www.availity.com 1 JUNE | JULY 2012 in Focus Newsletter for users of the Availity ® Health Information Network Find out the answers to the questions you always wondered, but never had time to ask. LOG IN • REGISTER • AVAILITY.COM Tell us what you think— email us at [email protected]News Events Training Good question
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inFocus - Availity4 Availity inFocus | June/July 2012 Good habit, bad habit Best practices in using Availity By Kristina Oliver Your Availity training team is committed to helping
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www.availity.com 1
JUNE | JULY 2012
inFocusNewsletter for users of the Availity® Health Information Network
Good questionFind out the answers to the questions you always wondered, but never had time to ask
Sometimes there just aren’t enough hours in the day. You’re busy tackling all the tasks of managing an office, from phones to billing to serving patients. And sometimes, that just doesn’t leave much time for anything else—like webinars or other training that can help you optimize your workflow.
So we’ve made it easier to get the answers to questions you may have, but don’t have time to ask. We’ve narrowed your questions about Availity down to your top five most frequently asked, because who has time to read more than that?
Availity displays information and
messages as the payer sends them.
Some health plans have multiple
systems in which patient and claim
information is stored. While the
health plan’s customer service center
has access to all of these systems,
the health plan may be sending data
to Availity from only one or a few of
their systems, not all of them.
Availity and our partner health plans
understand how frustrating these
discrepancies can be for our users,
and both we and they are continually
working to make sure that the
information presented on Availity is
the best available from the payer. If
the results are unclear, confusing, or
incomplete, you may contact Availity
Client Services, but we will probably
need to refer you to the health plan
for further assistance. While you’re
on the phone with the health plan,
be sure to express your interest in
having them send information from all
patient and claim systems to Availity.
continued on page 2
1 Why does the information I get in Availity sometimes differ from the information I get on the phone with the payer (especially for claim status and eligibility & benefits)?
Enhancement and update news from AvailityWHAT'S NEW
Changes coming to Blue Cross and Blue Shield of Minnesota PWSS/Provider Hub BlueCrossandBlueShieldof
Minnesota is transitioning Clear
Connect functionality from PWSS/
Provider Hub to Availity, effective July 1.
BlueCrossandBlueShieldof
Minnesota first partnered with
Availity in August 2009 and is
extending that relationship now as
it complies with the HIPAA version
5010 transaction standard.
As a result of this transition, you
can streamline your workflow by
conducting more of your transactions
withBlueCrossandBlueShieldof
Minnesota and other health plans
through Availity.
New to Availity?
Availity makes it a snap to get started
withavarietyoftrainingoptions.Be
sure to check the Training section of
this newsletter for a list of upcoming
webinars and workshops, or you can
always check Free Training in the
Availity portal for a comprehensive list
of live and on-demand webinars, online
demonstrations, tip sheets and more.
Workers’ compensation claims now available on the Availity portal In an ongoing effort to provide
you with greater value through
expanded services, Availity is
pleased to announce that workers’
compensation claims can now be
submitted to more than 450 health
plans via the Availity portal. With this
expansion, you can now:
• Submitworkers’compensation
claims(eBills)throughAvaility,
via EDI.
• ReceivestandardAvailityreports,
attachment request fax cover
sheets and notifications, and
electronic remittance advice.
• Search,view,andreconcileERAs
through Remit Reader.
To access workers’ compensation
features, click Claims Management
| Professional Claim or Claims
Management | Facility Claim in
the Availity menu. In the Payer field,
select Workers’ Compensation, then
click Workers’ Compensation Payer.
In the Workers’ Compensation
Payer field, select the specific payer
to which you are submitting the claim.
Complete the claim form as
appropriate. If an attachment
is required for the claim, a fax
coversheet will be made available in
your Availity Receive Files mailbox.
What’s New continues on page 8
If you currently use the PWSS/Provider Hub to verify eligibility and benefits and/or claim status for out of state Blue Cross and Blue Shield of Minnesota members, you will be able to conduct those transactions only through Availity for out of state members, effective July 1.
!
8 Availity inFocus | June/July 2012
TR
AIN
ING Learn more about Availity
To register for any of these upcoming webinars, just click the Free
Training tab at the top of any page in the Availity portal. All times are
Eastern Standard.
June 26 2:30 PM User Training for Anthem BCBS Providers
June 27 2:30 PM CareCollect Payment Processing
July 10 10:30 AM CareCollect Payment Processing
July 11 2:30 PM Web Data Entry Claim Submission
July 13 10:30 AM User Training for Anthem BCBS Providers
July 13 2:30 PM CareProfile® and Clinical Messaging
July 16 2:00 PM CareCost EstimatorSM for Blue Cross and Blue Shield Providers in Texas, New Mexico, Oklahoma and Illinois
July 17 1:30 PM Primary Access Administrator Training
July 20 10:30 AM EDI Training for EDI Submitters
July 24 2:30 PM User Training for Anthem BCBS Providers
July 25 2:30 PM Remittance Solutions and Claims Follow-up
July 26 1:00 PM Eligibility, Benefits and CareCalc for Florida Providers
We’re adding new webinars
every day, so be sure to check
the Availity portal for a complete
listing of upcoming training
events. Just click Free Training in
the Availity portal.
P Additional payers available for
Web transactions
P Expanded availability of Availity®
CareCost EstimatorSM for Cigna
P Certificate of Coverage Booklet
now available for Anthem
members
P Enhanced authorization and
referral service types for Florida Blue
P Enhanced printing for Remit Reader
P Clinical messaging now available from
Humana
P Authorization and Referral
enhancement
P New field for workers’ compensation
claims
Updates: Quick Hits
For complete updates on Availity enhancements, please review our release communications
Health care providers turn to RealMed, a complete revenue cycle management solution, when they want real results:
•Fastercashflow and fewer days in accounts receivable.•Automatedeligibilitychecking during claim submission.•Improvedoperationalefficiency including fewer claim errors and fewer denials.•Betterunderstandingofworkflowpatterns, to help you maximize revenue.
Click to learn how Asheville Anesthesia Associates SAVED
Across4. Recommended before starting any recreational or sports activity5. Helps providers reconcile accounts receivable more quickly and easily9. Traditional June birthstone12. City where the Declaration of Independence was signed13. The host city of the Summer Olympics14. Trained professional for water-related safety15. Lifesaving technique used for drowning rescues17. A popular savings tool for members with high deductible medical plans19. Administrative workflows in a practice that impact the ability to get paid
for services rendered22. Cool people eat this Great American Dessert23. Helps providers quickly collect the correct payment while patient is
still present25. Considered “safe” fireworks, but still contribute to burn-related injuries
Down1. Students go here for extended academic study2. One of two sports eliminated after the 2008 Beijing Games3. Popular summer fruit6. Traditional sleep-away program for youth7. Generic identifier used on Credit Reports for outstanding medical
expenses8. Plant commonly used to soothe sunburned skin10. Amount the insured member is responsible for paying11. Sending of a payment from one place to another16. Popular summer vacation destination for families18. National Pickle Month20. Host city of the only Olympic Games where the U.S. did not compete21. Family member honored in June24. A medical record in a digital format is known by this acronym
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CROSSWORD Dollars and Sense—Practice, Payments and More