Online Services for Employers User Guide. Mayo Clinic Health Solutions
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1 Online Services for Employers User Guide Mayo Clinic Health Solutions
2 Table of Contents 1.0 Registering and Signing In... 1 Registration... 1 User Definitions... 1 Signing In Enrollment Member Info... 5 How to Look Up a Member... 5 Health Plan Eligibility... 6 Health Plan Balances... 7 Health Plan Claims... 8 Find a Doctor Member Documents Reports Viewing Reports Granting Access to Your Broker Manage Users User Definitions How to Create a New End User How to Edit or Remove an Existing End User s Account Reimbursement Accounts My Account Support Member Forms Help Contact Us Signing Out... 20
3 1.0 Registering and Signing In Registration For access to Online Services for Employers, you must be registered as a Super User or an End User for your organization. To sign up for Super User access to Online Services for Employers, please contact your account manager. Your account manager will contact you to provide your Super User ID and password. To sign up for End User access to Online Services for Employers, please contact your employer's designated Super User. User Definitions Super User: Super Users are responsible for setting up and maintaining Online Services for Employers accounts for themselves and for other End Users for your employer. One Super User will be assigned per organization. End User: An End User is an employer representative whose job function requires access to data available through Online Services for Employers. This access may be granted at the discretion of the designated Super User for your organization. Signing In Complete the following steps to sign in to Online Services for Employers: 1. Type in the address bar of your Internet browser to access the Mayo Clinic Health Solutions Online Service Center home page. 2. Click on the Employers tab at the top of the page to access the Online Services for Employers page. 3. Type in the User ID and password provided to you, and then click Sign In. 4. You will now be signed in to your user account. Keep your user ID and password in a secure location where you can refer to it later, if needed. 1
4 The items you see listed in the menu bar at the top of the Employer Home page will vary depending on the level of access you have been granted as well as the benefits offered by your specific organization If you experience technical difficulty with Online Services for Employers, please our Web Master at Remember to include your user name and organization in your . Note for Super Users: The next step is to designate access to personnel within your organization. These are the individuals who will have access to the information through Online Services for Employers and will be referred to as End Users. To learn how to create End Users, see section 5.0 of this User Guide. 2
5 2.0 Enrollment Click on the Enrollment tab to access the Enrollment tool. Please note: The enrollment tools you will see here may vary depending on the specific enrollment options used by your organization. If your organization is using another method for employee enrollment, you will not be able to view or edit enrollment information using this tool. View Employee Enrollment: View an employee s plan options for the current benefit year. You can look up the employee by member ID number or name. 3
6 Submit Enrollment Change: Use this online form to change an employee s demographic details or allowed enrollment changes for the current benefit year. You can look up the employee by member ID number or name. Submit New Enrollment: Use this online form to submit a new employee enrollment. You will need to submit supporting documentation of the new enrollment to the Mayo Clinic Health Solutions Membership Department by fax or mail: Fax: Mail: Mayo Clinic Health Solutions Attn: Membership Department st Street NW Rochester, MN Employee Submitted Enrollment: View a list of pending employee enrollments requiring review and approval. 4
7 3.0 Member Info The Member Info tab provides access to a range of important member information and tools, such as health plan eligibility, health plan balances, health plan claims, provider search, and member documents. Your access to these resources may vary depending on the access you have been granted. How to Look Up a Member In order to view member information, you must first look up a member. Click on Change Member. In the Change Member box, enter your search criteria and click on the Search button. Your search results will appear under Select Member. Click on the member number of the member whose information you want to view. 5
8 Health Plan Eligibility The Health Plan Eligibility tool allows you to view member eligibility information, such as member number, name and address. To access this tool, click on the Member Info tab. The Health Plan Eligibility tool will display member and subscriber information, as well as information about the benefits in which the member is enrolled. If the member is enrolled in multiple plans (for example, a medical plan and a separate dental plan) the tool will display eligibility information for each plan. If you are looking up a subscriber, the tool will also display eligibility information for each covered spouse or dependent. 6
9 Health Plan Balances The Health Plan Balances tool allows you to view member balance information, such as the deductible and out-of-pocket maximum. To access this tool, click on the Member Info tab, then select Health Plan Balances in the left hand menu. Click on the View balances for drop down box to view balances for another type of benefit, such as dental (if applicable). Click on the Previous Year link to view balances for the previous coverage year. If you are looking up a subscriber, you will also see benefit balances for each covered spouse and dependent, as well as a family total. If you are looking up a dependent, you will see only the dependent s benefit balances and the family balance. 7
10 Health Plan Claims The Health Plan Claims tool allows you to view member claims information, such as claim number, status, and date paid, as well as copies of the associated Explanation of Benefits (EOB) statements. To access this tool, click on the Member Info tab, then select Health Plan Claims in the left hand menu. Select the time frame of the claims you would like to view. A results page will appear. By default, results are sorted by date of service, but the user can sort them in other ways by selecting a different Sort By option from the drop-down menu at top right. Options include: Claim number Status: open or finalized Provider: provider name Date of service Date paid Patient: patient name 8
11 If more than one claim is displayed in the search results, the search can be refined using the filters displayed on the left side of the page. Filter values are only displayed if there are claims that match the filter value. Possible filter types and values include: Claim type: medical, dental Date of service: last 30 days, last 60 days, last 90 days, last 6 months, last 12 months Status: open or finalized Provider: provider names found in the resulting claims Patient: patient names found in resulting claims To view claim details, click on the claim number associated with a finalized claim. Claim details are not available for open claims. If you hover over the? icons next to field/column labels, a message will display providing a definition of the label. If you are looking up a subscriber, the tool will also display claims information for each covered dependent under age 18. Information for a subscriber s spouse or over-18 dependent cannot be viewed through the subscriber s account, unless the spouse/dependent has granted access to the subscriber. This information may be accessed through the spouse s/dependent s account. 9
12 Find a Doctor The Find a Doctor tool allows you to search for in-network providers on behalf of a member. To access this tool, click on the Member Info tab, then select Find a Doctor in the left hand menu. Click on the network links shown under Networks Available to You to search for provider network options available to this member. Then follow the search instructions provided. If your search does not return the desired results, try refining your search criteria. 10
13 Member Documents The Member Documents tool allows you to view copies of documents that have been posted online, such as the Summary of Benefits and Coverage (SBC) and your plan document. To access this tool, click on the Member Info tab, then select Member Documents in the left hand menu. To download and view a document, click on the document link. 11
14 4.0 Reports Mayo Clinic Health Solutions provides one convenient location for employers to access quarterly, monthly and ad-hoc reports. You can access year-end and quarterly reports for the current year as well as for previous years (if applicable), and selected historical reports. Viewing Reports To access your reports, click on the Employer Info tab. On the Reports page you will see a list of your available reports with links. A detailed description of each report displays when you hover your mouse over the report link. Click on the link to view or download a report. Your reports will be uploaded by our Health Care Analytics team on a regular schedule, detailed in your customized Report Delivery Schedule, available on the Reports tab. Check this page for reports at the appointed times on your schedule. To request copies of historical reports not uploaded to the Reports page, please contact your account manager. 12
15 Granting Access to Your Broker If you would like to enable your broker to access your online employer reports, please contact your designated Super User. Your broker will be set up as an End User. 13
16 5.0 Manage Users This section applies to Super Users only. Manage Users is a tool available to Super Users only. This tool is used to grant End Users access to Online Services for Employers. In add addition, Super Users can also use this tool to edit or remove End User accounts. User Definitions Super User: Super Users are responsible for setting up and maintaining Online Services for Employers accounts for themselves and for other End Users for your employer. One Super User will be assigned per organization. End User: An End User is an employer representative whose job function requires access to data available through Online Services for Employers. This access may be granted at the discretion of a designated Super User for your organization. To access the Manage Users tool, go to the Employer Info tab and select Manage Users in the left hand menu. How to Create a New End User 1. Click on Create New End User. 2. Type in the information for the End User account you wish to create. You will assign the User ID and Password for each End User account. 14
17 3. Under Access, choose the types of information you would like the End User to have access to. The choices are listed in the screen shot to the right. 4. When finished entering information, select Create End User. 5. The message New user account was successfully created will appear at the top of the screen when the End User account is complete. 6. The End User will be required to change their password and select their security question the first time they sign in. How to Edit or Remove an Existing End User s Account To edit an End User s account, select the End User in the list of users displayed under Manage Users. You can change an End User s password, name, and access. If you change an End User s password, the End User will be required to change their password the next time they sign in using the Super User-specified password. To delete an End User, select Remove User. 15
18 6.0 Reimbursement Accounts Click on the Reimbursement Accounts tab, then Click here to access your Employer Reimbursement Accounts home page to access the Employer Reimbursement Accounts portal. Using the Reimbursement Accounts Portal, you can view and/or manage: Member reimbursement account balances and claims activity Reimbursement account contributions Reimbursement claims payment status Reimbursement account education materials To learn more, please refer to the Employer Online Reimbursement Account Resources Quick-Start Guide. Note for Super Users: When an End User account is set up with access to reimbursement accounts, using the Manage Users tool, it usually takes two or three business days for this access to be granted. An account is created for the End User on the Reimbursement Accounts portal, which is then linked to their Online Services for Employers account. When this access is granted, the Reimbursement Accounts tab will appear in the green menu bar. 16
19 7.0 My Account Click on the My Account tab to access the Account Settings tool. Using this tool, you can view and update your profile information, such as your password, address, and security question/answer. To change your password, enter the new password in the New Password box, confirm it in the Confirm New Password box, then select Save Password. To change your security question/answer, enter the new information in the boxes provided, and then select Save Preferences. To change your address: End Users: contact your Super User. Super User: Enter the new information in the boxes provided, and then select Save Preferences. 17
20 8.0 Support The Support tab provides access to a variety of helpful resources, which are also provided to members through Online Services for Members. Member Forms Click on Member Forms in the left-hand navigation to access a list of printable member forms, including authorization and claim forms. Help Click on Help in the left-hand navigation to access a glossary of insurance terms. 18
21 Contact Us Click on Contact Us in the left-hand navigation to access the guidance we provide to members if they have health plan or benefit questions, or if they experience technical difficulties with the Web site. 19
22 9.0 Signing Out To sign out of your account, click on Sign Out, located in the upper right corner of the page. Close your browser window to ensure you are completely signed out of the system. 20
23 111-MMS151 (06/15)
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