BSynchro 2014 BSYNCHRO [E-AUTHORIZATION USER GUIDE] This Document is intended as a user guide for providers who are planning to use the e-authorization system.
Contents I. Introduction... 2 II. Purpose of Document... 2 III. Targeted Audience... 2 IV. How to Sign Up... 3 V. How to Log in... 8 VI. How to create and submit a provider request... 10 A. How to check for member eligibility... 10 B. How to fill request details... 13 C. How to fill activity information... 17 D. How to add and fill observation details... 22 E. How to submit request... 28 F. How to cancel request... 29 VII. How to see pending requests... 30 VIII. How to see latest answers (active requests)... 31 IX. How to view pending request details... 33 X. How to view latest answers (active requests) details and print it... 35 XI. How to open authorization and send cancellation... 37 XII. How to open authorization and send correction... 38 A. How to edit request details and submit... 38 B. How to edit activity information and submit... 40 C. How to edit observation and submit... 43 XIII. How to refresh requests... 47 XIV. How to search inside insured medical history and view details... 48 XV. How to go to Home Page... 50 XVI. How to log out... 50 XVII. How to Access User Guide... 51 XVIII. Document History... 51
I. Introduction BSynchro E-authorization user Guide eauthorization portal enables access for providers to submit different type of authorizations (Out Patient, In Patient, Emergency, Dental, ). This portal allows provider s users to search their previously logged transactions. II. Purpose of Document This User Guide is intended as a series of steps to show how a provider user interacts with the system to establish the business goal of completing a workflow on e- authorization. III. Targeted Audience This document is intended for users logging into the system as providers.
IV. How to Sign Up Trigger: Browse e-authorization portal Outcome: Sign Up Step Step Description Step Representation 1. Browse e-authorization url 2. Click Sign Up 3. Personal Information Enter First name in field First Name
4 Personal Information Enter last name in field Last name 5. Personal Information Enter contact email in field Email (in the format of email@domain.com) 6. Account Details Enter username in field username (in the format of username@domain.com)
7. Account Details Enter password (passwords must have at least 8 characters and contain the following: uppercase letters, and symbols. (e.g. P@ssw0rd) 8. Account Details Confirm the same password in field Confirm password 9. Account Details Select secret question
10. Account Details Enter answers in field answer BSynchro E-authorization user Guide 11. Regulatory Information Select regulatory from field Regulatory 12. Regulatory Information Enter a valid facility license number
13. Regulatory Information Enter Username which is the user name as registered at the regulatory site 14. Regulatory Information Enter Password which is the password as registered at the regulatory site 15. Click Test Connection, to test if the regulatory credentials are valid or not
15.1 Optional: Click cancel anytime, in order to cancel Sign Up 16. Click on Register V. How to Log in Trigger: Browse e-authorization portal Outcome: Log in Step Step Description Step Representation 1. Browse e-authorization url
2. Enter username in field username 3. Enter password in field password 3.1 Optional: Check Keep me signed in, in order to preserve username at each log in
4. Click Login BSynchro E-authorization user Guide VI. How to create and submit a provider request A. How to check for member eligibility Trigger: Log in Outcome: Check for member eligibility Step Step Description Step Representation 1. See section V. to log in
2. Click on Provider Request tile 3. Select Request Type from drop down 4. Select Insurer from drop down 5. Enter card number in field card number
6. Click Start BSynchro E-authorization user Guide 6.1 In case the member is not eligible, a pop-up Member not eligible will be displayed
B. How to fill request details Trigger: Enter insured information Outcome: Fill request details Step Step Description Step Representation 1. Follow section V. in order to log in 2. Pick Prescription Date 3. Enter or search for clinicians and select one
3.1 Exception: In case request type selected in section VI.A is inpatient elective or inpatient emergency, Pick Admission date 3.2 Exception: In case request type selected in section VI.A is inpatient elective or inpatient emergency, Pick Discharge date 4. Search by ICD code or name and select Primary Diagnosis
4.1 Exception: In case request type selected in section VI.A is referral, the primary diagnosis cannot be selected, as it will be set by default to V68.81 4.2 Exception: In case request type selected in section VI.A is referral, search and select referral number from drop-down 5. Optional: Search by ICD code or name and select Secondary Diagnosis
6. Optional: repeat step 5 to add multiple secondary diagnoses
C. How to fill activity information Trigger: Fill request details Outcome: Fill activity information Step Step Description Step Representation 1. Follow section VI.B in order to fill request details 2. Click Next 3. Select the activity type between CPT/HCPCS/CDT/SRVC
3.1 Exception: Request type of Home Nursing does not have activity type CDT 3.2 Exception: Request type of Inpatient Elective and Inpatient Emergency have additional activity type DRG 5. For activity type CPT: Select Chapter from dropdown
5.1. Select Activity Code BSynchro E-authorization user Guide 5.2. Enter Quantity 5.3. Click on Add
6. For activity type HCPCS: Select Activity Code 6.1. Select Quantity 6.2. Enter Price
6.3 Click on add BSynchro E-authorization user Guide 7. For activity type CDT and SRVC: Select Activity Code 7.1 Select Quantity
7.2 Click on Add BSynchro E-authorization user Guide 8. For activity type: DRG Select activity Code D. How to add and fill observation details Trigger: Fill activity information Outcome: Add and fill observation details Step Step Description Step Representation 1. Follow section VI.C, in order to fill activity information
2. Click on Observation BSynchro E-authorization user Guide 3. Select Observation Type between CPT/LOINC/Text/file 4. Exception: For activity type CDT, select between: CPT/LOINC/Text/file/Univer sal dental
5. For observation type CPT and LOINC: Search and select code 5.1. Click on Add
6. For observation type text: Enter text in value and click on add 7. For observation type File: Click on upload
7.1. Select file of type pdf and size < 4MB and click on add 8. For observation type Universal Dental (only applicable for CDT activity types): Select tooth number, according to insured age, and click on add
9. Click on Save BSynchro E-authorization user Guide
E. How to submit request Trigger: Fill request details and activity information Outcome: Submit request Step Step Description Step Representation 1. Follow section VI. B, C, D to fill request details, activity information and add observation 2. Click on Submit
F. How to cancel request Trigger: Fill request details and activity information Outcome: Cancel request Step Step Description Step Representation 1. Follow section VI. B, C, D to fill request details, activity information and add observation 2. Click Cancel anywhere while filling details 3. Click the decision Yes/No on the confirmation pop-up
VII. How to see pending requests Trigger: Submit a request Outcome: See pending requests Step Step Description Step Representation 1. See section VI.E in order to submit a request 2. Go to Provider Request summary page and click on Pending title 2.1 Optional: Search for pending requests by request number, request type, disease name or card number
2.2 Requests of Pending status will be displayed VIII. How to see latest answers (active requests) Trigger: Submit a request Outcome: See latest answers (active requests) Step Step Description Step Representation 1. See section VI.E in order to submit a request
2. Go to Provider Request summary page and see latest answers (user can scroll down to see more) 2.1. Optional: Search for active requests by request number, request type, disease name or card number
3. View answers by their status: Totally approved (green), Partially approved (Orange) 3.1. View answers by their status: Rejected (Red) IX. How to view pending request details Trigger: See pending prescriptions Outcome: View pending request details Step Step Description Step Representation 1. See section VII. To see pending requests
2. Click on a pending request in order to view details 3. Click on View Details in order to view more details of an activity or Close details to close the details section 4. View details of activity submitted, in addition to quantity requested, quantity approved
X. How to view latest answers (active requests) details and print it Trigger: See latest answers (active requests) Outcome: View latest answers (active requests) details and print it Step Step Description Step Representation 1. See section VIII. In order to see latest answers (active requests) 2. Click on a request in order to see details
3. Click on View Details in order to view more details of an activity or Close details to close the details section 4. Click Print 4.1 View details of request and select format to export to (excel/pdf/word)
XI. How to open authorization and send cancellation Trigger: View latest answers (active requests) Outcome: Open a request and send cancellation Step Step Description Step Representation 1. Follow section X. in order to view latest answers (active requests) 2. Click on Cancellation 3. Select decision Yes/No, in the confirmation pop-up
XII. How to open authorization and send correction A. How to edit request details and submit Trigger: View latest answers (active requests) Outcome: Edit request details and submit Step Step Description Step Representation 1. Follow section X. in order to view latest answers (active requests) 2. Click on correction 3. Edit prescription date, clinician, primary diagnosis or secondary diagnosis and click on next
3.1 Exception: For requests of type Referral, the Primary diagnosis cannot be edited 4. Click on Submit 5. Enter comments and click Send correction
6. Optional: Upload a pdf file of size< 4MB and click Send correction B. How to edit activity information and submit Trigger: View latest answers (active requests) Outcome: Edit activity information and submit Step Step Description Step Representation 1. Follow section X. in order to view latest answers (active requests) 2. Click on correction
3. Click edit at the level of the activity 4. Edit Quantity or Price and click on Save 5. Or, click delete next to an activity
5.1 Select decision: Yes/No on confirmation pop-up 6. Click on Submit 6.1 Enter comments and click Send correction
6.2 Optional: Upload a pdf file of size< 4MB and click Send correction C. How to edit observation and submit Trigger: View latest answers (active requests) Outcome: Edit observation and submit Step Step Description Step Representation 1. Follow section X. in order to view latest answers (active requests) 2. Click on correction
3. Click edit at the level of the activity 4. Click on Observations 4. Follow section VI.D, in order to add an observation
5. Or, delete the observation 6. Click on Save 6.1 Click on submit
6.2 Enter comments and click Send correction 6.3 Optional: Upload a pdf file of size< 4MB and click Send correction
XIII. How to refresh requests Trigger: Submit a request Outcome: Refresh requests Step Step Description Step Representation 1. See section VI.E to submit a request 2. Click on Logo in order to refresh answers
XIV. How to search inside insured medical history and view details Trigger: Search inside medical history Outcome: View details Step Step Description Step Representation 1. Click on Medical History 2. Fill insurer 3. Select Prescription date or transaction date 4. Fill Start Date and click on Search 4.1 Optional: in addition to required fields, fill Request type and/or card number and/or request number and/or status and/or authorization number and/or end date and Click on Search
4. View search details BSynchro E-authorization user Guide 5. Click on a request in order to view details 6. Click on View details to view request details or Close details to close the details
XV. How to go to Home Page Trigger: Anywhere in the application Outcome: Go to Home page Step Step Description Step Representation 1. Click on logo XVI. How to log out Trigger: Anywhere in the application Outcome: Log out Step Step Description Step Representation 1. Click on Sign Out at the upper right corner of the page
XVII. How to Access User Guide Trigger: Anywhere in the application Outcome: Access the User Guide Step Step Description Step Representation 1. Follow section XVI to log out 2. Click on User Guide XVIII. Document History Name Date Reason For Changes Version Arin Chekijian March 25, 2014 Create Document 0.1