User Guide for the Provider Portal

Transcription

1 User Guide for the Provider Portal How to Register for the Portal How to Add and Delete Users to the Portal How to Change Users Passwords How to look up Member Eligibility How to look up Claims & Remittance

2 How to Register for the Provider Portal 1. Go to the HealthyCT website, and click Providers. 2. Select Provider Log-in. 3. To register for the Provider Portal, select Select Here next to Are you a New Healthcare Provider? 4. In the How may we contact you? box, fill out how you would like HCT to contact you. This information is stored in the Provider Portal only. 5. In the Provider Information box, fill out exactly how your information is recorded at HealthyCT. a. If you receive an error message, please make sure all the information is filled in correctly in the Provider Information box. b. If everything looks correct to you and you are still receiving the error message, contact HealthyCT at Enter in the Employee information that you would like to appear in the Portal. 7. Enter in all the Employee login information for the Provider Portal. 8. Once you receive your Approval message, select Done. 9. When you log in for the first time you will have to accept the terms and conditions.

3 How to Register for the Provider Portal 2. Select Provider Login 3. To register for the Provider Portal, select Select Here next to Are you a New Healthcare Provider?

4 How to Register for the Provider Portal 4. In the Provider Information box, fill out exactly how your information is recorded at HealthyCT. 5. In the How may we contact you? box, fill out how you would like HCT to contact you. This information is stored in the Provider Portal only.

5 How to Register for the Provider Portal 5a. If you receive an error message, please make sure all the information is filled in correctly in the Provider Information box. 5b. If everything looks correct to you and you are still receiving the error message, contact HealthyCT at

6 How to Register for the Provider Portal 6. Enter in the Employee information that you would like to appear in the Portal. 7. Enter in all the Employee login information for the Provider Portal. 8. Once you receive your Approval message, select Done. 9. When you log in for the first time you will have to accept the terms and conditions.

7 How to Add and Delete Users to the Provider Portal Add User 1. From the left hand side menu, select Administration and then select User List from the drop down. 2. If you do not see the user you want to add in the list, select Add user on the right hand side. 3. Select Provider Employee in the User List screen, and select Next. 4. In the Provider Employee screen, if you do not see the person you would like to add, select Add Employee. 5. In the Add Provider Employee screen, record the person s information and select Submit. 6. You are now brought back to the Provider Employee List screen. Choose the link Select next to the person's name that you would like create a user account for. 7. In the Add User screen, add in all the required information. This will be the information that the person will use to log into the portal. Then select Submit. Delete User 1. Select User List from the left side menu. 2. Select Delete next to the user you would like to delete from access the Provider Portal. 3. Review the user you would like to delete. Select the Delete button at the bottom of the screen

8 Provider Roles Provider Admin - Default Provider User View Member Eligibility Add Users to the Account View Member Eligibility View Claims Delete Users from the Account Change Users Passwords View Claims

9 Provider who is logged into the Portal. Provider Portal Home Screen Portal Menu - Navigation Sign out of the Portal. Useful tools for HealthyCT providers. HealthyCT s Medical Criteria.

10 Menu Navigation Legend List of people that are registered and able to log into with this Provider Portal. Manage your account, login name/password/ . Look up HealthyCT member eligibility, you will need members DOB and Id Number. Look up Claims that are associated with the Provider that is registered for the current portal account. Look up Remittance that are associated with the Provider that is registered for the current portal account. Phone numbers for contacting HealthyCT.

11 How to Add and Delete Users to the Provider Portal 1. From the left hand side menu, select Administration and then select User List from the drop down. 2. If you do not see the user you want to add in the list, select Add user on the right hand side.

12 How to Add and Delete Users to the Provider Portal 3. Select Provider Employee in the User List screen, and select Next. 4. In the Provider Employee screen, if you do not see the person you would like to add, select Add Employee.

13 How to Add and Delete Users to the Provider Portal 5. In the Add Provider Employee screen, record the person s information and select Submit. 6. You are now brought back to the Provider Employee List screen. Choose the link Select next to the person's name that you would like create a user account for.

14 How to Add and Delete Users to the Provider Portal 7. In the Add User screen, add in all the required information. This will be the information that the person will use to log into the portal. Then select Submit.

15 How to Add and Delete Users to the Provider Portal 1. Select User List from the left side menu. 2. Select Delete next to the user you would like to delete from access the Provider Portal.

16 How to Add and Delete Users to the Provider Portal 3. Review the user you would like to delete. Select the Delete button at the bottom of the screen.

17 How to Look up Member Eligibility 1. From the left hand side menu, select Patient. 2. From the drop down select, Member Eligibility. 3. In the Member Eligibility screen, put in the member s date of birth and HealthyCT Id number. 4. It is always best to select Yes from the drop down for Include Ineligible. 5. Select Search. 6. You will see a the member(s) that you are looking for. a. If the member is in the box Not Found box, this means the member is not found at all in our system regardless of effective dates. b. If the member is in the box Ineligible box, this means the member is not eligibility for the Eligible as of Date (located in the search screen). 7. If you would like to see the members benefits, select the hyperlink (underlined) benefit in the Policy Benefit Name column.

18 How to Look up Member Eligibility 1. From the left hand side menu, select Patient. 2. From the drop down select, Member Eligibility. 3. In the Member Eligibility screen, put in the member s date of birth and HealthyCT Id number. 4. It is always best to select Yes from the drop down for Include Ineligible. 5. Select Search.

19 How to Look up Member Eligibility 6. You will see a the member(s) that you are looking for. a. If the member is in the box Not Found box, this means the member is not found at all in our system regardless of effective dates. b. If the member is in the box Ineligible box, this means the member is not eligibility for the Eligible as of Date (located in the search screen). 7. If you would like to see the members benefits, select the hyperlink (underlined) benefit in the Policy Benefit Name column.

20 How to Change Passwords How to Change Your Password 1. Select User Profile from the left hand side menu. 2. Change your password in the Change Password box. a. You need to know your old password in order to create a new one. 3. Select Submit. How to Reset a Users Password 1. Select User List from the left hand side menu. 2. Select the users hyperlinked name from the list. 3. Select Reset Password. 4. Select Reset Password on Reset Password screen. 5. A new temporary password appears next to New Password 6. Select Submit 7. An is sent to the address associated with that user with the temporary password. 8. User needs to log into the Portal with the temporary password. 9. When the user logs in for the first with the temporary password they will be prompted to create a new password.

21 How to Change Passwords 1. Select User List from the left hand side menu. 2. Select the users hyperlinked name from the list. Testing

22 How to Change Passwords 3. Select Reset Password.

23 How to Change Passwords 4. Select Reset Password 5. A new temporary password appears next to New Password 6. Select Submit

24 How to Change Passwords 7. An is sent to the address associated with that user with the temporary password. 8. User needs to log into the Portal with the temporary password. 9. When the user logs in for the first with the temporary password they will be prompted to create a new password. Sent Testing

25 How to Change Passwords

26 How to Look up Claims and Remittance 1. From the left hand side menu, select Claim Status Search. 2. You can search by any of the fields. a. You must at the very least select from the Claim Type drop down (Institutional or Professional). 3. From the Claim Status List screen, you will see all the claims that are related to your search criteria. 4. You can select the Claim Number (if available) to see the claim details. a. From this screen at the bottom, you can also select RA Search to search from Remittances. 5. From the Claim Detail screen you can see all the details that are associated with the claim. a. If there is an EOP available for the claim, you can view the details by selecting View Payments from the bottom right hand side. 6. After selecting the View Payments link, you are brought to the Remittance Advice Search screen. 7. At the bottom of the screen, select the Check/EFT number to view the check details. a. You can also get to this screen by selecting the Remittance Advice Search tab from the left hand side menu. 8. On the Remittance Advice Detail screen, you can view all the details from the check.

27 How to Look up Claims and Remittance 1. From the left hand side menu, select Claim Status Search. 2. You can search by any of the fields. a. If you must at the very least select form the Claim Type drop down (Institutional or Professional).

28 How to Look up Claims and Remittance 3. From the Claim Status List screen, you will see all the claims that are related to your search criteria. 4. You can select the Claim Number (if available) to see the claim details. a. From this screen at the bottom, you can also select RA Search to search from Remittances

29 How to Look up Claims and Remittance 5. From the Claim Detail screen you can see all the details that are associated with the claim. a. If there is an EOP available for the claim, you can view the details by selecting View Payments from the bottom right hand side.

30 How to Look up Claims and Remittance 6. After selecting the View Payments link, you are brought to the Remittance Advice Search screen. 7. At the bottom of the screen, select the Check/EFT number to view the check details. a. You can also get to this screen by selecting the Remittance Advice Search tab from the left hand side menu. 1111

31 How to Look up Claims and Remittance 8. On the Remittance Advice Detail screen, you can view all the details from the remit.