In response to feedback from provider portal users, we made a few adjustments to the new workflow for saving draft preauthorization requests and emergent inpatient admission notifications.
Time Frame Change: Drafts Will Be Saved For 120 Hours
We will be expanding the time frame for saving draft preauthorization requests and emergent inpatient admission notifications to 120 hours.
Enter The NPI When Searching For Drafts
On the Incomplete Preauthorization Requests & Emergent Inpatient Admission Notifications screen, we added a field to enter the requesting or servicing provider’s/facility’s NPI to narrow down the number of drafts shown.
Expanded Provider Search
We expanded the provider search within the Preauthorization Requests and Emergent Inpatient Admission Notifications by lifting the requirement that the user and provider be linked under the same tax ID. This will help our ancillary providers submit requests for their services on behalf of a doctor or other practitioner.
Don’t Forget to Hit Submit
We noticed that some providers enter all the required information for a request/notice, but then do not actually submit the request/notice. You MUST click the Submit button on the bottom of the MCG screen to send us your request/notice.
Select The Correct Category and Sub-Category for Grievances and Appeals
To help us get your grievance or appeal to the right staff faster, look up the specific claim or preauthorization request you wish to dispute on the provider portal. On the Claims Details page or the Preauthorization Details page, use the Ask a Question button to create a message. Be sure to select the following:
Category: Grievance and Appeals
Sub-Category: Post Service Appeal
You can look up a claim and use the Ask a Question feature on the Claims Details page to:
- Request claims status.
- File a grievance; a claims dispute that does not involve a medical necessity decision.
- Respond to a claims denial request to submit records or other supporting documentation.
Note: The provider portal cannot accept corrected claims.
