Where Can I Find 1?
A Member's cost share, if a claim has been paid & how and a claim's status (paid, rejected, etc.)
Facets
Providers who have valid NPI #s
NPPES NPI Registry
An image of a paper claim
D2
The tool which allows PI agents to view, and status claims the same way a provider would view them through the Provider Portal.
Executive Admin Tool
Where agents can go to assist Providers with claim inquiries.
COTIVITI
A recurring reminder to do something.
Outlook
Provider Billing Manual
SharePoint > Quick links > Provider Portal
HAP's explanation of a claim payment to a Provider.
Remittance Advice (RA) - Negative Balance Inquiry
Members' current and/or previous Medicaid health plan status.
CHAMPS
Oracle Administrative Process
Where can an agent can:
- determine if a Provider's W9 has been updates
- determine the bulk amount of a check
- review a Payment Inquiry to verify the Tax ID # (TIN)
The application used to manage calls from Members and Providers. It is where agents log all calls to HAP.
Pega
Medical and Behavioral Health Authorizations
CareRadius
Policies, procedures and clinical guidelines
SharePoint > Quick links > Provider Portal