We wanted to let you know there are going to be demonstrations on upcoming changes to our provider portal (see original announcements ConnectiCare | EmblemHealth) to help you receive quicker determinations. Please mark your calendars for one of the sessions listed below.
We will show you the new workflows for requesting preauthorizations and submitting elective inpatient admission notifications. You will also learn how to:
- Save draft requests and notices for 96 hours.
- Find drafts.
- Address clinical guidelines and supporting documentation.
We would like to make some recommendations to help you prepare for this new way of creating a request/notice.
You should make sure:
- Everyone who may contribute to a request/notice is set up with a provider portal account and assigned to the Administrator/Office Manager or Clinical Staff role.
- Workflows are in place so there are clear hand-offs and responsibilities defined so request/notice drafts are completed and submitted within the 96-hour time frame.
Note: To help you manage the new process, we will send an email to the person identified in a draft request/notice as the Contact to remind them that there are incomplete drafts that require their attention. We will also send them an email when any of their drafts expire.
- Workflows are in place for addressing expired drafts.
- Staff responsible for adding clinical information are trained on finding incomplete drafts, addressing clinical criteria, and attaching supporting documentation.
- Everyone is aware that the portal will not allow a request to be submitted without expected clinical criteria addressed and supporting documents attached.
- Everyone is aware that once a draft expires, a new request/notice will need to be entered.
Please join us during one of the Zoom sessions listed below. For the best experience, make sure you have Zoom on your computer or other device you will be using. Just click “Join the Meeting” for the one you want to attend five minutes before the session begins. In case you are prompted, included below are Meeting ID and Passcode for each session.
