User Guide
Table of Contents
Getting Started
2 Website URL
3 Website Layout/Menu Links
Basics
4 Alerts/Selecting IPA
5 Search Methods
6 Indicator Icons
Using the Provider Portal
7 Provider Search
8 Auth Request - Referral Request 9 Can’t Find Member/Provider 10 Diagnosis/Procedure 11 Additional Information 12 Review/Submit/Attach/Print 13 Auth Search 15 Claim Search/Eligibility 16 My Members/Reference 17 My Documents/Sign Out
Frequently Asked Questions
20 Obtain access to the portal
20 Obtain additional web accounts/users 21 Access to other groups or providers 21 Can’t find claims
22 Can’t find member 22 Can’t find provider
23 Alternate method to submit auth 23 Request new eConsult login 24 Print authorization letters 24 Contact us
Getting started
Visit our website to sign up for our Provider Portal or to Login: www.medpointmanagement.com
• To sign up for our Provider Portal click “Online Form”
• To login click “Provider Portal Login”
Website URL
• Home (Select IPA)
• Providers (Provider Search)
• Auth Request (Submit Referral)
• Auth Search • My Auth My Hospital Members My eConsults • Claim Request* • Claim Search
• Upload Claim File*
• Eligibility (Member Search)
• My Members (Members assigned to your Provider Portal account)
• Reference (Diagnosis, Procedure, POS, CPT Modifier)
• My Documents (Eligibility & Cap Reports)
• Sign Out (HIPAA Privacy)
• Switch (Change Current IPA)
• IPA’s (Listing of IPA’s linked to your tax ID)
Website Layout
Menu Links
IPA Name
Basics
• Alerts display when MedPoint Management UM staff requires more information on any Authorization
• Once ‘Mark as Read’ the message is removed but can be accessed again by check-ing the “Show Read Items”
• Click on “Switch”
• Click on desired IPA
Alerts
• A simple search works best
• Example above uses the first 4 characters of first and last name
• all other fields are left blank or default
• Do a simple name search first, if that doesn’t work click “Reset” and try other individ-ual fields (Refresh page if it gets stuck)
• Advanced Search
• For advanced search options look for links like the one above “More Referral Search Options”
• Familiarize yourself with these advanced search options as they are useful for narrow-ing down long search lists
Search Methods
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• “Update in progress” Indicator
• Wait for this to complete before clicking on any other link
• This will disappear once the update is com-plete
• Internet Browser Indicator
• Pay close attention to your internet browser “wait” indicator
• If your browser or Web Portal get stuck click on the “Refresh” Icon on your internet browser, or open a new tab and try again
• You may only be logged into one computer at a time, if you try to login from a second computer using the same account it will log you off the first computer.
• See FAQs number 2 on page 20
Indicator Icons
Using the Provider Portal
• First select the correct IPA as discussed on page 4
• If you know the provider name “Use Sim-ple Search Technique” as discussed on page 5
• For a list of providers that belong to a spe-cific specialty click on “Specialty”
• If the search comes up empty try a diff er-ent specialty within the same medical field (only use if appropriate)
• Once you find the provider you may click
“Copy to Auth Request” (start referral)
Providers (Menu Link)
• Verify the correct IPA is selected as discussed on page 4
• Click on “Open Search Panel” to bring up the yellow boxes
• Searching for member use simple search technique
• Searching for provider use specialty field
• The best way to select a provider is to use the provider tab (see page 7)
• If you have the Provider Number (NPI#) enter it in “Enter Provider ID” and click “tab” on your keyboard
• Completed View (see below - Some information greyed out for HIPAA Privacy)
Auth Request - Referral Request
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• If you cannot find the member, you can still submit the Authorization by clicking on the “I can’t find the member (or provider) button”
• Fill out the additional required information which will help our agents when updating the Eligibility data for the member
• Although there is no “Submit” button shown in the yellow boxes you may continue filling out the Auth request form and click “Review” once all fields are complete
Auth Request - Can’t Find Member/Provider
• Fill out diagnosis Codes (see page 15 to search for codes).
• If the code is found in the Top 50, click drop down list, find code then click “Add”
• Not found - click “Search Diag Codes...” and use simple search method (see page 5)
• You may also use ICD 9 codes (for Diagnosis Codes)
• Once you have entered a code in “Diag Code 1” click “Validate Codes Now...”
• Follow the same steps for Procedures (up to 10 CPT codes)
(If the codes you are looking for are not found see page 15 to search using different search criteria. If that does not work you may make a side note on the message section)
• Include the following in “Additional Information” section 1. Name of practitioner submitting request:
2. Specific issue to be addressed by consultant: 3. Pertinent H & P exam details:
4. Relevant treatment history including medications /lab/x-ray/other test results: 5. Is co-management requested?
6. Are you requesting that the specialist take over treatment of the problem?
Auth Request - Additional Information
• Review and verify data entered
• If everything looks good click “Submit Referral Request”
• Take note of the Web Reference Key, attach additional documentation or medical notes, and print
• Verify that the auth was entered correctly by going to “My Auth” (see page 14)
• Make sure you choose the correct IPA (see page 4) before clicking on “My Auth”
• Auths take 2-3 hours to post onto your “My Auth”
• Verify the correct IPA is selected
• Use Simple Search Method discussed in Page 4
• Click on “More Referral Search Options” to narrow search criteria (Only if needed)
• Displayed data (Auth#, Status, Member ID, Member Name, etc - click on links to expand)
Auth Search
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• Verify the correct IPA is selected.
• Checking “My Auth” after submission allows you to verify the submission was success-ful, see status, and view details including ability to print authorization letter for any auths entered under your User ID
• My Hospital Members (List of all your Members admitted to the hospital)
• View - Member name, Auth #, Diagnosis, Procedure Code(s), Admit Date, Discharge Date
• My eConsults (List of all your eConsults)
My Auth
• Verify the correct IPA is selected
• Use Simple Search Method discussed in Page 4
• Verify the correct IPA is selected.
• Use Simple Search Method
• MPM Eligibility is updated monthly, some health plans twice a month. For current eligibility check the health plan website
Claim Search
Eligibility
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• Verify the correct IPA is selected.
• Members assigned to the Provider/User logged in
(Note you may not sort or export “My Members” data)
• Search for the proper code to use when entering Auths
• Search Procedure Codes, Diagnosis Codes, Place of Service, CPT Modifier(s) - Useful when Submitting Auths
My Members
• View Cap Reports, Claim EOB Reports, and Eligibility Reports
• Ability to search for “all” files or only “today’s” files
• Ability to filter on file type, category, and dates
• PDF, Microsoft Word, RTF formats, and Excel
•
Please remember to sign out for HIPAA Privacy reasons.
•
Signing out also ensures that no one else has access to the data while
you are away from your desk.
My Documents
How can I get access to the portal?
How can I get access to other groups or providers on the web?
Why can’t I find my member?
How can I obtain additional web accounts/users?
Why can’t I find any of my claims on the site?
Why can’t I find the provider?
Frequently Asked Questions
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2
3
4
5
6
How can I request new eConsult login accounts?
How do I contact you for additional assistance?
How do I print authorization letters?
Your own sub headline
Frequently Asked Questions
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1. How can I get access to the portal?
1. Visit our website
www.medpointmanagement.com
2. Click on
“Online Form”
3. Fill out form
4. Type “NA” for any information you are missing 5. Click “Submit” (24 hour processing time) 6. You will receive email with Login ID and Password once your account is created
2. How can I obtain additional web
accounts/users?
1. Visit our website
www.medpointmanagement.com
2. Click on
“Online Form”
3. Fill out form
4. Type a brief description of your request in the
“Your Message” field
5. Type “NA” for any information you are missing 6. Click “Submit” (24 hour processing time) 7. You will receive email with Login ID and
3. How can I get access to other groups or
providers on the web?
1. Visit our website
www.medpointmanagement.com
2. Click on
“Online Form”
3. Fill out form
4. Type a brief description of your request in the
“Your Message” field
5. Type “NA” for any information you are missing
6. Click “Submit” (24 hour processing time)
7. You will receive email with Login ID and Password once your account is created
4. Why can’t I find any of my claims on the site?
1. Your user account may needs to be updated to ensure that the proper provider tax IDs are linked (follow the diagram and wait 48 hours to process change and update claims on your account)
2. The claim(s) are not in our system
3. You submitted via Office Ally (allow 5 business days processing)
4. The claim posted on our database under a different tax ID number.
5. Inquire at
webclaiminquiry@medpointmanagement.com
5. Why can’t I find the member?
1. It takes 24 hours for members to show up online after they are added in our database
2. Your user account may needs to be updated to ensure that the proper provider tax IDs are linked (follow the diagram and wait 48 hours to process change and update claims on your account)
6. Why can’t I find the provider?
1. It takes 24 hours for providers to show up online after they are added in our database
2. Your user account may needs to be updated to ensure that the proper provider tax IDs are linked (follow the diagram and wait 48 hours to process change and update claims on your account)
3. If you are non-contracted you might have to submit W-9 to provider services
providerservices@medpointmanagement.com
7. How else can I submit auth/referral?
1. All authorizations/referral submissions must be done through our Provider Portal.
2. Visit our website
www.medpointmanagement.com
3. Click on
“Online Form”
4. Fill out form
5. Type “NA” for any information you are missing 6. Click “Submit” (24 hour processing time) 7. You will receive email with Login ID and Password once your account is created
8. How can I request new eConsult login
accounts?
Contact eConsult help desk at 855.532.6652 between 8:00AM – 5:00PM. They will assist you in creating new user accounts, and/or assisting with any eConsult issues.
9. How do I print authorization letters?
1. Visit our website
www.medpointmanagement.com
2. Click on
“Provider Portal Login”
3. Enter login information
4. Go to “Auth Search” or “My Auth”
5. Once authorization is identified, click on the authorization number and the authorization details will display (see image below)
6. Click on “Print Friendly Version”
10. How do I contact you for additional
assistance?
If you have a technical question or having problems on our site, please send us an email at mpmweb@medpointmanagement.com or call us at 818.702.0100 ext. 299
