Your NetCare Provider Website

Transcription

1 Your NetCare Provider Website

2 Your NetCare Provider Website The NetCare Provider Website offers Providers a user-friendly web experience, including account information and various other tools in a secure environment. The following Guide will help you to use the Provider Website and all its features. Table of Contents Accessing the Provider Website... 3 Registration Process... 3 Forgot Username... 6 Forgot Password... 7 Logging In... 9 Using the Quick Links Viewing User Guide...11 Viewing the Disclaimer...12 Viewing Privacy Statement and Terms of Use...12 Using the Change User Information Function...12 Using the Contact Us Function...14 Provider Claims Accessing Your Provider Claims tool...16 Using the Claims Status Inquiry tool Accessing Explanations of Benefits...18 Provider OnLine Claim Submission Using the OnLine Claim Submission tool Logging Out Page 2 of 25

3 Accessing the Provider Website The Provider Website is available via the Internet. Use the following steps to access the site. 1. Log into the Provider Website from If you have accessed another Provider Website in the past, you will need to have a new username and password generated for the new and improved Provider Website. Registration Process If you are a first time user, go to and Choose the Provider option 1. Enter your Provider Practice or Facility name in the Practice/Facility field. 2. Enter your Provider First Name in the Provider First Name field. 3. Enter your Provider Last Name in the Provider Last Name field. 4. Choose your Provider Classification from the drop down list. 5. Enter your Provider T.I.N in the Provider Tax Identification Number field. 6. Enter your National Provider Identifier in the National Provider Identifier field. 7. Enter your Provider address in the Address 1 and Address 2 (Optional) fields. 8. Enter your Provider city in the City field. 9. Select your Provider state from the State drop down box. Page 3 of 25

4 10. Enter your Provider zip code/postal code in the Zip/Postal Code field. Your Contact Information 11. Enter your First Name in the First Name field. 12. Enter your Last Name in the Last Name field. 13. Enter your Phone number in the Phone Number field. 14. Click the Next button to move on to step 2 of the Registration process. Clicking the Cancel button at any time during the registration process will prompt you to start from the beginning. The second Provider User Registration page will display. 15. Confirm that the information you have entered is correct. 16. Click the Next button to continue. NOTE: If any information is incorrect, click the Previous button to go back and correct it. The third Provider Registration page will display. 17. Create a username in the Username field. Page 4 of 25

5 18. Create a password in the Password field and re-enter your password in the Confirm Password field. Please be sure to create a Password that complies with the requirements listed on this page. 19. Enter your address in the Address field and re-enter your in the Confirm Address field 20. Click the Next button to continue The fourtth Provider User Registration page will open. 21. Create a security question and answer in the Security question and Security answer fields. NOTE: Please remember your Security answer you have created. You will need it in order to utilize the Forgot Username and Forgot Password functions. The final Provider User Registration page, which provides the Terms and Conditions of the site, will open. 22. Please read the entire statement and choose I Agree or I Disagree, which appear at the bottom of the page. 23. Click the Submit button to complete your registration. Page 5 of 25

6 You will now be able to log in to the provider portal. Forgot Username In the event that you don t have your username, use the following steps: 1. Go to and choose the Provider option then use Click here if you have forgotten your username. The Forgot Username page will open. 2. Enter your tax id in the Provider Tax Id field. 3. Enter your provider first name in the First Name field. 4. Enter your provider last name in the Last Name field. 5. Enter your address in the Address field. 6. Click the Next button. The second Forgot Username page will open. Page 6 of 25

7 7. Input your security answer in the Security Answer field 8. Input the characters that you see from the highlighted screen box in the Type Characters field. 9. Click the Next button and the following page will appear informing you that your Username will be ed to you. The third Forgot Username page will open. Forgot Password In the event that you don t have your password, use the following steps: 10. Go to and choose the Provider option then use Click here if you have forgotten your password. The Forgot Password page will open. Page 7 of 25

8 11. Enter your tax id in the Provider Tax Id field. 12. Enter your provider first name in the First Name field. 13. Enter your provider last name in the Last Name field. 14. Enter your address in the Address field. 15. Click the Next button. The second Forgot Password page will open. 16. Enter your username in the Username field. 17. Click the Next button. The third Forgot Password page will open. 18. Input your security answer in the Security Answer field 19. Input the characters that you see from the highlighted screen box in the Type Characters field. 20. Click the Next button. Page 8 of 25

9 The final Forgot Password page will open. 21. Enter a password in the Password field and re-enter your password in the Confirm Password field. Please be sure to create a Password that complies with the requirements listed on this page. A password complete page will appear, which allows for you to log-in with your Username and your changed password. Logging In 1. From the NetCare home page, enter your Username and Password in the Provider section. 2. Click the Login button. Page 9 of 25

10 The Provider Website Home page will open. Using the Provider Website The Provider Website offers Providers the ability to access Account Balances, Claim Information and Health Coverage Eligibility. The Provider Website Home page is designed to allow users easy access to all of the website s tools. Quick links provide easy access to key site features Please note that the Provider Website features may vary depending on Provider s access rights. Page 10 of 25

11 Using the Quick Links The Quick Links are available on the footer of every page within the NetCare Provider website: Home User Guide Disclaimer Privacy Statement Terms of Use Change User Profile Contact Us Log Out Viewing User Guide The User Guide function allows Providers access to Provider User Guide. 1. From the Provider Website Home page, click the User Guide link. The User Guide page will open. 2. Click the Provider Portal User Guide Reference Guide link. The Guide will open in a new window. Page 11 of 25

12 Viewing the Disclaimer 3. From the Provider Website Home page, click the Disclaimer link. The Disclaimer page will open. Viewing Privacy Statement and Terms of Use Access to both the Privacy Statement and the Site s Terms of Use are always available and accessible for viewing and printing from their respective links at the bottom of the page. Using the Change User Information Function The Change User Information function allows Providers to change their password, address information and secret question. Accessing the Change User Profile Function 4. From the Provider Website Home page, click the Change User Profile link. Page 12 of 25

13 The Change User Profile page will open. Changing Your Password From the Change User Information page, use the following steps to change your password. 1. Enter your current password in the Current Password field. 2. Enter you new password in the New Password and Confirm New Password fields. 3. Click the Save button. Page 13 of 25

14 A message will display that says: Your password has been updated. The new password will be active the next time you login. Changing Your Information From the Change User Information page, use the following steps to change your address. 1. Enter your new in the New Address field. 2. Click the Save button. A message will display that says Your address has been saved. Changing Your Security Question From the Change User Information page, use the following steps to change your security question. 1. Select a question from the Security Question dropdown. 2. Enter your answer in the Security Answer field. 3. Click the Save button. A message will display that says Your security answer has been saved. Using the Contact Us Function If for any reason you need to contact Customer Serivce use the Contact Us link. 1. From the Provider Website Home page, click the Contact Us link. The Contact Us page will open. Page 14 of 25

15 2. Choose your Area of Concern from the drop down box. 3. Enter in the details of your concern in the Request Details section. 4. Click on the Submit Request button to send your request for review. Page 15 of 25

16 Provider Claims You can quickly search for a patient and bring up their claim information. Accessing Your Provider Claims tool 1. From the Provider Website Home page, click on the Claims link located in the Provider Claims section. Or From the navigation bar, go to Claims The Claims Status Inquiry page will open. Using the Claims Status Inquiry tool. 1. After entering the parameters then clicking on the Search button it will return all results that match. Page 16 of 25

17 2. Clicking on the View link will bring up the detail for that patient. 3. Clicking on the Next button will bring up the Claims Status Inquiry screen for that patient. 4. To filter your search, enter any known information in the given fields and/or click the Search button. Page 17 of 25

18 The Claim History information will display NOTE: All columns can be sorted by clicking the arrow ( ) buttons under the column heading. Viewing Claim History The Claims History page displays the following information. Patient Name the name of the patient the claim was submitted for Date of Service the date the patient received provider/rx care Received Date the date the claim was received for processing Claim Status the status of the claim Provider the name of the provider that performed the service Claim the claim number associated with the service Billed Charges the charges billed by the provider before any discounts/health plan payments are applied Paid By Health Plan shows if the claim was paid by the health plan Check Date the date the check was issued Paid To who the check was paid to (Provider or member) Claim Type the type of claim submitted (medical, vision, dental) Accessing Explanations of Benefits To see an individual EOB, click on Explanation of Benefits where underlined, under the Claim Number. The EOB will open in Adobe Acrobat, and is printer-friendly. Page 18 of 25

19 Provider OnLine Claim Submission You are able to submit a HCFA form on Line for processing. 1. From the Provider Website Home page, click on the Claims link located in the Provider Claims section Or From the navigation bar, go to Claims The submit claim member selection opens 2. Enter in Member ID or Patient s First Name and Last Name and the Patient s Date of Birth 3. A selection may be presented to you. Choose the correct member by clicking the View button. Or, if this is not the correct member, search for your member again using different criteria Jane John Jack Jill Page 19 of 25

20 4. Once you have choosen your member, the following screen will appear: JANE 123 MAIN ST ANYTOWN USA JANE This information will appear automatically and does not require any additional entry. If this is not the correct member and patient, simply arrow back to the previous screen and try to make your selection again. If your member is not listed, or is incorrect, please call your Customer Service Representative. Page 20 of 25

21 5. The provider information follows the member and patient section. Arrow down to the Provider Billing and Service sections and fill in your address information. Service Provider Information is Optional. Required fields are noted below SMITH MD * JOSEPH * * Required Fields * * * * * * ** ** NPI is Optional Page 21 of 25

22 6. The next section includes the Rendering Provider, Accident, and other Misc. Information. Fields that are required are indicated below. 7. The next section is the Referring Provider Information. These fields are not required. Page 22 of 25

23 8. The Diagnosis Codes and the Service Lines are the last sections. 9. If you have any supporting documentation that you need to send with your claim, you can upload it by browsing for it and attaching. You will need to do this prior to submitting your claim. 10. There are validations set up once your have submitted your claim. If you have entered in invalid codes in either the Diagnosis or Detail Lines sections, you will be given a prompt at the top of your screen with the invalid values that need to be corrected. Below is an example of how the errors appear: Page 23 of 25

24 11. Once you have finished making corrections and you submit again, your confirmation that your submission was received is indicated by the following screen: 12. You can view a copy of your Claim and save it as a PDF. 13. When you choose Click here to return to the main menu, it will take you back to the main Provider Website page. If you would like to submit another form, you will need to choose the Submit a claim online link and begin the process again. Page 24 of 25

25 Logging Out Remember to log out of the Provider Website to ensure confidentiality of your health care information. 1. From any page on the Welborn site, click on Log Out button, located in the upper righthand corner of your screen. OR 2. Click the Logout link located in the footer of the website. Page 25 of 25