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Bethany Dumond and Rachel DeSantis June 2017

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Presentation on theme: "Bethany Dumond and Rachel DeSantis June 2017"— Presentation transcript:

1 Bethany Dumond and Rachel DeSantis June 2017
MyPHP Bethany Dumond and Rachel DeSantis June 2017

2

3 Learning Objectives Self-registration log-in and password re-sets
Navigating the MyPHP web portal View and print Primary Care Physician Patient Rosters Verify Patient eligibility and coverage information View and download a Patient's benefit plan, documents and summary of benefits Search and view claims (status, amount paid, paid dates and claim history)

4 Learning Objectives Search, view, and print EOP’s, search by Check number Search prescription drug claims View the status of an authorization and obtain the prior authorization number View Patient's out of pocket or deductible balances Change Provider profile add addition NPI and TIN to one account

5 Self-Registration

6 Link to MyPHP! You can find the link to MyPHP on the PHP website

7 Self-Registration

8 Agreement Please read the License agreement and Click Agree to proceed

9 Self-Registration Complete the Provider Contact form and click Add
Can add more then one provider from this page if know all the information

10 Self-Registration After clicking add this screen will populate
You will now have the opportunity to add additional groups or providers simply fill in the additional information Click Add for each additional provider When done adding providers Click Next

11 Self-Registration Create your Username, Password, and Security Questions and click Next Must be at least 3 characters in length and start with a letter. Characters accepted are: alpha-numeric, . (dot), - (dash), _ (underscore) (at sign) Please enter your full address, for example, Password: Minimum 8 characters in length. One letter, One Number and One Special Character Required Special characters accepted are

12 Self-Registration Complete
You will receive a confirmation once you have completed your registration

13 How to log in

14 How to log in Enter your username and password in provided box and click Submit

15 Navigating the Home Page

16 Signed in as: listed here
Home Page Signed in as: listed here

17 Navigating the Home Page

18 PCP Patient Roster

19 PCP Patient Roster In the Coverage & Benefits tab PCP are able to obtain a PCP patient roster PHP will stop mailing Rosters after July. All Providers will be able to pull a full roster at any time on the MyPHP portal

20 PCP Patient Roster If you have more then one PCP under your login you will have to select which PCP provider roster you are searching To search one member enter member ID or Last name and DOB

21 PCP Patient Roster You are able to print or download your results into excel by clicking, “Print Results” or “Download Results”

22 Checking Coverage & Benefits
Click the second tab in the Navigation tool bar labeled Coverage & Benefits. Click on Open Eligibility & Benefits

23 Coverage & Benefits From the Coverage & Benefits screen you can search by single or multiple members Single members eligibility search: enter member ID, or Last Name and DOB Multiple members eligibility search: enter all member ID’s into the Member ID(s) box and click Search

24 Eligibility and Benefits
Click on the member name to show eligibility

25 Eligibility and Benefits

26 Eligibility and Benefits
MyPHP is real time data including: The current deductible Copayment amounts Effective date/Termination date

27 Claims

28 Claims Search with Member ID Search Check Number
Or search multiple claims just by entering the claim numbers in the Claim Number(s) box Now Click Search to view a list of claims

29 Claims A list of claims with the criteria you have entered appears. Click on the claim number to view details You are also able to download these result by Clicking Download Results

30 Claim Details Claim detail screen shows

31 Claims EOP Click on the Original EOP View to open the EOP

32 Claims EOP The EOP will open in a new window

33 Prescription Drug Claims

34 Prescription Drug Claims
Search by Patient ID, DOB, Begin Date or End Date Or search by Claim number Once the information is entered click Search to view claim details

35 Prescription Drug Claims
All Prescription Drug claim information will populate. Click on the RXNum to view claim details

36 Prescription Drug Claim Details

37 Prior Authorizations

38 Prior Authorization Search multiple Prior Authorizations at the same time, Simply push enter after each authorization number Real time data on approval or denial through portal View and print all details for the authorization

39 Prior Authorization Click on the Prior Authorization number that you are referencing All data will populate Dates of Authorization Servicing Provider Facility information Authorization Status

40 Prior Authorization

41 Prior Authorization

42 Provider Directory

43 Provider Directory you can search by Network and zip code these are required fields and you can narrow the search bt provider type and or specialty where to find this on the member card

44 Provider Directory Search for a Provider
Network HMO/POS, PHP Exclusive, PPO, and TPA Provider Type Specialty Zip Code Explain network and where to find this information on the members cards

45 Provider Directory

46 Provider Directory Download the results or Print if desired

47 Provider Directory Click on Provider name to display details

48 Provider Directory For SPHN member directory there is a link to the right find the click here for In Network Physicians in the SPHN network

49 Facility Directory Facilities Search Network and Zip code is required
Or Facility Type

50 Facility Directory Click on the Facility to see details

51 Provider Directory Details show Address Phone Number Networks
Type of Facility

52 Quick Links

53 Quick Links

54 Quick Link Newsletter Link

55 Quick Links General Forms and Information

56 Quick Link Ask a Question
These questions will be routed to a PHP representative for review

57 Message Response If you send a question through the Quick link tab you will get a response through the message tab

58 Quick Links Provider Manual

59 Quick Links Find a Provider or Facility

60 Provider Profile

61 Provider Profile The Profile tab allows you to update your account, security and information at anytime

62 Provider Profile Quick and Easy way to change your password

63 Provider Profile From the Profile screen you can add more then one NPI or TIN to your profile This is helpful for multiple groups under one TIN or IPA

64 Forgotten Password or Username

65 Forgotten Password or Username
Password reset is quick and simple Find the forgot your username or password on the home screen

66 Forgotten Password or Username
Enter TIN and NPI that corresponds with the account

67 Forgotten Password or Username
Answer a few security questions

68 Thank you!


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