UM Process Change: Courtesy approval determination notifications

Effective April 15, 2019, the Indiana and Ohio local Utilization Management (UM) departments will no longer call providers with courtesy approval determinations.

 

You can find this information on the Interactive Care Reviewer (ICR), Anthem’s online authorization tool. Access to ICR is available exclusively on the Availity Portal.

 

Is it your first time using ICR on the Availity Portal?

Contact your Availity Administrator and request to be assigned the Authorization and Referral Inquiry role. Once you have the role assignment you can immediately access ICR, just log onto Availity and select Patient Registration > Authorizations & Referrals. Then choose Auth/Referral Inquiry.

 

Locate the case status and all available provider letters affiliated with the case in a few easy steps.

• Check Case Status is the menu item on the ICR tool that you’ll use to locate authorization requests associated with your organization’s tax ID that were submitted by ICR, phone or fax.
• You have three choices to conduct your search: By Member, By Reference Authorization Request Number or By Date Range. Each search option has required fields and will give you one or more results.
• Once you find the case, select the Request Tracking ID. You will land on the Case Overview screen. Expand the Letters Summary section and select the link to open, save or print a PDF of provider letters associated with the case, including approval determinations.
• Additionally, you can expand the Service Details section to view the case decision.

 

Need more information on how to navigate the inquiry features on ICR?

• Download the Interactive Care Reviewer Authorization Inquiries 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. Register Here for the next webinar.

 

Please note: As required, Anthem will continue to provide verbal approval determinations for any Ohio HMO/HIC products