In February, Anthem Blue Cross and Blue Shield introduced a new feature on Interactive Care Reviewer (ICR) that lets you request a clinical appeal for denied authorizations. Now instead of making a phone call or sending a fax, you can save time making your request online! This feature is available for authorization requests that were submitted through ICR, phone or fax.

 

Here’s how easy it is to request a clinical appeal using ICR:

 

Logon to ICR from the Availity Portal and locate the case from ICR’s dashboard – My Organization Requests or through Check Case Status if the case was submitted by phone or fax.

  • 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.

 

Want to check the status of your clinical appeal?

The Check Appeal Status feature was added to ICR in December 2018.

  • Select Check Appeal Status from the ICR top menu bar.
  • Type the Appeal Case ID and Member ID in the allocated fields (do not include the alpha/numeric prefix).
  • Select Submit.

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

Additionally, you will be able to access letters associated with the appeal.

 

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

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.

Register here for the April webinar.



Featured In:
April 2019 Anthem Provider Newsletter - Kentucky