Release Communication - Availity · 21-07-2018 · BCBSWY, TAHP, etc.) for more payer - specific...

Availity Portal and Basic Clearinghouse

Release Communication © Availity, LLC. All rights reserved | Page 1 of 32

July 21, 2018

ReleaseCommunication

Release Communication



July 21, 2018

Table of ContentsAvaility Portal Enhancements

When noted and for the purpose of this release communication only, Availity refers to the following organizations by informal name:

• Humana Inc. – Humana• Blue Cross and Blue Shield of Minnesota, Inc. – BCBSMN• Health Care Service Corporation – HCSC or individually BCBSIL, BCBSNM, BCBSOK, BCBSTX• Anthem, Inc. – Anthem or individually Anthem – CA, Anthem – CO, Anthem – CT, Anthem – IN, Anthem – KY, Anthem – ME, Anthem – MO, Anthem – NH, Anthem – NV,

Anthem – OH, Anthem – VA, Anthem – WI, BlueCross BlueShield of Georgia (BCBSGA), Empire BlueCross – NY, Empire BlueCross BlueShield – NY

GeneralCalifornia ● Colorado ● Connecticut ● District of Columbia ● Florida ● Georgia ● Indiana ● Iowa ● Kansas ● Kentucky ● Louisiana ●Maine ● Maryland ● Missouri ● Nevada ● New Hampshire ● New Jersey ● New Mexico ● New York ● Ohio ● Tennessee ● Texas ●Virginia ● Washington ● WisconsinColoradoIdaho ● Oregon ● Utah ● Washington

EDI Implementations

EDI Payer Name Changes

EDI Cancellations

MinnesotaNew York ● Virginia

Availity Basic Clearinghouse Enhancements

Table of Contents

B2B Implementations

B2B Payer Name Changes

B2B Cancellations

TennesseeTexas



July 21, 2018

The following Availity Portal enhancements, and any Availity Help topic updates, are available with the release.

To access Availity Help, click Help & Training | Find Help at the top of the Availity Portal.

If you do not see these enhancements upon login, ask your Availity administrator to grant you access to the feature. To identify your administrator, click your name in the top navigation bar, and then click My Administrators on the My Account page.

Note: These enhancements do not apply to Availity Revenue Cycle Management.

Availity PortalEnhancements


Availity Portal Enhancements



July 21, 2018

On-Demand Training UpdatesCheck out new or updated training programs, demos, and webinar recordings in the Availity Learning Center (ALC). To access these on-demand learning options:

1. Click Help & Training | Get Trained at the top of the Availity Portal.

2. In the ALC, search by words in a title, search by unique keyword, or filter by a category related to the demo or webinar recording you are interested in.

AVAILITY PORTAL – GENERAL

Looking for training demos?Check out some options.

• Administrator onboarding• Appeals• Claim status• EDI clearinghouse and gateway• Eligibility and benefits inquiry• Express entry• New user onboarding• Remittance solutions

New to Availity? Select Help & Training | My Learning Plan to build your customized learning plan.

Registered with Availity as a dental provider?Explore some training options dedicated to your needs.

• Getting Started for Dental Providers• Administrator training for dental providers• Dental claim, encounter, and pre-determination submission• Secondary and tertiary claims• Dental claim status

Providers with Anthem, Empire, BCBS Georgia, Golden West, and UniCare, check out these additional options.

• Register for an upcoming live webinar.• In Payer Spaces, access more dental-focused training including a

Payer Spaces features overview and dental attachments.

Need on-demand training focused on specific payers? Check out new or recently updated on-demand options.

• Introduction to Availity Portal for Anthem Providers in Missouri BCBSMN Referral Submission and Follow-up

• For BCBSND Providers – Availity’s FAQs Training – On-Demand

Tip: Search the catalog by keyword (i.e. BCBSTN, Florida Blue, Humana, BCBSND, BCBSWY, TAHP, etc.) for more payer-specific options.

Live Training Webinar SessionsJoin an upcoming live webinar session. Here’s how. Explore these upcoming sessions and more. Check out this medical attachments webinar.

1. Click Help & Training | Get Trained at the top of the Availity Portal.

2. In the Availity Learning Center, click Sessions and use the interactive calendar to find the live session you are interested in.

Viewing this information electronically?Use this link to save steps. You’ll be prompted to log in to the Availity Portal, and then redirected to the live sessions calendar in the Availity Learning Center (ALC).

• Availity Administrator Training• Availity Appeals (for Colorado BH providers)• Using Availity ERA and claim follow-up tools• Submit claims electronically with Availity's direct data

entry claim forms• Intro to Availity Gateway EDI Solutions• Intro to Availity EDI Gateway Services for Anthem

Provider Organizations

Are you a provider with Anthem Blue Cross in CA, Blue Cross and Blue Shield of Georgia, and Anthem BCBS plans in CO, NV, IN, KY, OH, MO, or WI? Search the catalog by keyword MEDATT and look for this title: Send Supporting Documentation using Availity’s Medical Attachments Tools – Live Webinar.

https://availity.webex.com/availity/onstage/g.php?PRID=bab6dd9645fa22f66fd698ec497b93a1

https://urldefense.proofpoint.com/v2/url?u=https-3A__apps.availity.com_public_apps_home_-23-21_newPage-3FappUrl-3D-252Favaility-252FSSOLinkoutServlet-253FtranType-253D250-2526redirectParam-253Dredirect-5Furi-2526redirectPath-253D-25252Fcatalog-25252Filt-2Dsessions&d=DwMFAg&c=A-GX6P9ovB1qTBp7iQve2Q&r=KzACJd7b-HZafu_pOk68WkG4-Xk19LUcz5oozgXKdUc&m=asouewSodeQMzzeX6DEQZU4MYvetYYEtJJrRTSG3444&s=-9UO156WnphjBNxb2aasw5Ygb22ZRejy3W_8ELlBKyA&e



July 21, 2018

Healthcare Industry TrainingThe Availity Learning Center offers training on a wide variety of healthcare topics:

• Coding• Customer service• HIPAA and compliance – learn more• OSHA and general safety

Featured courses:• Become a Revenue Cycle Expert with Elizabeth Woodcock• Transforming Your Practice in a Value-Based World with Denny Flint

Purchase the series for a discount or click an individual course name in the series description to register for one course.Use discount code LEARNMORE10 to save an additional 10%.


To enroll:1. Click Help & Training | Get Trained at the top of the Availity Portal.

2. In the Availity Learning Center, click Catalog in the upper left, and then click Store in the drop-down menu.

https://availitylearning.learnupon.com/store?utf8=%E2%9C%93&st=hipaa&commit=

https://availitylearning.learnupon.com/store?utf8=%E2%9C%93&st=revenue+cycle&commit=

https://availitylearning.learnupon.com/store?utf8=%E2%9C%93&st=value-based&commit=



July 21, 2018


Additional Payers Available for Availity Portal TransactionsAvaility is pleased to announce the following payers are now available for the specified transactions on the Availity Portal:

Payer Name RegionsEligibility & Benefits Inquiries

Claim Status

Inquiries

Professional Claims

Facility Claims

Encounter Claims Remittance Referrals Authorizations

Colorado Community Health Alliance

Colorado



July 21, 2018


From within the Availity Portal, account administrators can now create the account that will be used for accessing the FTP mailbox for an organization, and they can change the password on an existing FTP account.

FTP Mailbox Self-Service

ACCESS THIS FEATURE

1. At the top of the Availity Portal, click Claims & Payments | FTP and EDI Connection Services.

2. On the FTP and EDI Connections Services page, click Manage Your FTP Mailbox.

3. The Manage Your FTP Mailbox page displays, which allows you to create and manage mailbox credentials.

For more information, see the section Manage File Transfers in the Availity Health Information Network, in the EDI Companion Guide, which you can now access from the FTP and EDI Connection Services page.

NOTE: You can also access the FTP and EDI Connection Services page from the My Account Dashboard tab on the Home page.

https://apps.availity.com/public/apps/home/#!/loadApp?appUrl=%2Favaility%2Fdocuments%2Fedi%2520guide%2Fedi_guide.pdf



July 21, 2018


Aetna providers will now be able to select Telehealth as the Place of Service, when submitting a referral request.

New Telehealth Option for Place of Service for Aetna Referral Requests



July 21, 2018


When you check the eligibility and benefits of an Aetna member, Aetna’s address now displays in the Other Source of Data section on the Patient Information tab of the eligibility and benefits results.

The address is used for sending billing information to Aetna.

Payer Address in Aetna E&B Results



July 21, 2018

AVAILITY PORTAL – CA ● CO ● CT ● DC ● FL ● GA ● IN ● IA ● KS ● KY ● LA ● ME ● MD ● MO ● NV ● NH ● NJ ● NM ● NY ● OH ● TN ●TX ● VA ● WA ● WI

Providers assigned with the Office Staff role can now attest and submit Comprehensive Health Assessment forms.

Previously, only users assigned with the Medical Staff role could attest and submit Comprehensive Health Assessment forms.

This enhancement applies to the following payers:

• Amerigroup

• Anthem BlueCross BlueShield

• BlueCross BlueShield of Georgia

• Empire BlueCross

• Empire BlueCross BlueShield

Comprehensive Health Assessment -Allow Office Staff Role to Submit Forms

In the payer’s payer space, click Comprehensive Health Assessmentand then open a form from the Comprehensive Health Assessment Work Queue page.

HOW WILL I ACCESS THIS?



July 21, 2018

AVAILITY PORTAL – COLORADO

Availity is pleased to announce that, as of 7/1/2018, Colorado Community Health Alliance providers have Availity Portal access to the services and features listed in the table on the right.

Colorado Community Health Alliance now Available in the Availity Portal

NAME AND DESCRIPTION STEPS TO ACCESS

Eligibility and Benefits Inquiry

Verify eligibility for a patient and confirm the benefits covered under the member's contract.

Note: Requires the Eligibility and Benefits role.

1. Click Patient Registration | Eligibility and Benefits Inquiry.

2. Complete and submit the inquiry.

Claim Status Inquiry

View claim status and review results for claims that the payer adjudicated.

Note: Requires the Claim Status role.

1. Click Claims & Payments | Claim Status (New). 2. Select the organization associated with the claims you want

to research, select the payer, and then click Continue.

3. Enter search criteria in the fields provided, and then click Submit.

Professional and Facility Claims

Submit electronic professional claims or facility claims.

Note: Requires the Claims role.

Click Claims & Payments, and then click either Professional Claim or Facility Claim.

Authorization Requests

Submit an authorization request.

Note: Requires the Authorization and Referral Request role.

1. Click Patient Registration | Authorizations & Referrals.

2. Click Authorizations.

3. Complete and submit the request.

Authorization Inquiry Requests

Submit an authorization inquiry request.

Note: Requires the Authorization and Referral Inquiry role.

1. Click Patient Registration | Authorizations & Referrals.

2. Click Auth/Referral Inquiry.

3. Complete and submit the request.

Payer Spaces Click Payer Spaces | Colorado Community Health Alliance.



July 21, 2018

AVAILITY PORTAL – IDAHO ● OREGON ● UTAH ● WASHINGTON

Regence providers will now need to enter their FAX number when they’re creating an authorization request.

The field for entering the FAX number is on step 5 (Review and Submit) of the Authorizations wizard.

FAX Number Now Required for Regence Authorizations

This feature applies to the following payers:

• Asuris Northwest Health

• Bridgespan

• Regence BlueShield

• Regence BlueShield of Idaho

• Regence BlueCross Blue Shield of Oregon

• Regence BlueCross BlueShield of Utah



July 21, 2018

AVAILITY PORTAL – IDAHO ● OREGON ● UTAH ● WASHINGTON

When submitting authorization requests, Cambia providers can now attach files with sizes up to 60MB.

Attach Larger Files to Authorizations for Cambia

This feature applies to the following payers:

• Asuris Northwest Health

• Bridgespan

• Regence BlueShield

• Regence BlueShield of Idaho

• Regence BlueCross Blue Shield of Oregon

• Regence BlueCross BlueShield of Utah



July 21, 2018

AVAILITY PORTAL – MINNESOTA

When creating an outpatient authorization request, Blue Cross Blue Shield of Minnesota providers will be able to automatically populate the information for the rendering provider with the information from the requesting/ordering provider.

Auto-populate Rendering Provider Info with Requesting Provider’s Info

HOW IT WORKS1. On step 3 (Rendering

Provider/Facility) of the Authorizations wizard, select Provider for the provider type.

2. Select Use Requesting Provider Information.



July 21, 2018


On the eligibility and benefits results for BCBSMN, Availity has made the following changes to the Find Network Provider feature:

• The Find Network Provider link now directs you to a new URL. Although the URL has changed, you will receive the same great service as before.

• The Find Network Provider link no longer displays for patients with inactive health plan memberships.

Changes to Find Network Provider Feature on BCBSMN E&B Results



July 21, 2018


When creating an authorization request, Blue Cross Blue Shield of Minnesota providers will be routed to Evicore (via SSO) to complete the authorization request for particular service types.

Access Evicorefrom Authorizations app for Blue Cross Blue Shield of Minnesota

NOTE: If no new tab or window has opened, please turn off your browser’s pop-up blocker and click Next again.



July 21, 2018

AVAILITY PORTAL – NEW YORK ● VIRGINIA

The HEDIS Attestation for Maternity form is now available for the following providers in New York and Virginia:

• Anthem Virginia

• BlueCross BlueShield of Western New York

• Empire BlueCross

• Empire BlueCross BlueShield

Providers can capture a patient’s answers to HEDIS attestation for maternity questions on the patient’s eligibility and benefits response and the HEDIS Attestation for Maternity form.

HEDIS Attestation for Maternity Now Available for Additional Anthem/Amerigroup Payers

In the payer’s payer space, click HEDIS Maternity and then open a form from the payer's HEDIS Attestation for Maternity Work Queue page.

HOW WILL I ACCESS THIS?



July 21, 2018

AVAILITY PORTAL – TENNESSEE

COMING AUGUST 1!

You will be able to access the Fast Path customer service number from the eligibility and benefits results for BCBS Tennessee members.

ACCESS FAST PATH CUSTOMER SERVICE INFORMATIONOn the Eligibility and Benefits results page, click Send Message to Payer, and then click Call the Payer (Fast Path).

The Fast Path telephone number and transaction ID display in a separate window. When you contact BCBS Tennessee, reference the Fast Path transaction ID displayed in the window.

BCBS TennesseeFast Path Phone Number Available in E&B Results

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July 21, 2018


COMING AUGUST 1!

You will also be able to access the Fast Path customer service number when you complete a feedback survey from the eligibility and benefits results for a BCBS Tennessee member.

ACCESS FAST PATH CUSTOMER SERVICE INFORMATION1. On the Eligibility and Benefits results

page, click Give Feedback.

2. Complete the fields in the feedback window, and then click Send Feedback.

The Fast Path telephone number and transaction ID display in a separate window. When you contact BCBS Tennessee, reference the Fast Path transaction ID displayed in the window.

BCBS TennesseeFast Path Phone Number Available in E&B Results

2 of 2

1

2



July 21, 2018


Availity has added a Print button to the top of the Prior Authorization Requirements window accessed from the BCBS Tennessee eligibility and benefits information.

You can now print the prior authorization requirements without having to scroll to the bottom of the window.

Print Button Added to Prior Authorizations in BCBS TennesseeE&B Results



July 21, 2018


When submitting a claim status request to BCBS Tennessee, if you select a provider who does not have an NPI in the Express Entry field, the provider’s payer-assigned provider ID is now populated in the Provider Id field.

Provider ID in BCBS TennesseeClaim Status Requests

The Provider Id field is populated with the payer-assigned provider ID defined for the provider using the Express Entry app.



July 21, 2018

AVAILITY PORTAL – TEXAS

In the provider credentialing app, you can now terminate credentialing applications that are in progress but have not been submitted.

When you terminate a credentialing application, the application is removed from the Provider Credentialing dashboard.

TERMINATE A CREDENTIALING APPLICATION1. On the Provider Credentialing

dashboard, click next to the application you want to terminate, and then click Terminate Application.

2. Click Delete in the Terminate Application window.

Terminate a Credentialing Application

1

2



July 21, 2018

AVAILITY PORTAL – TEXAS

Availity has made several enhancements to the provider credentialing app to improve your experience using the app.

Some examples of these enhancements include the following:

A. Various questions/choices that were displayed as check boxes are now displayed as Yes/No options.

B. On a practitioner application, the Work History section now displays a set of fields for each employment gap that exceeds six months. Previously, the section displayed only one set of fields even if there were multiple employment gaps that exceeded six months.

C. The Personal Information section (practitioner applications) and Facility Information section (facility applications) now display the insurance disclosure questions only once. Previously, these sections displayed the questions for each insurer listed on the application.

Credentialing App Enhancements

A

B

Before Now

C Practitioner Applications

Facility Applications



July 21, 2018

The following EDI clearinghouse enhancements are either currently available, or will soon be available. For assistance or additional information on any of these enhancements, please contact Availity Client Services at 1.800.AVAILITY (282.4548).

For more information, access Availity’s EDI Guidelines.

Note: These enhancements apply only to the Availity Basic Clearinghouse and do not apply to Availity Revenue Cycle Management.

BasicClearinghouse


Basic Clearinghouse



July 21, 2018

BASIC CLEARINGHOUSE – EDI IMPLEMENTATIONS

EDI ImplementationsThese payers are now available for the transmission of certain EDI transactions via Basic Clearinghouse:

PAYER NAME PAYER ID 270 276 278 837P 837I 837E 837D 835

BENEFIT INC. R7003

COLORADO COMMUNITY HEALTH ALLIANCE

COCHA

DECARE DENTAL HEALTH INSURANCE

07035

DECARE FEP DENTAL BCAFD

DELTA DENTAL OF MINNESOTA

07000

DELTA DENTAL OF NORTH DAKOTA

07029

EMPIRE DENTAL 55093

FLEX COMPENSATION R7004



July 21, 2018

BASIC CLEARINGHOUSE – EDI IMPLEMENTATIONS

EDI ImplementationsThese payers are now available for the transmission of certain EDI transactions via Basic Clearinghouse:


HORIZON – BCBS OF NJ 22099

MEDICA DENTAL 07031

SECURIAN DENTAL 93742

WILSON MCSHANE R7002

ZENITH ADMINISTRATION

R7001



July 21, 2018

BASIC CLEARINGHOUSE – EDI PAYER NAME CHANGES

EDI Payer Name ChangesThis payer’s name has changed for the transmission of certain EDI transactions via Basic Clearinghouse:

OLD PAYER NAME NEW PAYER NAME PAYER ID

AETNA BETTER HEALTH ASCENSION HEALTH A0015

BLUECROSS BLUESHIELD OF WESTERN NEW YORK

BLUECROSS BLUESHIELD OF WESTERN NEW YORK MEDICAID

BCBSCAIDWNY and 00246



July 21, 2018

BASIC CLEARINGHOUSE – EDI CANCELLATIONS

EDI CancellationsThese payers are no longer available for the transmission of certain EDI transactions via Basic Clearinghouse:

PAYER NAME PAYER ID EXPIRATION DATE 270 276 278 837P 837I 837E 837D 835

AMBAY HEALTH NETWORK

AMBHN 7/1/2018

EQUITABLE PLAN SERVICES

73126 6/21/2018

IMAGINE HEALTH 43123 5/30/2018

INTERCARE HEALTH PLANS INCORPORATED

37227 6/26/2018

SCAN LONG TERM CARE

20460 6/20/2018

SOUTHLAND IPA SIPA1 7/1/2018

UNIVERSAL CARE CALIFORNIA

SPUCC 5/30/2018



July 21, 2018

BASIC CLEARINGHOUSE – B2B IMPLEMENTATIONS

B2B ImplementationsThis payer is now available for the transmission of certain B2B transactions via Basic Clearinghouse:


BCBS NORTH DAKOTA 55891

COLORADO COMMUNITY HEALTH ALLIANCE

COCHA

HEALTHPARTNERS 07003



July 21, 2018

BASIC CLEARINGHOUSE – B2B PAYER NAME CHANGES

B2B Payer Name ChangesThis payer’s name has changed for the transmission of certain B2B transactions via Basic Clearinghouse:

OLD PAYER NAME NEW PAYER NAME PAYER ID

BLUECROSS BLUESHIELD OF WESTERN NEW YORK

BLUECROSS BLUESHIELD OF WESTERN NEW YORK MEDICAID

BCBSCAIDWNY and 00246



July 21, 2018

BASIC CLEARINGHOUSE – B2B CANCELLATIONS

B2B CancellationsThese payers are no longer available for the transmission of certain B2B transactions via Basic Clearinghouse:

PAYER NAME PAYER ID EXPIRATION DATE 270 276 278 837P 837I 837E 837D 835

ARBOR HEALTH PLAN ARBOR 5/30/2018

UNIVERSAL CARE CALIFORNIA

SPUCC 5/30/2018



July 21, 2018

Contact AvailityAvaility is committed to providing you with comprehensive customer service and enhancements that make your Availity experience a more enjoyable one.

For questions, send an e-mail message to us using the Contact Us page. We look forward to hearing from you!

Call us at 1.800.AVAILITY (282.4548).

Contact Availity

http://www.availity.com/about-us/contact-us/

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Release Communication - Availity · 21-07-2018 · BCBSWY, TAHP, etc.) for more payer - specific...

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