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Provider Portal Enhancements for Home Care Agencies

July 2023

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TABLE OF CONTENTS

Making the Provider Portal Work for You

Updated Training Material

Learn About Other Portal Features

Still Don’t Have a Portal Account?

Making the Provider Portal Work for You

Thank you for being an active partner in caring for our members.

 

Much of what you do by phone or fax can be done faster and more securely by using the provider portal. To streamline your transactions, we have begun enhancing our provider portal to allow you to:

  • Receive faster responses to your preauthorization requests. In some cases, approvals will be issued at the end of the transaction when you use the Submit Request button on the new screen.
  • See Available Units* right above Requested Units in the preauthorization request.
  • Enter attestations for home health aide and social worker services as part of the preauthorization request.

Here are some other key features and improvements you may not have seen. On the portal, you can:

  • Attach files up to 25 MB in size to your preauthorization requests.
  • Use Home Health Care Status Reports to see how many visits are approved for each of your patients in one convenient place.
  • See if payment was made on a claim, when and how payment was made, obtain copies of Explanations of Payments, and even create your own claims reports in Excel.
  • Find a member’s Care Plan if they are in a Care/Case Management program.

*Available Units represent the total number of home care visits the member’s benefits cover in the current plan year, less the number of home visits previously approved. If the prior request(s) is still pending, the units will show as being available.

Available = Visits Under Covered Benefit – Visits Authorized

EmblemHealth: Explore Now

 

Connecticare: Explore Now

Updated Training Material

We have recently updated our Outpatient Preauthorization Request Guide to show you how to use the enhanced transaction. We have also created new supplemental guides specific to:
  • Home Care.
  • Private Duty Nursing.

You can find these materials on the EmblemHealth and ConnectiCare Provider Portal Training Materials pages.

Learn About Other Portal Features

Whether you’re a first-time user who needs to set up an account or a regular user who wants to learn more, we have videos, step-by-step guides, and frequently asked questions (FAQs) to help you:

  • EmblemHealth Videos and Guides and FAQs
  • ConnectiCare Videos and Guides and FAQs

Still can’t find what you need? If you have a portal account, please use the Message Center to send us your questions. If the question is urgent or too complicated to write out, please call our Provider Customer Service team:

  • EmblemHealth: 866-447-9717
  • ConnectiCare: Commercial: 860-674-5850, Medicare: 877-224-8230

We appreciate your commitment to our members’ health. Keep an eye out for more email updates on our provider portal.

Still Don’t Have a Portal Account?

If you need a portal account, your organization’s portal administrator/office manager can set you up. In support of HIPAA compliance, we look to our providers to manage their own users.

 

If your organization needs to set up a master account for a new Tax ID, contact our Provider Customer Service team at:

  • EmblemHealth: 866-447-9717
  • ConnectiCare: Commercial: 860-674-5850  Medicare: 877-224-8230

We hope you take advantage of our provider portal and all the ways it can save you time.

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Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office. Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage.

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