anthem blue cross and blue shield serving hoosier healthwise, … · 2017. 10. 13. · anthem blue...

Anthem Blue Cross and Blue Shield

Serving Hoosier Healthwise, Healthy Indiana

Plan and Hoosier Care Connect

The Availity multi payer Web Portal

presented by Anthem and Availity

2017 Annual Workshop

Anthem Blue Cross and Blue Shield (Anthem)

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Serving Hoosier Healthwise, Healthy Indiana Plan

and Hoosier Care Connect

Agenda

• Healthy Indiana Plan (HIP) overview

• POWER Account Estimator Tool (screens and stops)

• Eligibility and Benefits Inquiry

• Availity navigation bar

• Administrator dashboard

• Payer spaces

• Availity ― Online PMP Member Listing Reports

• Additional training

• Anthem portal/crossover

• Availity Web Portal support

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HIP overview

• HIP was created to help fund health care benefits for adults who have

traditionally been uninsured. It is an affordable health insurance program from

the State of Indiana for uninsured low-income Indiana residents (ages 19 to

64).

• In the HIP program, the first $2,500 of medical expenses for covered benefits

(excluding preventive care) is paid with a special savings account called the

Personal Wellness and Responsibility (POWER) Account.

• The state pays most of this amount, but participants are responsible for paying

a small portion of their initial health care costs, based on their income.

Source: in.gov/fssa/hip/

http://www.in.gov/fssa/hip/

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POWER Account Estimator Tool

Effective July 2017, Anthem introduces the POWER Account Estimator

Tool.

Available through the Availity Web Portal, this new tool allows primary

medical providers the capability to provide HIP members with an

estimate for rendered medical services.

This tool helps your HIP patients keep track of their POWER Account

dollars and take personal responsibility for their wellness — key

components of the HIP program.

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Accessing the POWER Account Estimator Tool

The POWER

Account Estimator

Tool is accessed

through the Availity

Web Portal.

Simply log in as

you normally would

to access Availity.

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First step —eligibility verification

As always, the first step

is ensuring your

patients are eligible for

HIP benefits.

In Availity, select

Patient Registration

from the top menu bar,

then Eligibility and

Benefits Inquiry from

the drop-down menu.

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Eligibility verification

Once you select the Eligibility and

Benefits Inquiry link, the New Request

screen will appear, prompting you to

input provider and patient information.

For Patient ID, you can input the

Anthem ID number or the state recipient

identification number (RID) to verify

eligibility.

The HCID prefix or YRK must be

entered with the member ID or as a

prefix to the RID.

Select Submit.

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Eligibility and Benefits Results screen

When eligibility is

verified, the Eligibility

and Benefits Results

screen will appear

with your patient’s

information and

POWER Account

balance. Select

Create Healthy

Indiana POWER

Account Service

Estimate.

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Provider screen

To start the process of creating a service estimate, input the servicing

provider information. When done, select the Services button.

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Services screen

The Services screen

provides a simplified

list of office visit and

diagnosis categories

to choose from with

a description to

streamline the

selection process.

Select one office

visit category and

any diagnosis

categories that

apply.

When finished,

select the Estimate

button.

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POWER Account Service Estimate

The POWER

Account Service

Estimate provides

your patients with an

estimate of the

services rendered

and a new POWER

Account balance.

The estimate also

shows what services

were provided and

how the service

estimate process

works.

Remember!

Select Print

and present

the estimate

to your

patients for

their records.

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Availity navigation bar

Your

favorite

tools.

My Top Applications

are the ones you use

most frequently.

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Availity navigation bar (cont.)

Select the heart

symbol to choose

as one of your

favorite tools.

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Administrator dashboard

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Administrator dashboard (cont.)

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Payer spaces

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Payer spaces (cont.)

Toggle between

Applications

and Resources

to see all

available tools.

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Payer spaces (cont.)

With Resources,

you have

Anthem-specific

resources such

as companion

guides and links.

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Anthem portal/crossover

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Operational updates

Availity — online PMP Member Listing Reports

o PCP member: Listing_Indiana

o New program for provider online reporting

HIP, Hoosier Care Connect and Hoosier Healthwise reports

will be combined into the PMP Member Listing Report.

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Operational updates (cont.)

Availity — online PMP Member Listing Reports

o PCP member: Listing_Indiana

o New program for provider online reporting

Program name: Member Panel Listing

Description: The PMP Member Listing Report is available to

providers to view and download a complete list of past

and current Medicaid members that have been assigned

to a specific provider or group.

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Member Panel Listing: Description will be added to home

and program pages.

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Report Search

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If you have any

questions about the

program, all inquiries

can be directed

through our Contact

Us page.

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Additional training

To find helpful Availity training,

go to the top navigation bar and

select Help then Get Trained.

You will be redirected to our

Availity Learning Center.

Training options:

• Live webinars

• Recorded webinars

• Quick demonstrations

• Quick reference guides

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Availity Web Portal support

Anthem providers can:

• Update with additional information

• Change main contact person for ACS

to reply

• Ask for multiple email addresses to

be notified of response

• Attach files to support cases

• Reopen a closed support case within

14 days of it being closed (after 14

days, resubmit a new one).

Availity client services

1-800-282-4548• Up to 24-hour response time

• Worked internally by our ACS team

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Thank you

www.anthem.com/inmedicaiddoc

Anthem Blue Cross and Blue Shield is the trade name of Anthem Insurance Companies, Inc., independent licensee of

the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc.

The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield

Association.

AINPEC-1484-17 September 2017

Thank you for your partnership and serving our Hoosier Healthwise,

HIP and Hoosier Care Connect members.

anthem blue cross and blue shield serving hoosier healthwise, … · 2017. 10. 13. · anthem blue...

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