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University of Maryland Health Advantage
Effective January 1, 2016
Agenda
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- Introduction
- History
- ProviderConnectSM Overview
- Resources
- Contact Info
- Questions
University of Maryland Health Advantage
Maryland Health Advantage Effective January 1, 2016 Agenda - - PowerPoint PPT Presentation
Maryland Health Advantage Effective January 1, 2016 Agenda - - PowerPoint PPT Presentation
University of Maryland Health Advantage Effective January 1, 2016 Agenda Introduction History ProviderConnect SM Overview Resources Contact Info Questions University of Maryland Health Advantage 2 History University
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SLIDE 3
History
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University of Maryland Health Advantage
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History
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- On May 24, 2015 University of Maryland Medical System
acquired Riverside Health, Inc.
- Riverside Advantage, Inc. is Riverside’s Medicare Advantage
subsidiary, a Maryland Managed Care Organization (MCO)
- Launched Medicare Advantage line of business January 1,
2016 called UNIVERSITY OF MARYLAND HEALTH ADVANTAGE (UMHA)
University of Maryland Health Advantage
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Membership Overview
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13 of the 24 Maryland Counties Anne Arundel Baltimore Baltimore City Caroline Carroll Cecil Dorchester Harford Howard Kent Montgomery Queen Anne’s Talbot
University of Maryland Health Advantage
- Anticipated Membership: 10,000 to 12,000 lives by end of year
2016
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ProviderConnect Overview
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University of Maryland Health Advantage
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ProviderConnect - Overview
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Services of ProviderConnect:
- Verify member benefits and eligibility
- View and print forms
- Request and view authorizations
- Download and print authorization letters
- Submit claims and view status
- Access Provider Summary Vouchers
(PSV)
- Request payment for EAP services
- Submit EAP case activity forms (CAF)
- Submit updates to provider
demographic information
- Submit recredentialing applications
- Submit customer service inquiries
- Access ProviderConnect message
center
University of Maryland Health Advantage
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ProviderConnect - Benefits
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Free and secure online application, available 24 / 7 Reduces paper files Mobile Device friendly Reduces the need to call for routine information Quicker Payment Mac and Windows compatible INCREASED CONVENIENCE, DECREASED ADMINISTRATIVE PROCESSES
University of Maryland Health Advantage
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ProviderConnect - Claim Submission
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- Accepts claims files from any Practice Management System
- utputting HIPAA formatted 837p or 837i batch files, and from
EDI claims submission vendors
- Offer Direct Claims Submission on website to providers who do
not have own software or who wish to submit certain claims
- utside their batch files
- These claims are processed immediately, and you are provided the
claim number
- You may submit batch claims files or Direct Claims interchangeably
- No charge for electronic claims submission
- Access to support:
- http://www.valueoptions.com/providers/Provider_Connect.htm
- EDI Helpdesk: 888.247.9311 between 8:00 a.m. – 6:00 p.m. ET
University of Maryland Health Advantage
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How to Access ProviderConnect
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- Go to www.ValueOptions.com,
choose “Providers”
- Existing users select “Log In”
- New users can click “Getting
Started” to self register using provider ID number
- Multiple logons from same provider
ID number available
University of Maryland Health Advantage
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Role-Based Security: Features
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- Allows administrator (Super User) for ProviderConnect
accounts who can:
- Create new users
- Manage existing users
- Deactivate accounts
- Password Verification
- Required for first time login users
- Increased security for new accounts created by Super User
- Managed user can change password
University of Maryland Health Advantage
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ProviderConnect Webinars
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- Scheduled monthly or as needed
- Topics include: high level overview, authorizations, claims,
enhancements, etc.
- Upcoming ProviderConnect Webinars:
- An Overview of ProviderConnect
- Wednesday, 1/20/16 from 2:00 p.m. – 3:00 p.m.
- Authorizations on ProviderConnect
- Thursday, 2/4/16 from 2:00 p.m. – 3:30 p.m.
- Registration available by clicking “Education Center” from the
Provider Homepage
- Additional webinars may also be offered for particular contracts, so
bookmark or visit Network Specific pages as needed.
University of Maryland Health Advantage
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ProviderConnect Resources
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- Free demonstration:
http://www.valueoptions.com/PMC_prototype/ProviderConnect/pvd.html
- Quick Start Guide and Comprehensive User Guide
- Short Video Tutorials:
- Viewing Member’s Eligibility
- Viewing and Submitting Authorizations
- Direct Claim Submission Process
- Batch Claim Submission Process
- Recredentialing
- Personal assistance available
- Contact the EDI Help Desk for more information
University of Maryland Health Advantage
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Additional Resources
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- University of Maryland Health Advantage Network Specific
Page: http://www.valueoptions.com/providers/Network/University-of- Maryland-Health-Advantage.htm
- Achieve Solutions:
https://www.achievesolutions.net/achievesolutions/en/umha/Ho me.do
- Claims Mailing address:
Beacon Health Options, Inc. P.O. Box 1347 Latham, NY 12110 *We encourage all providers to submit claims via ProviderConnect
University of Maryland Health Advantage
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Contact Information
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University of Maryland Health Advantage
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Contact Us
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University of Maryland Health Advantage Customer Service (Claims, Authorizations, Referrals) Monday through Friday, 8:00 a.m. – 8:00 p.m. ET Phone: 888.397.3887 Provider Service Line (Credentialing and Contracting) Monday through Friday, 8:00 a.m. – 8:00 p.m. ET Phone: 800.397.1630 EDI Helpdesk (ProviderConnect Technical Questions) Monday through Friday, 8:00 a.m. - 6:00 p.m. ET Phone: 888.247.9311 Email: e-supportservices@beaconhealthoptions.com
University of Maryland Health Advantage