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iEXCHANGE® USER MANUAL

1. eae eS ee ee ES E PEE Ce E pog Baum Tor p r rg mod tE irg E rape Prem alos ao 2 oS Toe ee es oum amp Pr Ef med ums ud mm a s E dam zb orn m bb La EDD Service Status Status of PETE a d xd oe John __ ache d en Qd requested services are listed lesa Bate 8 8 E CRZXJ4R LESE oo E individually with the service description Has kou a dad Kiklars John bereg oe eee wm 8 AI23315 12 10 2009 52 AmeriHealth Administrators Edit Case Allows you to add additional information to an existing case By clicking on Modify case and or treatment data or Add to comments from the Treatment Update Details page or the Treatment Search Details page you may be prompted to enter either Admission or Discharge information or respond to requests from AHA by entering additional comments Admission information You can inform AHA that a patient has been admitted and specify the Admit Date Discharge information You can inform AHA that a patient has been discharged specify the Discharge Date as well as specify the after care program discharge plan for the patient Entering Additional Comments You can add additional free text comments to a
2. AmeriHealth ADMINIS TR AT Se iEXCHANGE USER MANUAL 12 10 2009 1 AmeriHealth Administrators 12 10 2009 2 Table of Contents iEXCHANGE 3 5 Inpatient Request 0 0 2 7 2 2222220222 4 4 8 Inpatient Request 2 0 0 220227007 7222 227240222 2222 22 19 Inpatient Request 2 21 Outpatient Other Request 0 2 22 Outpatient Other Request 2 2 31 Outpatient Other Request 0 0 0 0 0 0 70 0022 33 WCAC Sis 34 Tredlment Upadle 40 Treatment 46 EHO Gas aces ceases 59 Extension 0 2 222 2 0 2 2 2 0240 00 0 7 2 59 iEXCHANGE Administrator 72 If you have questions or comments about this guide or experience problems using iEXCHANGE please contact Help Desk at AmeriHealth Administrators 1 888 444 4617 Ame
3. 68 AmeriHealth Administrators Extension Requests Extend Other Outpatient Extension information Select the submitting provider extensi n primary diagnosis and enter the additianal requested units visits well the extension start and end dates Click Next step to continue IEX CHANGE evaluatez your other extension request and displayz the Other request extension preview page 12 10 2009 Other request extension entry Submitting Welby Marcus A23456 provider Extension primary diagnosis Enter Oba gnaoesis Secondary diagnosis Secondary diagnosis Attending physician Select atteandin the list aor enter or A23456 saarch for ID Additional 1 requested unit jh 2009 ivan Extension end date pho 17 Purchase Rent 69 Providersearch Enter required E information including Additional requested units and Extension start and end date AmeriHealth Administrators Extension Requests Extend Other Outpatient Additional Comments optional IEXCHANGE Contact Information IEXCHANGE Clinical Information IEXCHANGE Additional Comments 12 10 2009 70 7 Clear form Comments may be added as necessary Click Next step to continue AmeriHealth Administrators Extension Requests Extend Other Outpatient
4. Frequent diagnoses Click the Frequent diagnoses link above to set up a shortlist to used iEXCH AMGE to hold the diagnosis codes your Provider Group most often uses 18 Select Submitting providers to add providers AmeriHealth Administrators IEXCHANGE Administrator Submitting Providers Select Edit_to information add payers for existing providers remove providers Step iiz Submitting Prowider wi informati 12 10 2009 Submitting providers list Organization or Provider name Kildare John elate Welby Marcus Edit Edit Delete Suess Theodor Add new provider Cancel Setup submitting prowider Test Group OR Organization na me First name Middle imitial Last na mme Holes SUPBPROw SUBPROWYW SUBPROY 111111111 prow id er TED 73 Select Add new the list Enter the requested demographic information for the new provider and click Next step AmeriHealth Administrators IEXCHANGE Administrator Submitting Providers Setup submitting provider 2 Step 2 MCO provider ID setup University Hospital Select a payer from the drop down list enter the mu AmeriHealth Administrators __ click Add to list to list Independenc
5. SS Facility search Click on Drop Down Arrows to fill in required fields or maternity pre notification use the estimated date of confinement for the admit AmeriHealth Administrators Inpatient Request Entry Diagnosis Code a category to encode by Encode by A Diagnosis Description or B Diagnosis Code Enter the appropriate values for the selected category Click Encode to convert the description to a 12 10 2009 setting Is this a surgical admission Admit date Is this an emergency Primary diagnosis Enter Diagnosis code or Select from Short list Secondary diagnosis optional Secondary diagnosis optional Diagnosis Encoder Use this page to convert the diagnosis from English to the appropriate code First select Enter the Primary and secondary diagnosis codes or click Diagnosis Search to find code s using a description For maternity admissions use 650 for vaginal delivery or 669 7 for cesarean section either the diagnosis description or the diagnosis code Then click Encode Convert diagnosis description to Description Enter the diagnosis description Encode 13 Enter text and click e to code AmeriHealth Administrators Inpatient Request Entry Diagnosis code cont Encoder Results This page lists the diagnoses meeting your search criteria Click the Select button next to the diagnosis you want Use the pre
6. Andy Estrella log out Referral Search Preview Page will display Informational messages along with the expected status of thecase Description Accessed affects status Click Submit to complete the request Preview changes Cancel 66 AmeriHealth Administrators Extension Requests Extend Inpatient Inpatient request extension preview PATIENT JOAN _ Se ee ee ee FRE Tm S e TI at g aps ms gt La a ru 3 Principal service Status Pena Loe write AS a To dats E rirri m cy diagnosis Bed tps attending physician Sco ID igre theme ILS of birth Grew Tes ora rr Subecriber TE Subacriber om Pe IDE Submrikting provi Submitting prow idar Mis ID ao ra mom 12 10 2009 Cat status Authorized fiom m A Or OB zorcd TE CCONMELIZIIATICI C ME CIEDILIM E FB Aorta Pond John 812345 PATIENT JOAN Oz O 1i7 amp 7 1coocow0i 1224386 PATIENT gt Bis EAST STREET 6 Confirmation screen provides the overall Case status NOTE a status of Authorized in this
7. NPI EXCHANGE Help Desk at Provider Code Supplemental Prowider ID ri Hea th 221 Administrators assistance with identifying your Provider Code C Select provider roles Provider Role Tk as default for the role in the group IF Servicing B Attending physician Yodo E Facility Add to list4 7 Clear form 12 10 2009 85 AmeriHealth Administrators IEXCHANGE Administrator Frequent Providers Step 2 MCO provider ID setup Smith John A Select a payer Payer NOTE The MCO provider Independence Administrators codes are the same for both AmeriHealth Provider ID Administrators and NPI MCO Provider Code Supplemental Provider ID Administrators but need to 2 be added separately C Select provider roles Prowider Role Mark as default for tha ef the group After you select Add to list for the first payer you can select a new payer from the drop down list add the MCO provider code select L Servicing vider mending physician E fx Facility CI a Provider Role and click Add to list again Add to list 4 Providers for the group Supplemental SrneriHealth 123456 TTPROW EE ae cc CEU IL 12 10 2009 86 AmeriHealth Administrators IEXCHANGE Administrator Frequent Providers Step 2 MCO provider ID setup Smith John A Select a payer B Provider ID
8. After your payers have MCO Provider Code Supplemental Provider ID been added tl ey will __ appear at bottom of the C Select provider roles Provider Role Mark as default for the role in theoroup Servicing provider attending physician L Click Save list and your Facility m newly added providers will appear your drop down lists the next time you access the transaction request screens Supplemental koles roviders for the group Save list 12 10 2009 8 AmeriHealth Administrators IEXCHANGE Administrator Frequent Procedures 12 10 2009 IEXCHANGE Administrator Administer prowider D 4083 Group administration Click the Group Administration link above to enter or edit information about your EXCHANGE Provider Group Account administration Click the Account administration link above to enter or edit information about account users for your iEXCCHANGE Provider Group New users of EXCHANGE set up here roviders Click the Submitting prowiders link above to enter or edit information about the providers for which an iEXCH AMGE transaction can be submitted Submitting providers should correspond to healthcare providers within your iEXCHANGE Provider Group At least one Submitting provider must be set up in order to perform a transaction in iEXtCHAMGE Frequent providers Click the Frequent prowiders link
9. ID LOS Bed Type Acue Med Sug 7 type i e Acute Med Surg ICU Hospice eu Telemetry Sub acute For DRG Neonatal ICU admissions enter the bed type of Acute Med Surg For maternity skilled Nursing Step Down Unit and surgical admissions use Subacute Acute Med Surg T elemetn eview Type If you know the clinical details of the case select the appropriate clinical review option Initial non clinical review otherwise select nitial non clinical review Subsequent clinical review 12 10 2009 16 AmeriHealth Administrators Inpatient Request Entry Inpatient Treatment Type and Procedure Code Inpatient Treatment type Hospice Long Term Acute Care Inpatient Treatment type Enter the type of ee admission i e Medical Surgical Obstetrics Obstetrics 22 Neonatal skilled Nursing Skilled Nursing Subacute Surgical Transplant maternity and surgical admissions always provide Services information EE the procedure s Up to 5 Principal Service optional procedure codes can be Procedure 57447 Total Knee Replacement added by entering the codes If necessary record the using drop down list principal procedure and any Enter search by description by additional procedural Procedure ema aE aS information Enter the exact code or Procedure search clicking Procedure search code or select the
10. 01234567 02 m digne LAMINOTOMY oe M Ww EM DECOMPRE HE UNSPECIFIED 715 10 OSTEOARTHRUS LOCALIZED PRIMARY SITE UNSPECIFIE Inpatient request LOS LENGTH STAY PATIENT JOHN 10393410001 01234567 01 TRI CS ARTHROPLASTY KNEE CONDYLE AND PLATEAU MEDIAL AN 27447 LOCALIZED PRIMARY SITE UMSPECIFIE 12 10 2009 49 Pr 715 10 OSTEOARTHROSIS Sli Treatment search summary hat meet the search criteria entered atus e ie inel atment Click to extend the View all View open Confirmed treatment end date Last detail line status reason Treatment dates 01 05 2010 Authorize Approved 01 07 2010 by PCM 01 05 2010 Authorize Approved 01 05 2010 01 01 14 2010 Approval 01 11 2010 Authorize Auto 01 11 2010 Approval View all View open New search Submitting a search by date range will return cases for multiple members sorted alphabetically by member s last name that occured within the dates provided AmeriHealth Administrators Treatment search Member ID or Case ID Treatment search Use this page to search for existing referral requests and or inpatient and other 1 a category to search by Choose ONE Category and enter the appropriate values Click Submit search to view referrals and or inpatient and other requests 12 1
11. Diagnostic Procedure Home Care Durable Medical Equipment AmeriHealth Administrators Outpatient Other Request Entry Procedure Code B Services information Enter or select the principal procedure code and any additional secondary procedures Enter the servicing provider the number of requested units visits as well as the start and end dates for each procedure 12 10 2009 Principal Service c ui Enter Procedure 3 110 Physical Therapy 97110 he code or Select from Short list Procedure search provider Select servicing provider from the list or enter or search for ID Provider search Start date e o mm dd yyyy Purchase Rent 29 Up to 5 procedure codes can be added by entering the codes using a drop _down list OR search by description by clicking Procedure search Servicing provider Units and the Start End date must be added for each procedure code AmeriHealth Administrators Outpatient Other Request Entry Additional Comments Additional Comments optional 12 10 2009 iEXCHANGE Contact Information John Smith 215 555 1212 iEXCHANGE Clinical Information provide additional clinical information iEXCHANGE Additional Comments 30 Contact Information Number where Patient Care Management can reach you with any questions Clinical Inf T Patient symptoms and treatment plan
12. Inpatient instructions Click Inpatient _ Select New Inpatient Request New Inpatient Request Click the New Inpatient Request link above A blank Inpatient request entry page appears You can add a member ID and all request information for this member Extend Inpatient Click the Extend Inpatient link above You must use the Treatment search functionality to search for the inpatient trestment you wish to extend Depending on the payer you hawe selected you will be able to submit an Inpatient request extension or an Inpatient notification extension A Note before you begin if you selected the wrong payer you want to submit this request to a different payer click the Starting point link above to return to the Starting point page and select the correct payer 12 10 2009 9 AmeriHealth Administrators Inpatient Request Entry Member ID Sponsored by Ameritlealth mom om og xa moa LLT Starting point Payer selected Ane ribealth Ad ministrators 1 General information Use the General information Section to record the member ID click Member by member The Member ID field iz mandatory The Dette of birth and First name fields are optional Wou may be instructed te woalue the Date cf birth and or First name Freld fs if the member Search you perform returns more than one member record matching the search criteria you
13. Other request extension preview Patient John case status Authorizes Cue stionnaire EFE I ar La d lanas E T ra ama 117 414 ra Principal services Status Broce ue HALLUX A C CORRERECTIGCHM Ea Baro iit DEBRIDEMENT AND CAPSULAR Description RELEASE OF THE ion mtamrt date and clama tu 7 200E Limit i Purch a nm 1 lew Patient John Bir boar 13345657 Dmte cf birth CHA a Greup IL Group oer Gru Name SaubecriG er IL 1134587 beceri b r ogres Patient John IR amimticnmkhip zubmcribamr Subraikting previdear Welby Marcus Previder Ms ID A23j34556 F cd cd pum 210 505 COL H AVE Cty REV EH Stats Bac Zip fo Sie ly BA ii li 1 Grae i Preview changes display Informational messages along with the expected overall status of the case Click Submit to complete the request 12 10 2009 71 Cancel AmeriHealth Administrators IEXCHANGE Administrator Administrative users for iEXCHANGE can perform the below functions Group administration Allows provider to add edit information abo
14. SEPARATE PR New or updated treatments will show Facility or Servicing provider name instead of the PCP name Otherwise the Treatment update summary page new or updated treatments m View is identical to the Updates for PCP view see page 37 Advanced search Cancel 38 AmeriHealth Administrators Treatment update details This page lists all treatment updates associated with the case listed below Click on treatment update link below to view the details of a treatment update Click Remove all treatment updates from current view to indicate that all the treatment updates listed below should no longer display on the Treatment update summary page when accessed from the IEXCHANGE starting point page Click Extend to add units providers dates to a service Click Modify case and or treatment data to add additional information to the case and or a treatment Treatment updates Remove all treatment updates from current view EXCHANGE Addit Service 44960 was added Service 091770002502001 was added 39 Treatment Updates View details The Treatment update details page displays a listing of all Treatment Updates that have been generated for the case at the top of the page The rest of the information you with a complete view of all case activity Selecting a Treatment Update link will scroll the to the appropriate section w
15. status reason Inpatient request Authorize Apmprowad 62040 LAMINOTOP Welby 1093410002 ie e treatment TENE summary displays results sorted OF MER VE ROCCTIZ z INCLUDING PARTIAL Treatment Updates matching your search criteria Treatment Updates for Facility Servicing Provider kihe hi o UP ates that have been marked as viewed as well as those that Member PATIENT JOHN 01234567 01 have not been viewed Facility randa i rmm rr pue e x Last request 4 Case ID ET lx Primary dimgnesis inim m tree bere mk ered cate Impatient request 715 10 CEHTEDARTHROZSZIS ARTHROFHPLAZTTY LOCALIZED PRIMARY SITE UNSPECIFIED POS 34 10D01 wid added Kildare ent Jahn 12 07 2009 Auto Approval Oifiifzoia Click View details if you E wish to view additional 4 E Tea m E nim E T 5 715 10 iD OL 2005 Aube vid dicm ma enl Ki information OSTEOGARTHREOASI amp Aperewal emt LOCALIZED PRIMARY i0 0i1 2z009 PRETRIAL PROSTHETIC REPLACEMENT TOTAL HIP ARTH 12 10 2009 44 AmeriHealth Administrators Treatment update search Treatment update details Treatme
16. 0047 0047 Inpatient Yes No M If you would like Member searbh 10 change any of the information entered onthe previous screen you can edit information on the preview screen and click Preview changes to update your request searc Click Submit to complete the request Preview changes 20 AmeriHealth Administrators Inpatient Request Confirmation E int friendly wersion Click the Printer Friendly buttonto print a copy of your request 12 10 2009 Patient Joan case rp 1091212121 Authorize Case Reference Inpatient request confirmation Confirmation screen provides the overall Case status Status Authorized NOTE a status of Authorized in this field does not mean all services and LOS requested are approved 20912121211 00001 General member information Patient Joan 555555555 02 Member name MIen ber ID Date of birth Age Group Il Group nam Subscriber ID Subscriber name Refer to the LOS and Service status to determine the individual Patient John Relationship Dependent Principal Serwice amp Procedure EEEN DEC TOMY FOR RUPTURED ITH E ae Fx 4112 44560 Service s Status Status of requested services are listed individually with the service description FER ITOTI Serwicing prowid r Servicing prowider NP
17. Group New users of EXCHANGE can set up here Submitting providers Click the Submitting prowiders link above to enter or edit information about the providers for which an iEXCHANGE transaction can be submitted Submitting providers should correspond to healthcare providers within your iEXCHANGE Provider Group At least one Submitting provider must be set up in order to perform a transaction in iEXtCHAMGE Frequent providers Click the Frequent prowiders link above to set up a shortlist to be used in EXCHANGE to hold the providers your Provider Group rnost often uses uent procedures Click the Frequent procedures link above to set up a shortlist to be used in iEXICH AMGE to hold the procedure codes your Provider Group most often uses Frequent diagnoses Click the Frequent diagnoses link above to set up a shortlist to be used in iEXCH AMGE to hold the diagnosis codes your Provider Group most often uses 12 10 2009 745 Account administration ad m n istration to add y information about account users for your iEXCHANGE Provider edit delete users AmeriHealth Administrators IEXCHANGE Administrator Account Administration _ existing user or add a new user To edit an existing user select the radio button mest to the user name then click the Edit user button To add new user click the Add new user button logon and password information Enter the required informati
18. Treatment search link above The Treatment search entry page appears You can search by treatment range case ID or request ID for treatment information After performing a Treatrnent search you may choose to extend a service Provider search Click the Prowvider search link above The Provider search entry page appears You can search by provider ID provider name or geographic location specialty for provider information Under the Search tab select Member search reatment update search to Click the Member search link above A blank Member search entry Page appears You can search by member ID only for view newly created member information modified requests Treatment update search P Click the Treatment update search link abowe The Treatment update search entry page appears 12 10 2009 41 AmeriHealth Administrators Treatment update search Treatment update searc the Search For n treatment update Updates from MCO search criteria updates for PCPs 9 New or updated treatments Specify the category and the Providers for whom Provider s Select all providers Specify the provider s whose treatment updates you wish to view Kildare John 412345 Welby Marcus 423456 Suess Theodore 11111 you want to search Date range Specify the date range for your treatment update search Search filter Specify the types of treatment updates you want to
19. Updates View updates for PCPs m 6Updates for PCPs are sorted dai Click the Remove marked items from current view link to remove alphabetically by PCP physician 77 the individual Treatment Updates you have checked in the Viewed then alphabetically vu indicator column and mark them as viewed Treatment Updates that member name atn have been marked as viewed are longer considered new and are not displayed on the Treatment update summary page when Remove marked items from current viey accessed from the EXCHANGE starting point page They are still accessible through Treatment Update Search Updates for Facility 5ervic Provider Welby Marcu pon PATIENT 01234567 02 Treatment Confirmed Update Facility gt 4 Servicio Cane IE Last request treterent m LUE miry Provider diagnosi dimitinm praet eee and date TOT E E zz 1 L 5 TM 1 i Treatment Welby 16093410002 inpatient request 724 5 o1 o5 zo10 au sthorize Approved mz added 63030 LAMINOTOMY BACKACHE by PC oni Marcus LAMINECTONMY LINSPECIFIED oz os zo10 12 07 2009 DECOMPRESSION OF NERVE ROOT S CLUDING PARTIAL Updates for Facility Servicing Provider Kildare aate Summary Column indicates why the Treatment Update was Member PATIENT JOHN 01234567 01 generated new treatment a
20. a Payer the Treatment updates notification will appear on the EXCHANGE starting point page Note A Treatment Update is considered new when the Treatment Update has been generated within the past 4 days the Treatment Update has not been designated as having been viewed by anyone in your provider group Announcement Monthly maintenance on iEXCHANGE Web is complete Go to MEDecision If there are no Treatment Updates for your group in a category you will not receive a link for that category 12 10 2009 35 AmeriHealth Administrators ieXcHANGE USER MANUAL Treatment Updates View updates from MCO Treatment me su ummary This page provi T group Click Vin remove one r treatment from cur ent lono r apear ct XC ANGE sta 7 statu sj reason Submitting e Case ID Service Provider vin diagnosis 724 5 01 05 2010 Authorize Approved Status Kildare 1093410002 Inpatient request changed 5 Jahn LOS Length of Stay BACKACHE by PCM approved UNSPECIFIED 01 07 2010 12 07 2009 View gi Status 10233410084 changed to eli 6 3799 55 HEMILEPN ere E WITH DECI NERVE INCLUDING Remove marked items from current view 12 10 2009 36 AmeriHealth Administrators Treatment
21. a shortlist to ed iEXCHP GE to hold the provide our P ider Group to ho the prowiders your Provider Group servicing providers uent procedures Click the Frequent procedures link above to set up a shortlist to be used in iEXICH AMGE to hold the procedure codes your Provider Group most often uses Click the Frequent diagnoses link above to set up a shortlist to used iEXCH AMGE to hold the diagnosis codes your Provider Group most often uses 83 AmeriHealth Administrators IEXCHANGE Administrator Frequent Providers Step 1 Submitting provider information 12 10 2009 Frequent providers list To view providers that have already been added select a Provider type and click Go Organization or Provider name to provider to the list Add new provider Setup frequent provider _ MS Organization name Enter provider First name mith information Middle initial E click Next step Last name Suffix NPI Next step 84 AmeriHealth Administrators IEXCHANGE Administrator Frequent Providers Setup frequent provider Step 2 MCO provider ID setup John Smith Select a payer from the drop down list enter the A Select a payer Payer select a Provider Role and ud click Add to list NOTE Please contact the AmeriHealth Administrators B Provider ID
22. entered by last name date of birth when you search by last name date of birth you must welue the Last nare and Date of birth Fields The First mame field iz optional wou may be instructed to the First name field the Last name and Date of birth you hawe entered matches more than one member record 12 10 2009 HELP PREFER IEXCHANGE MEDecision System Admin log out Search Inpatient Referral You must select Member search to retrieve the Patient s ID Jew Inpatient nd Inpatient Inpatient request entry Notification date Member ID Enter or Search for IQ 08 18 2009 mi 1 ds FY Y Y 4 Member search Search using Member ID search Member Enter the ID of an individual member Date of birth optiomsal Enter the member s date of birth 1 Member family ID no alpha characters and Date of birth or first name OR 2 Member s last name and date of birth or first First name optional Enter the first name of the member Cancel Submit search Last name date of birth search Last nan Enter the last name of the member Dake of birth Enter the member s date of birth First name if Enter the first name of the member Submit search 10 AmeriHealth Administrators Inpatient Request Entry Member ID cont Member search result Use
23. in this does not mean all services and LOS requested are approved Inpatient request preview Refer to the LOS and Service status to determine the individual status of services and requested LOS If questionnaires are Additional Authorization Questions available links will be available in this box which will allow you to provide additional Clinical information re which could change the expected status of your case to Approved Joan Patient Case status will be Authorized inpatient request Information Principal service Procedure ROUTINE OBSTETRIC CARE INCLUDING ANTEPARTUM CARE VAGINAL DELIVERY WITH OR WITHOUT 59400 Servicing Provider MILA LL J2 fol Arrese EB slelus 12 10 2009 19 AmeriHealth Administrators Inpatient Request Preview Submit request General information Use this section to edit any General information including the member ID click Member search to verfy eligibility providers submitting facility treatment setting admit date and any diagnostic information 12 10 2009 Notification date Member ID Enter of Search for ID Submitting provider Facility Select facility from the list or Enter or Search for ID Treatment setting Is this a surgical admission Admit date Is this an emergency 12 08 2009 01 234567 01 Kildare John A412345 Crozer Taylor Springfield Inpatient
24. procedure Salart fram PES E and scheduled Short list For maternit delivery use date for the service 59400 for vaginal delivery Scheduled or date 12 Bo mm dd yyyy and 59510 for cesarean section Servicing Your ID Provider search provider Ealar c NOTE when requesting multiple Eus units for a procedure the procedure ID code scheduled date and servicing provider must be entered separately for each unit 12 10 2009 17 AmeriHealth Administrators Inpatient Request Entry Additional Comments Contact Information Number where Patient Care Management can reach you with any questions Additional Comments optional iIEX CHANGE Contact Information Your name and phone number Clinical Information Patient symptoms and treatment plan iIEX CHANGE Clinical Information Dyspnea O2 Resp 26 Bronehodilators name ot drug IV Solumedrol dosage Additional Comments Information relevant to this notification Note It is possible to paste Direct adm from SNF name these fields iIEXCHANGE Additional Comments Click Next step to continue Cancel _ 12 10 2009 18 AmeriHealth Administrators Inpatient Request Preview Expected Status and questionnaires Preview Page will display the expected status of the case NOTE a status of Authorized
25. search for 12 10 2009 42 AmeriHealth Administrators Treatment update search Click Submit search to view updates that match the search criteria selected 12 10 2009 Date range Specify the date range for your treatment update search Search filter Specify the types of treatment updates you want to search for Submit search Search filter Specify the types of treatment updates you want to search fnr Submit search Today Past 1 days Past days sedips Specify the Date range Past4 days Past5 days for your search Past6 days Past days Past days Past9 days Past 10 days Past 11 days Past 12 days Past 13 days Past 14 days Specify the types of Treatment Comments added S h filt Status changed to Approved earch Titer Status changed to Denied NOTE the values in the search filter drop Status changed to Pend down list will vary based on your category treatment update type selection 42 43 AmeriHealth Administrators Treatment update search ERE update summary View di a ails marked Pom Current View Remove marked items from current view Updates for Facility Servicing Provider Welby Marcus Member PATIENT Jc JOAN 01234567 02 m Update Facility wt Servicing Case p nar mir ak Provider Confirmed treatment end date Tree rien Prime diagnosis Last request
26. this page to Select a specific member from a subscriber group Click View details to see individual member records Click New search if you would like to search for a different member Click on View existing cases to review TENE d previously submitted Member ID mme Birth Relation requests and avoid Select details potential duplicates JOAN J View existing cases Click on Select to return to the Request New search Cancel Entry screen 12 10 2009 11 AmeriHealth Administrators Inpatient Request Entry Submitting and Facility Provider ID Sponsored by Amertfiealth Starting point Payer selected Ae rib e za th Administrators General information Use the General information Section to record the member ID click Member Search te werify eligibility prowicderz submitting and Servicing as well as diagnestic information 12 10 2009 HELP PREFER ENTES Inpatient Mevr Inpatient Ectend Inpatient Inpatient request entry Notification date Member ID Enter or Search for ID Submitting prowider Treatment setting Is this a surgical admission Admit date Is this an emergency 12 iEXCHAMNMGE Pat Lake log owt Search The Submitting provider and Facility fields can be saved as favorites by administrative users eliminating additional keystrokes or searches Referral Provider searc
27. to list for the first payer you can Crestor select a new payer from the When this provider is filed they will be immediately available to users for The soe inpatient and other requests The provider vall not be available in Treatment Search the drop down list add the Care Organization has approved the submitting provider for use in Treatment Search transactio Managed Organization determines that the submitted Provider ID iz not correct or not app provider code and click Add to list again then the provider will be removed from the list of available submitting providers for referral inp other requests Providers for the group SrneriHealth 123456 LIBER OV Delete Aa Save list Cancel 12 10 2009 81 AmeriHealth Administrators IEXCHANGE Administrator Submitting Providers A Select a payer B Provider ID Pa yer MCO Provider Code Supplemental Provider ID After your payers have oo ee appear at the bottom of the screen L Mark as Default Submitting provider Addio list Providers for the grop Sadrninistrators rneriHealth Sdrninistratorz 12 10 2009 When this provider is filed they will be immediately ailable to users for the submission of referral inpatient and other requests The provider will be available in Treatment Search until the Managed Care Orga
28. 0 2009 requests for a member s associated with a provider This includes referring providers servicing providers submitting providers and or the member s A Treatment Range Start Date mm dd vyyy mm dd yyyy Search filter Show Referral Inpatient and Other treatments G AI cases Open cases Requesting provider All A m po optional To narrow your search search for a Case ID Member ID or enter 1 Requesting provider Case Reference pu Requesting provider AII 1 20 20 AmeriHealth Administrators Treatment search Member ID or Case ID Treatment search summary This page provides a summary of the treatments that meet the search criteria entered such as the service primary diagnosis and the status of the requested treatment Click View details to see more information about the treatment and the ability to extend the treatment dates Your search results will only include Treatment Lastdetailline 70 1 dates status reason d TT specific Inpatient request LOS 724 5 BACKACHE MTM Member ID or LENGTH OF STAY UNSPECIFIED ene a the Case ID PATIENT JOAN 01234567 02 View details AMINOTOMY 724 5 BACKACHE 01 05 2010 Authorize Approved that was HEMILAMINECTOMY WITH UNSPECIFIED 01 05 2010 by PCM entered Click View details if you wish to view additional information
29. 009 Extension Requests Extend Inpatient Inpatient request extension entry Submitting Kildare John A12345 provider Extension 315 90 Advanced Joint Disease 71990 primary r Diagnosis search Diagnosis Code er Select from Short list Secondary diagnosis Secondary diagnosis _ optional Attending Welby Marcus A23456 physician Can dm attending physician from the list 274714106 A23456 Providersearch ID Additional requested LOS units LOS bed Acute Med Surq we type 64 Enter required information including Additional requested LOS units LOS bed type AmeriHealth Administrators Extension Requests Extend Inpatient Soe optional 7 P gcheduted necessary procedure codes as well provider zrwiciri dg NOTE when requesting gt Visti ID the procedure code Md ditional Comments optional scheduled date and servicing iEXCH ANGE Contact Information separately for CHANGE Clinical Information Comments added as necessary Click Next step to continue gt Additional Comments 12 10 2009 65 AmeriHealth
30. Additional Comments Information relevant to this notification Note It is possible to copy and paste in these fields ai Click Next step to continue AmeriHealth Administrators Outpatient Other Request Preview Expected Status and questionnaires Other request preview Preview Page will display the expected status of the case NOTE a status of Authorized in this field does not mean all services are approved Refer to each individual service status to determine the status of each Other request information t bow n service requested PATIENT JOAN Case status will be Authorized Additional Authoriz Principal service Procedure AR THROSCOFYT KNEE SURGICAL WITH MENISCECTOMY MEDIAL AND LATERAL available links will be INCLUDING ANY 29580 Description Unit s i E available in this box which Start date 12 29 2005 will allow you to provide End date 12 29 2009 M e 5 additional clinical information Servicing KIldare Jolhri 412345 which could change the ae i expected status of your case Address 2 to Approved City ALTOONA State Zip code 14660253454 Specialty Internal Medicine Status Authorize ons Suestionnaire vou mil be ac 12 10 2009 31 AmeriHealth Administrators Outpatient Other Request Preview Submit Request mnrn dd w
31. Administrators Starting point Payer selected AmeriHealth Administrators Sanat friendly wersion atient John Principal service Status Authorize Extension LOS units Admit date To date Primary diagnosis Bed type Attending physician Attending physician MCO ID Attending physician NPI Procedure Servicing provider MCO ID Servicing provider NPI Member name Member ID Date of birth Group ID Group name Subscriber ID Subscriber name Relationship Treatment setting Submitting provider Submitting provider MCO ID Submitting provider NPI Address City State Zip code Specialty Type Facility Facility MCO ID Facility NPI Address City State Zip code Specialty Type 12 10 2009 HELP PREFERENCES Inpatient New Inpatient Request Extend Inpatient Informational Rule ID 8 status com A Inpatient request extension preview Case status Authorized 1 07729 2009 08 02 2009 540 0 ACUTE APPENDICITIS WITH GENERALIZED PERITONITIS Private Room BEAULIEU JACK 383206 PEND LIGHT COMPRESSION BANDAGE ELASTIC KNITTED WOVEN WIDTH GREATER THAN OR EQUA A6449 A00178 1234567 02 Inpatient BROWN MARK J Aoooss DEPT OF NEUROLOGY 3400 SPRUCE ST PHILA PA 19104 Neurclogy BARNES JEWISH ST PETERS BARNES JEWISH ST PETERS PO BOX 60331 ST LOUIS MO 631600331 Inpatient Extension Requests Extend Inpatient iEXCHANGE MEDecision
32. Home Health KePRO Inpatient Keystone Mercy Healthplan Liberty Mutual UM MDwise Hoosier Alliance aS et ee Te ee rT 12 10 2009 73 AmeriChoice NE Share Advantage Select button You Select AmeriHealth AmerCheice PAMedicid Mi Administrators Independence MEDecisigg Anno Administrators and click Select AmeriHealth Administrators IEXCHANGE Administrator Starting point Payer selected AmeriHealth Administrators Sponsored by AmeriHealth Starting point Payer selected AmeriHealth Administrators 12 10 2009 HELP PREFERENCES Inpatient Referral Available tasks Inpatient Other Referral appear above to the right of the payer yo Click the task you want to open the task page Noti that the available tasks may vary by payer iEXCHANGE MEDecision HELP PREFERENCES System Admin log out iE CHANGE administrator Select IEXCHANGE Pl administrator iEXCHANGE preferences Change password Click the Change password link abowe iIEXCHANGE administrator Click the EXCHANGE administrator link above 74 AmeriHealth Administrators IEXCHANGE Administrator Account Administration IEXCHANGE Administrator Administer Group administration Click the Group Administration link above to enter or edit information about your EXCHANGE Provider Group Select Account Click the Account administration link above to enter or edit
33. I Servicing prowider Mhi Service 22 Procedure aime OR OTHER OUTPATIENT Form ATION ANG PmASITQACSEPRTEPMT OF AM ESTA Serwicing prowider Serwicing prowider NPI Serwicing prowider Maco Ir LOS Status Status of requested LOS Submitting provider Physician Hame Gubmitting prowider NPI Submitting prowider iD LS status ID Admit date Te date Los days Treatment setting Inpatient 2l AmeriHealth Administrators Outpatient Other Request 1 Outpatient Request Entry all fields must be completed unless marked as Optional Certain optional fields may be required by the payer such as contact information in the Additional Comments fields Additional comments can be provided or cut copied and pasted using the free text boxes at the bottom of the Inpatient Request Entry page Please do not use the following characters the fields Additionally please do not use non English language characters in IEXCHANGE Notes or any other iEXCHANGE field Use of characters such as N will result in delayed processing of your request Outpatient Request Preview evaluates the information entered and provides the expected status of the case and provides the opportunity to add or edit information prior to submission Outpatient Request Confirmation provides the overall case status including the Case ID along with the status of each individu
34. Search Treatment Update Search If receive a pended response via iEXCHANGES how will be notified of a change in status After you logon to iEXCHANGES and select AmeriHealth Administrators or Independence Administrators as a payer you will receive a Treatment Updates message Clicking on this option will notify you when AmeriHealth Administrators has updated the status for any requests previously submitted via iIEXCHANGE If the initial request was submitted manually will be able to view the case electronically by submitting a treatment search Yes you will be able to search for the case within iEXCHANGE However you will be able to view cases only if you are associated with the case i e you are listed as the facility attending or servicing provider Can submit inpatient requests a Monday for patients that were admitted on Friday or over the weekend Yes Can information be printed from iEXCHANGE You can print any of the Web page screens you view by clicking on the Print button on your browser The printed pages can then be retained for your records 12 10 2009 94 AmeriHealth Administrators
35. Subscriber IL Subecriber name Primary care physician ec Io ce sahoans iEX CHANGE Centect IES CHANGE Clinical I nferrmatian iExX CHANGE Additional Comments LO Information Tremgtrent setting 12 10 2009 the lats al m Est 1 button ick Extend to add I Modify case and for treatment data i 1 1 1 1 Case ID 1093S 410002 Status Approved 2 DA 01 1967 An Adm Oi Oi1 2zO0OO00 999999 Click the Extend Request button associated with the LOS treatment The Inpatient request extension entry page will open Group Name 01234557 PATIENT JOHN i A mL 12 07 2009 03 56 FM ET User TEXCHANGE Provider User EPmatf 2152 222 121z 22 O7 zogogo 9O3i 5 amp PM Usar TES CHANGE Web Provider User EYmMmpteans nd treastmoant plan LZ 07 2009 035S EM ET User Wah Provider User informstion relavant to the if applica blg Extend Request 63 AmeriHealth Administrators Extension information Select the submitting provider a tansian primary diagnosis and enter the additional requested length of stay units You may select m procedures if applicable Click Next step to continue iEXCHANGE evaluates your inpatient extension request and displays the Inpatient requaest extension preview page 12 10 2
36. View all View open View all View open Member Service Primary diagnosis New search Cancel 12 10 2009 51 AmeriHealth Administrators Treatment search View details Provides the overall Case status ails including the case ID member data ami NOTE a status of Approved in an Extend button Click Ext d to acd E ick Modify case and or treatment this field does not mean all services UU NUR and LOS requested are approved PATIENT JOAN Case ID 1093410002 Status Approved Refer to the LOS and Service status to determine the individual status of Emend Request 216 24 1419 05 Les Trt aie Sri Sa Eo tiem gH 0 POE a oe CRI mS IER T wf oo OTF DEBER b E amor of ete Ea auem ame ro Din Gisele eo m Prine Din Bae oh 8 Eh oe a ee a ee ee ee Camm Ras asgcamaua a O34 OOOFL Oooo LOS SICHER Status of ER RUN bee ee start tate requested LOS eS ee ee 7 Pe racine soe fo la aa Rcx Boc ee od Kildare John 8 2345 ew me cdd d eu Sener icles ee Le Pee TS eee Se FELA Ss Fo
37. above to set up a shortlist to be used in EXCHANGE to hold the providers your Provider Group rnost often uses Select Frequent Frequent procedures __ _ proceaures ures O a 2 22 frequently used Provider Group most often uses codes Frequent diagnoses Click the Frequent diagnoses link above to set up a shortlist to used in iEXCH AMGE to hold the diagnosis codes your Provider Group most often uses 88 AmeriHealth Administrators IEXCHANGE Administrator Frequent Procedures Frequent Procedures Procedure code Edit Delete PUn 27447 Delete Delete 43370 e n m 45378 12 10 2009 Procedure description Total Hip Replacement Total Knee Replacement Arthroscopy Knee Bronchoscopy Diagnostic Biopsy Lung Procedure codes that have been added Pacemaker Insertion CABG previously can be edited or deleted Tog fomy and A amp denoidectorny age lt 12 Tonsillectomy Gastric Bypass Colectomy Partial Colectomy Total Appendectomy Colonoscopy Ambulance Transfer Click to list to add new procedure codes Add to list 89 AmeriHealth Administrators IEXCHANGE Administrator Frequent Procedures Edit Frequent Procedures Procedure code Procedure Physical Therapy Office Visit Skilled Nursing Visit Occupational Therapy Outpatient Setting Ambulanc
38. al requested service and LOS 12 10 2009 22 AmeriHealth Administrators Outpatient Other Request Entry HELP PREFERENCES Starting Inpatient point Payer selected New Other request AmeriHealth Extend Other Administrators Othe Referral Other instructions 2 New Other Reguest Click the New Other Request link above A blank Other request entry page appears You can add a member ID and all request information for this member Extend Other Click the Extend Other link above You must use the Treatment search functionality to search for the other treatment you wish to extend Depending on the payer you have selected you will be able to submit an Other request extension or an Other notification extension 12 10 2009 23 Click on Other gt gt Select New Other Request AmeriHealth Administrators Outpatient Other Request Entry Member ID HELP PREFERENCES Starting Inpatient Referral Search point Payer selected New Other Request AmeriHealth Extend Other Administrators You must select Member Other request entry search to retrieve the Patient s ID General information _ _ Notification 09 30 2009 mm dd yyyy date section to record the Enter or member ID click Member Search for ID Search using by member Member ID search The Menier Enter the ID of an individual member 1 Me
39. dded or existing treatment extended Additionally the date the Treatment Update was generated appears in this column Treatment rare en Jahn ART JA i Pee FRAGE i d 12 07 2009 Vitis sie ELLA m Testment RS ACELA 12 07 2009 John wish to view additional UNSPECIFIED LU tD O1 200 A THROSIS 42 ERES Vm LIZED DRIM information 12 10 2009 3 AmeriHealth Administrators Treatment Updates View new or updated treatments Treatment update summarv View details from current view Remove marked items from current view Updates for Facility Servicing Provider Kildare John Member Patient John 123456701 Remove Click View details if you wish to view additional information 12 10 2009 vent Confirmed Servicing Case ID Service Primary diagnosis reatment Last request treatment EY Provider dates status reason ond date L Treatment Kildare 0032700002 Other request 511 71 09 30 2009 Authorize Auto added Jahn 19100 BIOPSY OF MASTODYNMIA Approval on BREAST 05 30 2009 05 27 2005 PERCUTANEOUS NEEDLE CORE NOT USING IMAGING View details GUIDANCE
40. e Administrators A Select a payer Payer E Provider ID NOTE Please contact the EXCHANGE Help Desk at AmeriHealth Administrators for assistance with identifying your Provider Code When this prowider filed they vill be immediately available to users for the submission of referra 1 888 444 4617 inpatient and other requests The provider will not be available in Treatment Search until the Mana Care Organization has approved the submitting prowider for use Treatment Search transactions Managed Care Organization determines that the submitted Provider ID not correct or not approy then the prowider will be rernowed from the list of available submitting prowiders for referral inpati other requests PICO Prowider Code Supplemental Prowicdgs m Mark as Momitting prowider Providers for the group M Eee Save list Cancel _ _ 12 10 2009 80 AmeriHealth Administrators IEXCHANGE Administrator Submitting Providers 2 MCO provider ID setup University Hospital A Select a payer NOTE The MCO provider codes are the same for both AmeriHealth Administrators and Independence Administrators but need to be added separately Independence Administrators B Provider ID NPI MCO Provider Code Supplement Prowider ID Mark as Default Submitting provider After you select Add
41. e Transfer ve Cancel 12 10 2009 90 Enter the Procedure code and description Click Save and the newly added codes will appear in your drop down list the next time you accessthe transaction request screens AmeriHealth Administrators 12 10 2009 IEXCHANGE Administrator Frequent Diagnoses IEXCHANGE Administrator Administer provider D 4083 Group administration Click the Group Administration link above to enter or edit information about your EXCHANGE Provider Group Account administration Click the Account administration link above to enter or edit information about account users for your iEXCCHANGE Provider Group New users of EXCHANGE set up here roviders Click the Submitting prowiders link above to enter or edit information about the providers for which an iEXCH AMGE transaction can be submitted Submitting providers should correspond to healthcare providers within your iEXCHANGE Provider Group At least one Submitting provider must be set up in order to perform a transaction in iEXtCHAMGE Frequent providers Click the Frequent prowiders link above to set up a shortlist to be used in EXCHANGE to hold the providers your Provider Group rnost often uses Frequent procedures Click the Frequent procedures link above to set up a shortlist to be used in iEXCHAMGE to hold the procedure codes your Provider Group most often uses Frequent diagnoses Click the F
42. e the updat ou have made to the case and return Treatment se Re abite case and treatment inform natio mm 15 oe am below Additional treatment information Enter additional treatment information Has the patient been admitted When was the patient admitted Additional case gt Edit information related to case information Enter additional case IEXCHANGE Contact Information information iEXCHANGE Clinical Information iEXCHANGE Additional Comments 12 10 2009 Edit information related to length of stay Yes No 55 Select the Yes indicator to specify that the patient has been admitted The admission date fields will be enabled Specify the date that the patient was 74 admitted additional comments in the Comments section Click the Save button AmeriHealth Administrators Edit Case Discharge information Edit case __ EXCHANGE will sava the EAE yau hava made Ihe case cre Select the Yes indicator to specify rmation is Fi that the patient has been Additional treatment Edit information related to length of stay discharged UAE discharge date information fields will enabled Specify the The patient was admitted on 09 20 2009 date that the patient was Has the patient been discharged Mies No discharged When was the patient discharged 09 me AOS mmidd y Enter additi
43. equently Used Diagnosis from the drop down list OR 2 Select Diagnosis search to search by code or description Diagnosis search AmeriHealth Administrators Outpatient Other Request Entry Attending physician amp Review Type Attending Select Attending physician from the physician Services information Enter or select the principal procedure code and any additional secondary procedures Enter the Servicing provider the number of requested units visits az well as the start and end dates for each procedure 12 10 2009 Select Name 4747 physician Name 2 C12121 from the list search for ID Review Type Other se ms z Treatment Initial clinical review type Initial non clinical review Subsequent clinical review Other Treatment type Chiropractic Diagnostic Procedure Durable Medical Equipment Home Care Hospice Procedure Medical Enter Procedure i code or Select Obstetrics from Short list Orthotic Prosthetic Principal Se Servicing provider Transplant Select servicing Transport provider from t 28 drop down list created by administrative users or search by name by clicking on Provider search Provider search Review Type If you know the clinical details of the case select the appropriate clinical review option otherwise select nitial non clinical review Other Treatment type Enter the type of treatment i e Medical Surgical
44. field does not mean all as 24 services and LOS requested are Ee approved A JAffascEm pte tue accessed Refer to the LOS and Service status to determine the individual status of services and requested LOS AmeriHealth Administrators Extension Requests Extend Other Outpatient 12 10 2009 fem ry in Selatan Treatment search details Joan Case O09 7800001 Status Hiab BD Cente p birth Maeve soe fubscriber merma Primary tare phyygkicimm 5 PEOP Le phocmna 24 7 Lah x E ev me pem Ad mentum iens UUg358 Group Hame Graup Name Click the Extend Request gt button associated with the treatment The Other request e eXtension entry page will open mAH arr ton ihe C Currer 818 Extend Request HLALLLKEE Slots temp Of Hj freee Trmmkrriammd pisri ama Tem mtr ad ol mi do PY Cid Otel pon arwerbrtge prewar proevider Blo DD ier provider n PET E ISIL ug Sepia censuum Cute Perio LEN L4 10 124 200 ARLATEN MIMO LAL OPT aL Dansa Mm ie m BA Gih
45. hat reads Back to login 12 10 2009 4 AmeriHealth Administrators Logging In You can access IEXCHANGE from the below websites For AmeriHealth Administrators members Go to http Awww amerihealth topa com providers and click on iEXCHANGE Login For Independence Administrators members e Go to http www ibxtpa com providers and click on IEXCHANGE Login Please note AmeriHealth Administrators provides health utilization management case management and other administrative services for Independence Administrators Registered NaviNet users for AmeriHealth Administrators and Independence Administrators can access IEXCHANGE through a link added within NaviNet at httos navinet navimedix com 12 10 2009 5 AmeriHealth Administrators Logging In A Username iEXCHANGE ID and password will need to be created for each user IEXCHANGE ID is a unique account number assigned for your provider and will stay the same for all payers Passwords must be reset by the user every 30 days Click the Cancel button if you incorrectly enter any of the information or you simply want to start again If you are unsure of how to proceed click HELP at the top of the page to open the IEXCHANGE Web Help IAN iEXCHANGE Select Provider login and enter your User ID ID Password 12 10 2009 6 AmeriHealth Administrators Logging In Select a payer Sponsored b
46. here you can view the updated treatment information AmeriHealth Administrators Treatment update search Use the Treatment Update Search functionality to search for and display Treatment Updates for your group The Treatment Update Search will return all Treatment Updates matching the search criteria you specify including those that have been marked as viewed When you perform a Treatment Update Search and access the Treatment update summary or Treatment update details page you will not have the ability to mark the Treatment Updates as viewed remove Treatment Updates from the current view As a result of this the following differences should be noted Treatment Update Summary Page The Viewed indicator column and the Remove marked items from current view link do not appear when the Treatment update summary page is accessed through Treatment Update Search Treatment Update Details Page The Remove all treatment updates from current view link does not appear when the Treatment update details page Is accessed through Treatment Update Search 12 10 2009 40 AmeriHealth Administrators Treatment update search HELP PREFERENCES System Admin log out Starting Inpatient othe Referral Search point Payer selected Treat nen AmeriHealth presen Administrators Treatmatnt search Se TTL Zar informatio Tation about a ng your gro Treatment search Click the
47. irmation Sia rwice information ama Reference X5 QUI420003 901001 Status Authorize E ricecaech ure Limiti S j Start dats End date Servicing provider HECO ED Servicing provider mane Purch hart Diagnosis information Primary diagnosis Trestment informa tian Setting Descriptio Pictifirzmkimrn date Typ Other A Extend e vul lg Case ID OO93 470002 Status Authorized Referral memes Confirmation screen provides overall Case status NOTE a status of Authorized in this field does not mean all services are approved if multiple services have been entered Refer to the Service status to determine the individual status of each service requested ARTHROSCOPY KNEE SURGICAL WITH z eECTOMY MEDIAL ATI Any ME 1 12 29 2009 12 29 2009 Status of each Requested 412345 Kildare John Service are listed as well T17 B8 THIS IS AN INVALID LCD 99 CNM STH DIOGITZ REQUIRED OTHER INTERNAL DERANGEMENT Gutpstiesnt Facility Imitiml memnm eclimicmal 33 AmeriHealth Administrators Treatment Updates Treatment Update functionality notifies you when AmeriHealth Administrators AHA or another provider has created or modified a Request Categories of Treatment Updates include Updates from MCO Inform
48. mber f ly ID mandatory The Date of Date of birth Po er birth and First name fields optional B are optional You may be Enter the member s date of birth instructed to value the Date alpha characters and Cf birth and or First First 77771 fieldiis if the member optional search you perform returns Enter the first name of the member of birth first eee eh criteria you entered Se grates B Last name date of birth search Last nan 2 Member s last name Enter the last name of the member When wou search by last name date of birth you Date of birth se must walue the Last name Enter the member s date of birth date of birth and Date of birth fields The First name field iz optional First E a E You may be instructed to optional f t waelue the First name field if Enter the first name of the member Irs name the Last name and Date of birth wou hawe entered Submit search Clear form Cancel matches more than one member record 12 10 2009 24 AmeriHealth Administrators Outpatient Other Request Entry Member ID cont Member search result Use this page to Select a specific member from a subscriber group Click View details see individual member records Click New search if you would ee mes E 1 Click on View existing different member cases to review elect a req
49. n existing case 12 10 2009 53 AmeriHealth Administrators Edit Case Treatment search details PATIENT JOAN Member 10 Cate of birth Meornber Line of business Cowversge dates Group ID Group name Clienmt code description Subscriber ID Subscriber name Primary physician PCP PP ID EGP phone IEJ CHANGE Contact Information Clinical Imnforrmtiarn IEXCHANGE Additional Cemments 12 10 2009 Case ID 1093410002 Status Approved cte i lt Extecna T Modify case treatment data Modity case and or treatment dats 01238056702 02 01 1967 42 AH Adm Oi Oi 2000 990909 Group Name 01233456527 PATIENT JOHN 2009 6247586 PM ET User EXCHANGE Web Provider Liner Pet 215 222 1z142 12 07 2009 02 56 PM ET User EXCHANGE Vet Previder User symptoms and traatemment plan L2 o7 2008 03 56 ET User IEXCHANGE Wieb Previder User information ralavant to the admission if applicable 54 Treatment search details or Treatment update details page select either Modify case and or treatment data or add to comments to display the Edit Case NOTE These links ill not display if The case you are attempting to edit has been closed by AHA AmeriHealth Administrators Edit Case Admission information Edit case enter the appropriate information r
50. nistrators and click Select 12 10 2009 7 AmeriHealth Administrators Inpatient Request 1 Inpatient Request Entry all fields must be completed unless marked as Optional Certain optional fields may be required by the payer such as service procedures for surgical and maternity admissions and contact information in the Additional Comments fields Additional comments can be provided or cut copied and pasted using the free text boxes at the bottom of the Inpatient Request Entry page Please do not use the following characters in the fields Additionally please do not use non English language characters in IEXCHANGE Notes or any other iEXCHANGE field Use of characters such as will result in delayed processing of your request Inpatient Request Preview evaluates the information entered and provides the expected status of the case and provides the opportunity to add or edit information prior to submission Inpatient Request Confirmation provides the overall case status including the Case ID along with the status of each individual requested service and LOS 12 10 2009 8 AmeriHealth Administrators Inpatient Request Entry Starting Point Sponsored by iEXCHANGE MEDecision AmeriHealth HELP PREFER ENTES System Admin log out Starting Inpatient Referral Search point Payer selected Mew Inpatient AmeriHealth Request Administrators Extend Inpatient
51. nization has approved the subrnitgesfa provider for use in Treatment Search transactions If the Managed Care Organization determines the submitted Provider ID is not correct or not appropriate then the provider will be removed frorgesfne list of available submitting providers for referral inpatien oiher esses Click Save list and your newly added providers will appear your drop down lists the next time you access the transaction request screens 123456 SUBPR OW AmeriHealth Administrators IEXCHANGE Administrator Frequent Providers 12 10 2009 IEXCHANGE Administrator Administer prowider group 4083 Group administration Click the Group Administration link above to enter or edit information about your EXCHANGE Provider Group Account administration Click the Account administration link above to enter or edit information about account users for your iEXCH JANGE Provider Group New users of EXCHANGE can be set up here Submitting providers Click the Submitting prowiders link above to enter or edit information about the providers for which an iEXCHANGE transaction can be submitted Submitting providers should correspond to healthcare providers within your iEXCHANGE Provider Group At least one Submitting provider must be set in onder to perform a transaction in EXCHANGE Select Frequent roviders to add facility attending and Click the Frequent prowiders link abowe to set up
52. nt Joan seein lew Inpatient request 1234567 02 APEENDECTOMY 44950 Inpatient request BRONCHOSCOPY RIGID OR FLEXIBLE WITH OR WITHOUT F 31622 2092800001 Other request HALLUX 2 d RISE CORRECTION lists View details 12 10 2009 Primary diagnosis 485 BRONCHOPNEUMONIA ORGANISM UNSPECIFIED 485 BRONCHOPNEUMONIA ORGANISM UNSPECIFIED 485 BRONCHOPNEUMQONIA ORGANISM UNSPECIFIED eT PNEUMONTA RGAN I SM UNSPEL 727 1 BUNION 62 The Treatment search summary page will display a summary of all _ Inpatient and or Other Outpatient cases matching the search criteria you entered Treatment E dates 10 07 2009 10 11 2009 10 07 2009 10 07 2009 NOTE If the search results one case being returned only one case matched your search criteria iEXCHANGE G Web will send you directly to the Treatment search results details page 10 08 2009 Authorize Approved 10 08 2009 by PCM 10 09 2009 Aut hgg Oy og 20059 Click the View details link associated with the case 10 16 2009 Aut 10 16 2009 AmeriHealth Administrators Extension Requests Extend Inpatient Treatment search details Tht page let the f ts luigi PATIENT JOAN ID Date of birth Miar mage Ling of Business Coverage dates Group ID Group ane Client code description
53. nt updat m ooo Loo PATIENT JOAN Maprminae ELI Dmte of birth Lines of business Coverage dater Group ID Grou e code demscripkin Submcriber TE ber numos Primary PSP e phere Contact nfornrnation IE CHANGE a bior 12 10 2009 Case ID 1093410002 Status Approved Modify come and or brestment data oOz O1 1967 Ah Admi L L 2000 9999999 Group Name PATIENT JOHN 2009 03 54 ET Users ENR CH 4508 Vee Pravidar Eat E 215 455 2 i2z Q07 20059 03 5386 ET Users EXCHANGE syrnptornm and testment plen 45 The Treatment update details displays listing of all Treatment Updates that have been generated for the case at the top of the page The rest of the information presented on provides you with a complete view of all case activity Selecting a Treatment Update link will scroll the page to the appropriate section where you can view the updated treatment information AmeriHealth Administrators Treatment search Allows you to search and view all requests submitted Date range For a specific member For a specific case or service Case ID or Case Reference search Use this to view an updated status comments from AHA and respond to the AHA s comme
54. nt update search link above The Treatment update search entry page appears 12 10 2009 47 AmeriHealth Administrators Treatment search Treatment Range Treatment search Use this page to search for existing referral requests and or inpatient and other requests for a member s associated with provider This includes referring providers servicing providers submitting providers and or the member s 1 a category A Treatment Range to search by Start Date Choose ONE Category and enter the appropriate values Click Submit search to view referrals and or inpatient and other requests Show Referral Inpatient and Other treatments End Date Search filter cases Open cases All Memberssarch Submit search Case ID Case ID Requesting provider Member ID optional Requesting provider Submit search Case Reference Case Reference Requesting provider 12 10 2009 48 To submit a broad search enter a Start Date an End Date selecta Requesting Provider AmeriHealth Administrators Treatment search Treatment Range Treatment search summary This page pro vides a such as the ser View details to treatment dates prima LR gn Member Service Primary diagnosis 724 5 BACKACHE UNSPECIFIED Inpatient request LOS STAY TN 1093410002 jew details PATIENT JOAN Inpatient uest
55. nts Displays all Inpatient and or Outpatient Other treatments for a member associated with a provider This includes Referring Providers Servicing Providers Submitting Providers and or the member s PCP 12 10 2009 46 AmeriHealth Administrators Treatment search HELP PREFERENCES System Admin log out Starting Inpatient Referral Search point Payer selected Treatr e nt search AmeriHealth Administrators Search instructions Use this page to perform various searches Treatment search allows you to view JU isting referral inpatient her requests F ider information about a provider Member search a y i out a member Treatment update search allows you to view tr In Your group Treatment search oS Click the Treatment search link above The Treatment search Under tab select entry page appears You can search by treatment range case ID or request ID for treatment information After performing a Treatment search to view status of all requests Prowider search submitted on behalf of your Click the Provider search link above The Provider search entry roviders page appears You can search by provider ID provider name or geographic location specialty for provider information Member search Click the Member search link above blank Member search entry page appears You can search by member ID only for member information Treatment update search Click the Treatme
56. on 12 10 2009 Account Administration Results 1 1 of i User name System Admin Logon ID sysadmin Edit user Add Account Information Requested logon ID Hew password Confirm new password First name Middle name Last name Suffix Status Assign admin privileges ACTIVE 76 Current status ATIVE Add new user Cancel il Click Add new user to create user ID s for new staff members Password Upon the initial login the new user will be prompted to change his her password Status Select Active for new users Assign admin privileges Add additional administrative users by selecting System Administrator Submit cantet AmeriHealth Administrators IEXCHANGE Administrator Account Administration an existing user or add a new user To edit an existing user select the radio button next to the user name then click the Edit user button To add a new user click the Add new user button password information Ser profile information 12 10 2009 Account Administration Select the radio button to the left of the User name and select Edit user to reset User napa Logon ID User role Current status passwords change System Admin sysadmin admin ACTIVE privileges or deactivate users Results 1 1 of 1 Edit user H Add new user Edit Account Information Reset passwords by assigning a temporary password Logon ID Hew pas
57. onal treatment information Specify the 222 sai cse after care program discharge plan for the patient from the drop list Additional case Edit information related to case information Enter additional case iEXCHANGE Contact Information information iEXCHANGE Clinical Information Add any additional comments iEXCHANGE Additional Comments Click the Save button Save Cancel 12 10 2009 96 AmeriHealth Administrators Edit Case Admission and Discharge already provided Edit case Use this page to edit case Once you entel iEXx CHANGE will sawe the updates vou haw Treatment search result bee bow Add itional treatment Edit information related to length of stay information If admission and Enter additional treatment The patient was admitted on 08 23 2009 discharge The patient has been discharged information information has The patient was discharged on 08 29 7009 The after care program discharge plan for the patient is Transfered to IP ali eady been Rehab Medical provided you are still able to enter t Edit information related to case additional comments Enter additional case IEXCHANGE Contact Information information IEXCHJ AAMGE Clinical Information iIEXCH ANGE Additional Comments Click the Save button Save Cancel 12 10 2009 of AmeriHealth Administ
58. point Payer selected Ao rl EHE e Heh Administrators 12 10 2009 Inpatient Referral gt hea we Inpatient Request Emternd Inpatient Inpatient instructions A blank Inps Click the Bow Inpatient Reguest link a bowe request entry page appears You can add a mern be request information for this ber Extend Inpatient Click the Extend Inpatient link a bowe Wow must use th Treatment search functionality to Search for the inpatient treatment wou wish te ecbend Depending cra the paper wou hawe Selected wou wall be able to submit an Inpatient request ercbensionm or an Inpatient meotification estensiom Inpatient Other Referral Search Mews 2 lt Request Extend Other Other instructions New Other Request Click the New Other Reqwest link abowe A blank Other request entry page appears You can add a member ID and all reg Extend Other Click the Extend Other link a bowe You must use the Treatment search functionality to search for the other treatment you wish to estend Depending on the payer wou hawe Selected pou will be able to submit an Other request extension or an tether notification estension 60 Sy stent od Search Inpatient extensions click on the Inpatient tab and select Extend Inpatient For Outpatient extensions click on the Other tab and select Extend Other AmeriHealth Administrators Extension Requests Treatment
59. rators Edit Case Outpatient Other Request Additional case information Enter additional case information 12 10 2009 Edit case Once you enter the appropriate information click Save the updates you have made to the case and returns you to the Treatment search result page Related case and treatment information is displayed helow FPT Edit information related to case IEXCHANGE Contact Information Add any additional comments in the Comments section IEXCHANGE Clinical Information Click the Save iEXCHANGE Additional Comments button 58 AmeriHealth Administrators Extension Requests Allows you to request additional days or services for an existing certification Extend Inpatient On the Inpatient Request Entry page you will be prompted to enter the below information e Submitting provider e Extension primary diagnosis e Attending physician e Additional requested LOS units Procedure Optional e Scheduled date Optional Comments Extend Other Outpatient On the Other Request Entry page you will be prompted to enter the below information e Submitting provider Extension primary diagnosis Additional requested units Extension start date Extension end date Comments 12 10 2009 59 AmeriHealth Administrators Extension Requests Starting Point Starting proint Payer selected ee a a ir m istra tors Starting
60. requent diagnoses link above to set up a shortlist to be used in iEXCH AMGE to hold the diagnosis codes your Prowider Group most often uses 91 Select Frequent diagnoses to add frequently used codes AmeriHealth Administrators IEXCHANGE Administrator Frequent Diagnoses Frequent Diagnoses Diagnosis code 153 9 162 9 12 10 2009 Diagnosis description Colon Cancer Lung Cancer Tancer Uterine Diabetes Morbid Obesity Depression Unspecified Diagnosis Postoperative Complications Preqnancy High Risk Pregnancy not otherwise specified 92 Diagnosis codes that have been added previously can be edited or deleted Click on Add to list to add new diagnosis codes T Cancer AmeriHealth Administrators IEXCHANGE Administrator Frequent Diagnoses Edit Frequent Diagnoses Procedure codes that have been added previously can be edited Diagnosis code Diagnosis description or deleted Unspecified Diagnosis Click Save and the Postoperative Complications newly added codes Pregnancy will appear in your High Risk Pregnancy not otherwise specified drop 22 drm next time you lr 0011 3 04 RN transaction request screens 12 10 2009 93 AmeriHealth Administrators iEXCHANGE Frequently Asked Questions What transactions are supported via iEXCHANGE Inpatient and Outpatient Certification and Extensions Treatment Search Provider Search Member
61. riHealth Administrators iEXCHANGE Features Improve communication and collaboration As a network provider with AmeriHealth Administrators and Independence Administrators you can streamline the precertification process and effectively communicate online by using IEXCHANGE a HIPAA compliant online solution offered by MEDecision Inc With iEXCHANGE you can Hequest inpatient and outpatient certification amp extensions Receive treatment updates Perform searches for members providers and treatments Delegated security model Allows iEXCHANGE system administrator to create and maintain user ids for the group and customize the drop down lists Frequently used diagnosis list Frequently used procedure list Frequently used provider list 12 10 2009 3 AmeriHealth Administrators iEXCHANGE Features iEXCHANGE benefits Reduced time and expense associated with paper telephone and fax processes Heal time responses for initial requests and extensions Treatment updates when a request has been modified or status changed Convenient access hours 6am 11pm EST No cost to providers iIEXCHANGE security Please be aware that if there is no activity for 30 minutes during your iEXCHANGE web session you will be timed out of the product that is your session will terminate automatically You will receive the following message Your session has expired Please login again You will be presented with a link t
62. s you of changes made by AHA to requests submitted by a provider in your group You can receive Updates from MCO when e AHA has modified the status of a treatment from Pend to Approved Pend to Denied Approved to Pend or Approved to Denied e has added comments to a Request or Notification submitted by a provider in your group Updates for PCPs Primary Care Physicians Generated for Primary Care Physicians in your group when treatments have been added or extended for their patients Updates for PCPs are designed to keep Primary Care Physicians informed of treatments initiated by other providers on behalf of the PCPs patients New or Updated Treatments Informs you of new or extended treatments added by a specialist or AHA with which your Facility or a Provider in your group is directly involved For example when a treatment is added and your Facility or a Provider in your group is listed as the facility attending physician or servicing provider you will receive a Treatment Update 12 10 2009 34 AmeriHealth Administrators Treatment Updates iEXCHANGE MEDecision HELP PREFERENCES System Admin log out Starting Inpatient Referral Search Payer selected a Select a task Administrators Available tasks Inpatient Other Referral or Search Select a link below to view treatment updates for the past 4 days View updates fram MCO View updates for PCPs View new or updated treatments After you have selected
63. search Use this page to search for existing referral requests and or inpatient and other 1 a category to search by Choose ONE Category and enter the appropriate values Click Submit search to view referrals and or inpatient and other requests 12 10 2009 requests for a member s associated with a provider This includes referring providers servicing providers submitting providers and or the member s PCP A Treatment Range Start Date mm dd vyyy mm dd yyyy Search filter Show Referral Inpatient and Other treatments From the 7reatment 2 all cases Open cases search page choose to Requesting provider perform rs Treatment _ ee optional search Case Reference search to Cancel search for the case B Case ID containing the case 1D treatment you wish to Requesting provider extend Submitsearch CancaL Click Submit search 5 C Case Reference n Requesting provider All 61 AmeriHealth Administrators Extension Requests Treatment search summary This page provides a summar such as the service primary r af the treatments th at meet the ip iere and the status of the View details to see more information about the ERE uA on Service Inpatient request LOS LENGTH OF STAY Inpatient request INCISION AND DRAINAGE OF APPENDICEAL ABSCESS OPEN 1092800002 44900 Patie
64. sword Confirm new password User must change password Change status or administrative privileges of current Suffix users Status Assign admin privileges System administrator Click Su bmit to save changes First name 77 AmeriHealth Administrators IEXCHANGE Administrator Submitting Providers 12 10 2009 IEXCHANGE Administrator Administer prowider D 4083 Group administration Click the Group Administration link above to enter or edit information about your EXCHANGE Provider Group Account administration Click the Account administration link above to enter or edit information about account users for your iEXCH JANGE Provider Group New users of EXCHANGE up here Submitting providers Click the Submitting prowiders link above to enter or edit information about the providers for which an iEXCH AMGE transaction can be submitted Submitting providers should correspond to healthcare providers within your iEXCHANGE Provider Group At least one Submitting provider must be set up in order to perform a transaction iEXtCHAMGE Frequent providers Click the Frequent prowiders link above to set up a shortlist to be used in EXCHANGE to hold the providers your Provider Group rnost often uses uent procedures Click the Frequent procedures link above to set up a shortlist to be used in iEXICH AMGE to hold the procedure codes your Provider Group most often uses
65. uests and avoid lew eGxIERLDng Cases E n potential duplicates ID name 1234567 PATIENT ct Wiew details JOAN D Click on Select to wWiew existir return to the Request Entry screen Cancel 12 10 2009 25 AmeriHealth Administrators Outpatient Other Request Entry Submitting Provider amp Treatment Setting Other request entry The Submitting provider General information field will be valued by Notification 09 30 2009 mm dd yy e date administrative users Use the General information Member ID 1234567 01 eliminating additional section to record the Enter or member ID click Member Search for ID keystrokes searches search to verify eligibility Zubmittin submitting provider as well 9 5 as diagnostic information provider Click on Drop Down Arrows o to fill in required fields Is this an emergency Treatment Outpatient Facility 12 10 2009 26 AmeriHealth Administrators Outpatient Other Request Entry Diagnosis code 12 10 2009 Enter Diagnosis code or Select from Short list diagnosis 2 optional diagnosis 3 optional diagnosis Enter Diagnosis code or Select from Short list per 7 diagnosis 2 optional diagnosis 3 optional 27 Enter Primary and secondary diagnosis codes be enter the code Back Pain 724 5 Diabetes 250 0 or selecting Fr
66. ut their group Account administration Allows providers to add edit account information users associated with their group Submitting providers Add edit or delete submitting provider numbers Frequent providers Add edit or delete servicing facility or attending provider numbers Frequent procedures Add edit or delete frequently used procedure codes Frequent diagnoses Add edit or delete frequently used diagnosis codes 12 10 2009 72 AmeriHealth Administrators IEXCHANGE Administrator Sponsored by EX iEXCHANGE HELP PREFERENCES sys admin log out Starting point list of payers Sel gt Select t mta payer once on the tuni Inpatiern Click on the dro down arrow to payer to which Search appear above to vem ik to you select Click AmeriChoice AZ Medicaid APIPA 2 display the AmeriChoice MD Medicaid United then click the very REPARA AmenChoice NJ Medicaid ray need teo scroll te find the AmenChoice WI AmenHeath Administrators AmenHealh Mercy Health Plan Awidyn Health BCBS of Illinois Retred Blue Cross Blue Shield of Delaware CapitalCare Only CareFirst BlueChoice CareFirst Maryland Indemnity DHP Separate Legal Entty Facets CareFirst Healthy Indiana Plan Independence Administrators KePRO Hillsborough KePRO
67. wious and mest links to wiew the prior or next set of diagnoses meeting your Search criteria Diagnosis chf Diagnosis HEART FAILURE UNSPECIFIED CONGESTIVE HEART FAILURE UNSPECIFIED Select the appropriate LEFT HEART FAILURE description HEART FAILURE DIASTOLIC HEART FAILURE COMBINED SYSTOLIC AND DIASTOLIC HEART FAILURE Encoder Results Click Yes to add the diagnosis code to the list Code 428 9 Yes to HEART FAILURE UNSPECIFIED the code to your request 12 10 2009 14 AmeriHealth Administrators Inpatient Request Entry Requested length of stay Diagnoses Diagnosis code Diagnosis description Primary Click Save to HEART FAILURE UNSPECIFIED o retu rn to the Request screen 428 9 E Save Cancel Primary diagnosis Enter Diagnosis Requested length of stay LOS aap nee If the admission is a DRG admission enter 1 for the length of stay Secondary T th b dispo otherwise enter the number ol optional requested days For maternity pre Secondary e 2 i delivery or 4 days for Cesarean optional section Requested length of stay 12 10 2009 15 AmeriHealth Administrators Inpatient Request Entry LOS Bed Type and Review Type Attending The Attending physician hwsici z can be saved as favorites by physician from the E administrative user enter or search Provider search
68. y Ameriffealth iEXCHANGE MEDecision HELP PREFERENCES sys admin log out Starting point Select a payer Select a task Click once on the Available tasks Inpatient Other Referral or payer to which Search appear above to the right of the payer You want to you select Click the task you want to open the Il mast hoica AF APIPA subrniE a 7 task page Note that the available tasks may transaction am gt AmenChoice MD Medicaid United then click the vary by payer AmeriChoice NE Share Advantage A AmeriChoice NJ Medicaid am scroll to find the Cl k h d d AmenChorce MJ Personal Care Plus payer you want 1 rop own arrow to AmeriChoice PA Medicaid WI jAmenHealth Administrators AmernHealth Mercy Health Plan Avidyn Health BCBS of Illinois Retired Blue Cross Blue Shield of Delaware CapitalCare Va HMO Only CareFirst BlueChoice CareFirst D C Indemnity CareFirst D C National Accounts CareFirst FEP PPO CareFirst Maryland Indemnity DHP Separate Legal Entity Facets CareFirst Healthy Indiana Plan Independence Administrators KePRO Hillsborough KePRO Home Health KePRO Inpatient Keystone Mercy Healthplan Liberty Mutual UM MDwise Hoosier Alliance MEDecision display the list of payers ci 2 Select AmeriHealth Administrators Independence Admi
69. yyy Preview changes Motification 12 08 2009 date 0123456 7 02 Member ID Thomas Jefferson University 0082 Treatment Enter or Search for ID Submitting Qutpatient Facili X Is this an emergency La provider F176 General information this section te edit any General information fields You can continue the Service fields or click the Preview changes button to re evaluate your updated request Member search Primary diagnosis Enter Diagnosis code or Select from Short list Diagnosis search Secondary diagnosis 2 optional Secondary diagnosis 3 optional Attending physician Select Jenkins Benjamin JT1336 from the list or e9 nter or search for ID Initial non clinical review Surgical C Rewiew Type Other Treatment type TS Changes to update If you would like to change the information entered on the previous screen you E edit information the preview screen and click Preview your request Click Submit to Sunt 12 10 2009 32 complete the request AmeriHealth Administrators Outpatient Other Request Confirmation Starting point Pa Der zelected Independence Administeators Click the Printer Friendly button to print of your request 12 10 2009 PATIENT JOAN Inpatient k Other request conf

iEXCHANGE® USER MANUAL

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iEXCHANGE&reg; USER MANUAL

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iEXCHANGE® USER MANUAL