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Provider Educational Seminar

Provider Educational Seminar. Provider Tools and Resources. 8/22/2014. Provider Tools & Resources: Provider Relations Department. Recruit providers to meet members’ needs Monitor network for adequacy, access, and appointment availability

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Provider Educational Seminar

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  1. Provider Educational Seminar Provider Tools and Resources 8/22/2014

  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 Presented by: Johns Hopkins HealthCare 8/22/2014

  3. Provider Tools & Resources:HealthLINK@Hopkins 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 Presented by: Johns Hopkins HealthCare 8/22/2014

  4. HealthLINK@Hopkins Priority Partners/EHP portal login USFHP portal login Presented by: Johns Hopkins HealthCare 8/22/2014

  5. HealthLINK@Hopkins Welcome back! 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. Start exploring by clicking the links to the left or the right. If you need any help, please contact your Provider Relations Network Manager or Provider Relations at 888-895-4998. Presented by: Johns Hopkins HealthCare 8/22/2014

  6. Provider Tools & Resources:Other Electronic Support Services • Electronic claims submittal • Partners with most major EDI clearinghouses. Payer IDs: 52189 (Priority Partners and EHP), 52123 (USFHP, Emdeon only) • Automated Voice Response Unit (AVRU) • Electronic Funds Transfer • Website: www.jhhc.com Presented by: Johns Hopkins HealthCare 8/22/2014

  7. Provider Tools & Resources:Provider Communications • Manuals (Priority Partners, EHP, USFHP ) • Line of business quick reference guides (Priority Partners, EHP, USFHP) • Lab & Rad guidelines (Priority Partners) • Outpatient Referral Guidelines (Priority Partners, EHP, USFHP ) • Quarterly newsletter: Across the Board • Formularies All are available on www.jhhc.com : Resources and Guidelines Presented by: Johns Hopkins HealthCare 8/22/2014

  8. Provider Tools & Resources:Contact information Provider Relations Department: • 1-888-895-4998 • www.jhhc.com for a list of network managers Presented by: Johns Hopkins HealthCare 8/22/2014

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