OneHealthPort offers you a single easy-to-find location for online training. Whether you are new to OneHealthPort, new to your job, or an experienced user looking for new features, there a topic of interest for you in the
Training Center.
At OneHealthPort's Training Center, you will find video tours on a variety of subjects including:
Setting your OneHealthPort password
Special topics for OneHealthPort administrators
Health plan secure provider site features
Patient payment
Change management
Now there is a new resource to help your hospital or practice increase patient revenue collections: OneHealthPort’s
Patient Payment Library (requires a OneHealthPort userID to log in). Here you will find tools and resources—from work flow diagrams to job descriptions and scripts,
to patient communications and more—to help you change how your practice or hospital deals with patient payment. This new library is located on the WorkSMART site which is a secure site that requires a OneHelathPort login.
We know that right now, every dollar counts. Over the last few years, the patient's portion of the bill has been increasing, unfortunately most providers don't collect as much of this revenue as they could. In fact, Milliman estimates that between 2005 and 2015, patient out-of-pocket costs will increase almost 70% and providers will on average collect less than 50% of the amounts patients owe.
To help hospitals and practices increase their patient collections, OneHealthPort convened a work group of representatives from local practices and hospitals to review and compile best practices. OneHealthPort's Patient Payment Library contains the online tools, information and other resources compiled by the work group.
The Patient Payment Library contains a variety of materials including: (requires a OneHealthPort userID to log in)
Work flow diagrams
Job descriptions
Scripts
Policies and procedures
Reference material and patient communications
To use the library, first select the area of the library that's relevant to your organization:
Primary Care
Specialty Care
Hospital and ASC
Emergent
Once you select the setting, the materials are arranged in four areas of change management:
Captivate - Selling the idea for change
Assess - Knowing where to start
Change - Getting it done
Sustain - Making change last
In each of these sections, you will find tools and resources to help you change how your practice or hospital deals
with patient payment and ultimately increase patient revenue collections.
OneHealthPort is proud to offer HPM, a Web-based,
HFMA peer-reviewed suite of payment-assurance tools to simplify
cash, check, credit and debit card handling. HPM takes the headache and hassle out of collecting patient payables at the
point of service. This modular, Web-based tool offered by U.S. Bank can give you a new level of confidence about your
patients’ ability to pay – and your ability to collect.
With HPM, you can easily.....
Collect co-pays, deductibles, and self-pay balances at any Web-enabled computer in your facility.
Accept all standard forms of payment
Offer patient-friendly payment options - including automated payment plans!
Interested? Find out more. Click here to get information and hear how the Wenatchee Valley Medical Center streamlined
acceptance of credit cards and improved collections of patient payments with HPM.
More and more, patients are asking to know what their share of the cost of specific services will be up front. To help
you provide this information to patients, Premera’s new Real-Time Estimates/Claims tool is now available at
www.premera.com/provider. Just select “Submit Estimate/Claim” from the left navigation menu under “Tools”.
Contracted physicians and other professional providers can access the innovative new tool to help reduce
administrative expenses associated with collecting payments and allow patients to pay upfront for services.
The Real-Time Estimates/Claims tool has a number of features including:
User-friendly web-based technology
Real-time estimates of the patient's share of cost using most CPT and HCPCS codes
Print capability to provide a copy of the estimate to patients
Time-saving template option for your most common services
Option to submit claims in real-time (upon request)
Comprehensive help file with answers to common questions about navigation and functionality
The calculation is completed within seconds and the response is based on current contract pricing for each specific
physician or provider; patient eligibility and benefit plan; patient deductible, coinsurance or co-pay; and accumulators
met to date and out of pocket maximum.
Still submitting paper claims because you don’t want to pay for a clearinghouse? Office Ally offers a free and
easy way to submit claims electronically from a web browser application if you don’t have a practice management
system. Office Ally also offers a free hosted practice management service called Practice Mate that further simplifies
electronic billing.
Already submitting claims with Office Ally? You can now call (866) 575-4120 24 hours a day, 7 days a
week with your support questions or email Support@OfficeAlly.com.
The process for submitting electronic claims to Healthcare Management Administrators (HMA) has changed. To expedite
claims processing, instead of submitting these claims within your Regence electronic claims file, you should now submit
them to Availity® with the Payor ID HMA01. The claim should include the three-digit prefix and the subscriber number
listed on the member’s card.
Continue to mail paper claims to: Healthcare Management Administrators, Inc. , P.O. Box 85008, Bellevue, WA 98015.
Reimbursement for the HMA Preferred plan is the same as Regence BlueShield Preferred and/or Participating plan networks.
HMA is a third-party administrator providing benefit administration to over 100 self-funded employers primarily located
in Oregon and Washington. Additional information, such as member benefits, the status of submitted claims and a provider
directory, is available on HMA's Provider Services Portal.
You now have the option of electronically submitting corrected professional claims to Regence. The correction must:
• Include code source “235” Claim Frequency Type Code
• Be submitted in an American National Standards Institute (ANSI) 837 Health Care Claim transaction
• Include the appropriate code in ANSI 837, loop 2300, CLM05-03 “Claim Frequency Type Code” READ MORE
The Claim Frequency Type code specifies the frequency of the claim. The third position of the Uniform Billing Claim Form
Bill Type should be used as follows:
1 - ORIGINAL (this is the first submission of the claim)
6 - CORRECTED Adjustment of Prior Claim
7 - REPLACEMENT Replacement of Prior Claim
8 - VOID Void/Cancel of Prior Claim
If you are submitting a correction to a hospital claim, please use code 7 Replacement of Prior Claim as the third digit
in the Type of Bill code and indicate all changes in the remarks field.
If you send your correction on paper, please help us identify the claim quickly and route it to the appropriate area
for reprocessing by using the Corrected Claim Cover Sheet, available on our Provider Web Site in the Provider Library
section, under Forms. Identifying the claim as a correction allows us to process it correctly and prevents it from being
denied as a duplicate.
Several new health plans will soon be offering access to their secure portals through OneHealthPort. KPS Health Plans,
CIGNA, and Molina will be OneHealthPort’s newest additions. Remember - you will need a free OneHealthPort credential to access these new services.
KPS Health Plans Coming Online Soon
Coming soon! KPS Health Plans will offer a secure web portal, available through OneHealthPort, for its participating
providers.
The site will offer providers information about members enrolled in KPS Health Plans, including:
Eligibility - plan effective dates and basic demographic information
Benefits - deductible and benefit limit accumulators
Claims - claims status inquiry
Reference materials - provider manual and newsletters
CIGNA Coming Online Soon
Coming soon! CIGNA will offer health care professionals direct access to the secure CIGNA for Health Care Professionals
(CHCP) web site through OneHealthPort.
The site will allow users to:
Access eligibility and benefits and claims status information
Generate personalized estimates of a covered individual's out-of-pocket costs for that service/treatment
View claim coding policies and payment guidelines
Inquire about covered services
Review CIGNA medical or pharmacy coverage positions
View the pharmacy drug list
Access provider reference guides
Access claim payment appeal forms, procedures, and addresses
Molina Healthcare Available Soon on OneHealthPort
Molina Healthcare of Washington, Inc. is very excited to announce that participating providers will soon be able to
access ePortal through OneHealthPort!
Some of the features available on the Molina ePortal are:
Eligibility look-up
Prior authorization submission
Claim submission
Eligibility lists for PCP's
CPT prior authorization look-up
Claim payment history
Authorization history
Provider Network look-up
If you have any questions about Molina's ePortal, please call your Provider Services Representative at 800-869-7165.
OneHealthPort News is published quarterly. Look for periodic "OneHealthPort Update" emails for timely information between issues. Questions or comments? Email newsletter@onehealthport.com.
Copyright © 2007 OneHealthPort. All Rights Reserved. This newsletter produced by OneHealthPort and Aukema & Associates.
