Anthem Secure Mailbox Setup

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What is Secure e-Review

 Secure e-Review is a way for providers and facilities to relay information

electronically to Anthem for pre-authorizations

 No need to fax or phone.

 The user just needs internet access and a work e-mail address

 Replies from the Anthem Utilization Management area will also be returned

electronically (Hard copy decision letters are still mailed)

 Secure e-Review is HIPAA compliant

 It is free – no cost to the provider

 Anthem e-Review is only for certain Anthem member’s. It CAN NOT be used

for BlueCard member’s. (If the member’s card does not state “Anthem” then it

is probably not ours.)

 Outpatient radiology requests are out of scope for e-Review.

 To receive more information on getting connected to the Anthem web

portal for outpatient radiology requests, please send an e-mail to:

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How To Get Connected to

Secure e-Review

 In the Internet Explorer window type in

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Registering Your Account

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Registering Your Account

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Registering Your Account

You should receive a confirmation response.

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Registering Your Account

 In a moment or two, you should see a confirmation mail come into the

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Registering Your Account

 Open the e-mail and click on the link that states: “To ACTIVATE your new

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Registering Your Account

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System Log In

 You are now back at the home log in screen. Log in using your e-mail

address, enter the password you just established & click “Sign In”.

 Your password should never need to be changed unless you would lock up

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Set Anthem e-Review Addresses

 After you log in, you will see the following format. Let’s set the Anthem

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Set Anthem e-Review Addresses

 Now you are in the “Address” section. To set the addresses click on “Add

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Set Anthem e-Review Addresses

 Enter the addresses provided later in this presentation (one by one) based

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Set Anthem e-Review Addresses

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Again, Anthem e-Review is only for certain Anthem member’s. It

can not be used for Blue Card member’s. (If the member’s card

does not state “Anthem” then it is probably not ours.)

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You are able to do preauthorizations for Anthem Local Commercial

accounts (by state), certain National accounts, Federal accounts,

and Managed Medicare accounts.

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Enter the name of the Anthem department as the “First Name” /

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Set Anthem e-Review Addresses:

Federal Accounts

 Prior approvals for Federal accounts are in scope.

 SNF, LTAC, Rehab requests are out of scope.

 If the member’s ID prefix is a “R” - this indicates a Federal plan and

the preauth can be sent to the Federal shared mailbox for e-review. (example = “R1122656”)

 Federal Prior Approval Address:

 “First Name” = Prior Approval

“Last Name” = Federal

“E-Mail Address” = [email protected]

 This e-mail address is for any initial demographics as well as clinical

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Set Anthem e-Review Addresses:

National Accounts

 For National accounts you can complete precertifications for surgery

requests, inpatient stays, SNF/LTAC/Rehab, Specialty Pharmacy, DME, etc. You can also submit your predetermination requests in this manner.

 If the member’s ID prefix is an “AN” – this indicates a National plan and the

precert can be sent to a National shared mailbox for e-Review.

Example – AN0000000 or PGRAN 0000000. (This rule applies to a majority of the National accounts. There are a few that they may not be able to

handle)

 National e-Review Addresses:

1. “First Name”= Demographics

“Last Name” = National

 This e-mail address is for the initial demographic submission

2. “First Name” = Clinical

“Last Name” = National

 This e-mail address is for any clinical updates after the initial

demographic submission of information

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Set Anthem e-Review Addresses:

Local Commercial Accounts

 For Local Commercial accounts you can complete precertifications for

surgery requests, inpatient stays, SNF/LTAC/Rehab, Specialty Pharmacy, DME, etc. You can also submit your predetermination requests in this manner.

 Local Commercial accounts generally have a “M” or “A” in the middle of the

ID number.

Example – YRP000M00000

 The Local Commercial Addresses in the Anthem Central Region are

separated by state (OH, IN, KY, MO, WI). Please see the following pages for your state addresses.

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Local Commercial Accounts

--Ohio Addresses

Ohio Local Commercial e-Review Addresses:

1. “First Name” = Precert - Demographics “Last Name” = OH Local

This e-mail address is for the initial demographic submission

2. “First Name” = Precert - Clinical

“Last Name” = OH Local

This e-mail address is for any clinical updates after the initial demographic submission of information

3. “First Name” = SNF/LTAC/Rehab

This e-mail address is for any demographic and /or clinical submission of information for SNF, LTAC or Rehab stays

4. “First Name” = Predeterminations

This e-mail address is for any demographic and /or clinical submission of information for predeterminations

5. “First Name” = Specialty Pharmacy

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Local Commercial Accounts –

Indiana Addresses

Indiana Local Commercial e-Review Addresses:

1. “First Name” = Precert - Demographics “Last Name” = IN Local

2. “First Name/Last Name” = IN Local Precert - Clinical

“Last Name” = IN Local

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Local Commercial Accounts –

Kentucky Addresses

Kentucky Local Commercial e-Review Addresses:

1. “First Name” = Precert – Demographics “Last Name” = KY Local

“Last Name” = KY Local

This e-mail address is for any demographic and /or clinical submission of information for specialty med requests

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Local Commercial Accounts –

Missouri Addresses

Missouri Local Commercial e-Review Addresses:

1. “First Name” = Precert – Demographics “Last Name” = MO Local

“Last Name” = MO Local

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Local Commercial Accounts –

Wisconsin Addresses

Wisconsin Local Commercial e-Review Addresses:

1. “First Name” = Precert - Demographics “Last Name” = WI Local

“Last Name” = WI Local

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Set Anthem e-Review Addresses:

Managed Medicare Accounts

 For Medicare Advantage accounts you can complete precertifications for

surgery requests, inpatient stays, SNF/LTAC/Rehab, Specialty Pharmacy, DME, etc. You can also submit your predetermination requests in this manner.

 Medicare Advantage accounts generally start with the prefix of YRA, YRE,

YRS, JWM, VZM or YRF.

 Please see next page for your Managed Medicare addresses.

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Set Anthem e-Review Addresses:

Managed Medicare Accounts

Managed Medicare e-Review Addresses:

1. “First Name” = Precert – Demographics & Clinical “Last Name” = Managed Medicare

This e-mail address is for any initial demographics as well as clinical information (initial clinical and updates)

“Last Name” = Managed Medicare

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Set Anthem e-Review Addresses

 Once you enter all the addresses that you need, your address tab should

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You Are Now Ready to Send An E-Mail

 Choose the e-mail you would like to send your information to by doulble

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Composing an e-Mail

 After you click on the address you want it should bring you to the Compose

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Composing Email Request

 Its just like a regular e-mail you send from your home personal computer.

 Never enter anything into the “CC” line

 In Subject Line always enter: “Secure – your facility name”

 In the Message Area please provide the following plus any clinical

information you would like to add:

 Requesting Provider / Facility Name:

 Tax ID:

 Contact Name and Phone Number:

 Patient Name:

 Insurance ID:

 Date of Birth:

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Composing Request Continued

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You may click “Attach” button to attach:

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File or document with additional information

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Precert Clinical Review Template

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Clinical Data Submission Tools for

Predeterminations

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Great for photos / scanned documents

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Sent Mail

 For your tracking purposes, all sent e-mails will be stored under the “Sent

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Processing Request

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Anthem associates process information & respond to sender via

secured link. In general, Precertification requests are handled in 1-2

business days and pre-determination requests are handled within 15

business days

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When the Anthem associate replies to the request, the Provider will

receive a notice in the email account used to setup account informing

of message on the secure e-mail site. At the bottom of this notification

there is a link that can be clicked on that will take the Provider to the

log-in screen.

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Log into the system to access the response.

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Types of Responses

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Not Our Member: reply via secure e-mail notifying the

Provider if they have sent in information on a member that

is not managed by Anthem.

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Approvals: reply via secure e-mail advising of approval,

authorization number & appropriate disclaimer.

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Denials: reply via phone call advising of denial. Provider

will still receive mailed notification letter.

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In Process: if case is being sent for a RN or MD review, an

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Thank You

Anthem Blue Cross and Blue Shield is the trade name of: In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain

affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Ohio: Community Insurance Company. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWi), which underwrites or administers the PPO and indemnity policies; Compcare Health Services

Insurance Corporation (Compcare), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS