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Health Plans

In addition to vital clinical information, providers can access helpful patient insurance information instantly. Through My WorkspaceSM, providers can check member eligibility, claims status, submit applications, review code editing explanations and manage referrals. These features enable physicians and their staff to not only make better clinical decisions, but also cost-effective decisions for their patient at the point-of-care while reducing costs associated with duplicate or unnecessary tests and procedures.

Features

Benefit Administration Manual
Review or search online benefit manuals containing coverage criteria, plan coverage, and policy change updates.

Membership Eligibility, Contracts and Riders
Review patient eligibility benefits, coverage, copay's, coinsurance and rider agreements at the point-of-care.

Claims Applications
View the status of all claims, make corrections to unaccepted claims and appeal claims online.

Code Editing Explanations
Review claim editing rules and clinical rationale.

Additional Benefits

  • Coordination of benefits online
  • Valuable prescription drug information include average retail cost and generic alternatives
  • Online referral management
    Online provider directories, affiliated hospitals and labs