Interactive Care Reviewer (ICR), Anthem’s online authorization tool is adding a new feature to further increase the efficiency of your authorization process. In mid-December, you can begin using ICR to request a clinical appeal for denied authorizations and check the status of a clinical appeal. This feature is available for authorization requests submitted through ICR, phone or fax.                                                                                                                                             

Requesting a clinical appeal is easy:

 

Logon to ICR from the Availity Portal and locate the case using one of the search options, or from your ICR dashboard.

 

  • Select the Request Tracking ID link to open the case. If the case is eligible for an appeal you will see the Request Appeal menu option on the Case Overview screen.
  • Select Request Appeal to open the Appeal Details screen and complete the required fields on the appeal template. (You also have the option of uploading attachments and images to support your request.)
  • Select Submit

 

Take the steps below to check the status of a clinical appeal:

 

Logon to ICR from the Availity Portal

  • Select Check Appeal Status from the ICR top menu bar
  • Type the Appeal Case ID and Member ID in the allocated fields
  • Select Submit

 

The appeal status and detail of the decision will open on the bottom of the screen.

 

Need more information on how to navigate the new ICR Appeals feature?

 

Download the ICR Clinical Appeals Reference Guide located on the Availity Portal. Select: Payer Spaces | Applications | Education and Reference Center | Communication and Education. Find the link to the reference guide below the ICR menu.

 

Additional Training:

 

If you are new to ICR or want to get a refresher please attend our monthly ICR webinar. The next event is taking place on December 6 at 1 PM ET. Register Here



Featured In:
December 2018 Anthem Provider Newsletter - CO