Introducing Interactive Care Reviewer

Use this tool to initiate Anthem | MaineHealth inpatient and outpatient medical prior authorization requests online

As we communicated in this issue of Provider News, MaineHealth and Anthem will offer Medicare Advantage plans in 2020 under the Anthem | MaineHealth brand. We’re pleased to announce that beginning January 1, 2020, your practice can initiate online prior authorization (PA) requests for Anthem | MaineHealth members efficiently and conveniently with our Interactive Care Reviewer (ICR) tool available through the Availity Portal. The ICR offers a streamlined process to request inpatient and outpatient procedures. ICR is available for Anthem | MaineHealth and Anthem Medicare Advantage at this time. It is not yet available for Anthem commercial authorizations.

 

How do I gain access to the ICR?

You can access our ICR tool via the Availity Portal. If your organization has not yet registered for Availity, go to www.availity.com and select Register in the upper right-hand corner of the page.

 

If your organization already has access to Availity, your Availity administrator can grant you access to the Authorization and Referral Request for submission capability, and Authorization and Referral Inquiry for inquiry capability. You can then find our tool under Patient Registration > Authorizations & Referrals. From this area, you can select the Authorizations or Authorization/Referral Inquiry option as appropriate.

 

Whom can I contact with questions?

For questions on accessing our tool via Availity, call Availity Client Services at 1-800-AVAILITY. Availity Client Services is available Monday through Friday from 8:00 a.m. to 7:00 p.m. (excluding holidays) to answer your registration questions.

 

Register and attend one of the ICR monthly webinars.

 

What benefits/efficiencies does the ICR provide for Anthem | Maine Health and Anthem Medicare Advantage authorizations?

 

ICR:

• Can determine if PA is needed. For most requests, when you enter patient, service and provider details, you will receive a message indicating whether review is required.
• Provides inquiry capability. Ordering and servicing physicians and facilities can locate information on PA requests for those they are affiliated with; this includes requests previously submitted via phone, fax and ICR.
• Reduces the need to fax. The ICR allows text detail and images to be submitted along with the request. Therefore, you can submit requests online and reduce the need to fax medical records.
• Is available with no additional cost to you. The ICR is a no-cost solution that’s easy to learn and even easier to use.
• Is accessible from almost anywhere. You can submit your requests from any computer with internet access. (Note: We recommend you use Internet Explorer 11, Chrome, Firefox or Safari for optimal viewing.)
• Provides a comprehensive view of all of your PA requests. You have a complete view of all the utilization management requests you submitted online, including the status of your requests and specific views that provide case updates and a copy of associated letters.

 

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