe@general.org 9/25/1962 GENERAL CENTER Acute Care Y ROUGE Acute Care N Matt Dough Supervisor Authorizations Mat.dough@general.org 12/15/1979 GENERAL CENTER ROUGE Acute Care N Real Dough Utilization Review Real.Dough@general.org 3/16/1984 GENERAL CENTER ROUGE SNF Y Jane Doe Manager Business Services Jane.Doe@general.org 9/25/1962 GENERAL CENTER ROUGE REHAB Y Jane Doe Manager Business Services Jane.doe@brgeneral.org 9/25/1962 GENERAL CENTER Comments Blue Cross IT security team will then set up the designated administrative representative(s) with access to our Security Setup Tool, which is used to delegate employees at your organization. 8 Each organization can set up more than one administrative representative as needed. (e.g. one per physical location, etc.) 4

5 the security setup PROCESS Once the administrative representative is set up in our security system, a secure will be sent to the address provided. The first step is that the administrative representative must set up a secure account in our security system to receive their secure . Once the secure is obtained, you will need to ACTIVATE your temporary password to access our secure system. If you DECLINE the password, then you will not be able to access our secure system and therefore be unable to set up access to our Security Setup Tool. sample From: notification@secur -bcbsla.com Sent: To: Subject: This is the last step in this one-time process. To DECLINE your new password, click the link below: Your Blue Cross Blue shield of Louisiana Secure password is pending. To ACTIVATE your new password, click the link below: If the link above is disabled, copy and paste it into your Internet browser address bar. 9 your customized Click on the link to the Security Setup Tool: Enter the user name and temporary password provided in the . sample From: information security mailbox Sent: Friday, July 17, :15 AM To: firstname@abchosp.com Subject: Admin Rep-BCBSLA Security Setup Tool The system will prompt you to change this password before you are able to log in. Do not forward this to any other persons. Dear Fname Lname, You have been designated and set up as an Administrative Representative for use of our Security Set-Up Tool. This new tool will allow you to set-up and delegate security access for staff to the Blue Cross and Blue Shield of Louisiana (BCBSLA) Authorization Portal (AP). Access should only be granted to employees that require access in order to perform the authorization processes for your BCBSLA members. You will also be allowed and required to delete access when an employee terminates employment or is no longer required to perform this function. Please use and maintain the attached User s Profile spreadsheet to comply with all AR obligations. 10 Use the Security Set-Up Guide to gain access to the tool 5

6 delegating staff Designated Administrative Representative Imaging Authorizations Inpatient Authorizations Medicare Advantage Coordinator Behavioral Health Coordinator 11 Outpatient Authorizations All delegated staff must have their own ilinkblue user-access and complete Blue Cross training tutorials. delegated staff details Designated Administrative Representative Does each delegated staff member have individual access to ilinkblue? 12 6

7 attestation form The administration representative must complete Blue Cross Acknowledgment of Staff Self-Training Attestation Form and return to Blue Cross. This form is verification that the administrative representative confirmed that all delegated staff have completed our training tutorials. 13 If you still have not completed this form, please to receive a copy. delegated staff documentation The administrative representative should maintain a chart of who in the organization is a delegated staff member. Blue Cross has developed a template spreadsheet for your office use. It should not be returned to Blue Cross. Sample Spreadsheet: BCBSLA Authorization Portal (AP) Users (FOR PROVIDER USE ONLY) User's First Name Enter the first ilb ID# Request ID# name of the User's Address User's Work Phone # Enter the ilb ID# (5 After the successful setup, add, person who will Enter the work address for the Enter the work phone User's Date of Birth positions) assigned to this modifing or terminating provider use the User's Last Name User. Cannot use a shared number and extension Enter the User's Facility/Location Name/Speciality (if applicable) speciality as found on your access, the system assigns Request ID#, Authorization Enter the User's Last User's Job Title address and cannot exceed 100 (if applicable) for the offical date of birth Enter the Facility Name as it appears on your BCBSLA payment Register Record that number here for future Portal name. Enter the User's Job Title. positions. User. (MMDDYY). BCBSLA Payment Register(s) in the ilb ID# field. use on My Requests application. Comments Sun Shine Auth Specialist Sunshine@testhospofbr.org /17/68 TEST HOSPITAL OF ROUGE Acute Care Example Only Cake Walk Auth Specialist cakewalk@testclinicofbr.com /25/86 TEST CLINIC OF ROUGE Example Only Monkey Shine Sr. Auth Rep Monkeyshine@testclinicofbr.com /01/90 TEST CLINIC OF ROUGE Example Only Easy Money Sr. Auth Rep Easymoney@testhospofbr.org /25/79 TEST HOSPITAL OF ROUGE REHAB Example Only Pretty Day Auth Specialist Prettyday@testhospofbr.org /01/77 TEST HOSPITAL OF ROUGE SNF Example Only The purpose of this template spreadsheet is to help the administrative representative to (at all times) maintain an accurate record of delegated staff. 14 7

8 moving forward Insert your organization s administrative representative here Technology is ever changing More and more services are being offered electronically Prepare today for tomorrow s business solutions 15 let s review 1. Read, sign and submit the Administrative Representative Acknowledgement Form to Blue Cross 2. You/Your organization must submit an Administrative Representative (AR) Set Up Request spreadsheet to Blue Cross 3. To obtain your secure password and Security Set-up Guide, you must activate the secure sent to you by Blue Cross 4. Decide who at your organization should be delegated to perform authorization services 5. Ensure that all delegated staff members have completed Blue Cross training tutorials 6. Read, sign and submit the Staff Self-Training Attestation Form to Blue Cross (only one form needed for all current delegates) 7. Use the Authorization Portal (AP) Users spreadsheet to chart who in your organization is a delegated staff member 16 8

9 support Provider support for the Authorization Portal is available during our normal business hours (excludes holidays): Monday Friday 8 am to 4:30 pm CT Phone: BLUE (2583) ilinkblue.providerinfo@bcbsla.com Fax: Mailing: EDI Customer Operations-iLB Address BCBSLA P.O. Box Baton Rouge, LA