Solutions
Provider Portal
Automating Provider Offices
Tools for the "Paperless Office" of the 21st Century Provider Organization
The provider portal gives physicians and their staffs the ability to tap into the AboveHealth
product suite and perform numerous efficiency and cost-saving functions.
The health plan's utilization management protocols can be incorporated into the program giving provider offices instant online service. Providers can submit and follow authorizations online and communicate with the plan via secure messaging regarding any authorization. Many times, an authorization response is given instantly without needing to wait days for a reply.
The program issues real-time answers from the health plan that benefit the provider, the referred-to provider, and the member.
The features built into the provider portal not only fit into the workflow of today's provider offices, they demonstrate value by reducing or eliminating many of today's manual, paper-intensive tasks.
Increased Productivity and Patient Satisfaction
AboveHealth creates an environment of simplified operations that increases productivity and results in better healthcare service. At any time, day or night, the provider portal enables healthcare professionals to interact with a health plan using nothing more than an internet connection and a web browser.
PROVIDER PORTAL ACTIVITIES:- View member eligibility and eligibility history
- Search member eligibility in batch mode
- View member benefits and validate coverage information such as co-pays, deductibles, and out-of-pocket amounts
- View member benefit accumulators and EOPs
- Review panel rosters and search for plan member details at any tme including their personal health record and health plan recommended interventions
- Submit professional and inpatient claims directly to health plan
- Check status of submitted claims whether the claims originated within AboveHealth or elsewhere
- Review claim payments and compare to the associated claim
- View provider scorecard on health plan-defined ratings categories such as clinical quality or member satisfaction
- Search online Provider Directory using a variety of search criteria
- Access news, documents, and other content provided by the health plan
Remittance Advice Search
Providers can search for claim payment information by a variety of search criteria, or they can narrow the search by entering specific search criteria.
Personal Health
Providers can search for a member's personal health records, and the dates of required immunizations are received, among several other things, by using a variety of search criteria. The search can be narrowed by entering specific search criteria.
Authorization List
Providers can search for an authorization using a variety of search criteria. Using the member search function, they can locate and specify a member for the authorization search. The search can be narrowed by specifying specific authorization information.
