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5/3/2015 Provider Educational Seminar Provider Tools and Resources 5/3/2015.

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Presentation on theme: "5/3/2015 Provider Educational Seminar Provider Tools and Resources 5/3/2015."— Presentation transcript:

1 5/3/2015 Provider Educational Seminar Provider Tools and Resources 5/3/2015

2 Provider Tools & Resources: Provider Relations Department Recruit providers to meet members’ needs Monitor network for adequacy, access, and appointment availability Conduct orientation, provide on-site training, and host educational seminars on new programs and services Ensure providers have updated policy and procedure information Director, manager, supervisor, nine network managers, and five network coordinators ensure questions are answered and concerns are addressed quickly and efficiently 5/3/2015 Presented by: Johns Hopkins HealthCare

3 Features: Submit claims and search for existing claims Review and download electronic remittance advice Search for members based on name, member PCP name and DOB Run and receive reports such as member rosters Check the status of referrals and authorizations Directly enter referrals and certain services for prior authorization Correspond with customer service and care managers via secure messaging 5/3/2015 Presented by: Johns Hopkins HealthCare Provider Tools & Resources:

4 5/3/2015 Presented by: Johns Hopkins HealthCare Priority Partners/EHP portal login USFHP portal login

5 5/3/2015 Presented by: Johns Hopkins HealthCare Delivering quality medical services to our members is the hallmark of Johns Hopkins HealthCare, and we are dedicated to our providers who deliver these services. To streamline the process and assist you in meeting your patients’ – and our members’—needs, we are proud to offer this secure, online portal. Start exploring by clicking the links to the left or right. If you need any help, please contact your Provider Relations Network Manager or Provider Relations at Start exploring by clicking the links to the left or the right. Welcome back!

6 Electronic claims submittal  Partners with most major EDI clearinghouses. Payer IDs: (Priority Partners and EHP), (USFHP, Emdeon only) Automated Voice Response Unit (AVRU) Electronic Funds Transfer Website: 5/3/2015 Presented by: Johns Hopkins HealthCare Provider Tools & Resources: Other Electronic Support Services

7 Manuals (Priority Partners, EHP, USFHP )Priority PartnersEHPUSFHP Line of business quick reference guides (Priority Partners, EHP, USFHP) Lab & Rad guidelines (Priority Partners)LabRad Outpatient Referral Guidelines (Priority Partners, EHP, USFHP )Priority PartnersEHPUSFHP Quarterly newsletter: Across the Board Formularies All are available on : Resources and Guidelineswww.jhhc.comResources and Guidelines 5/3/2015 Presented by: Johns Hopkins HealthCare Provider Tools & Resources: Provider Communications

8 Provider Relations Department: for a list of network managerswww.jhhc.com 5/3/2015 Presented by: Johns Hopkins HealthCare Provider Tools & Resources: Contact information


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