Medicare AdvantageMay 31, 2020
Introducing Interactive Care Reviewer - an online prior authorization tool
Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.
What benefits/efficiencies does the ICR provide?
- You 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.
- You receive a comprehensive view of all your prior authorization 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.
- You will have inquiry capability. Ordering and servicing physicians and facilities can locate information on preauthorization requests for those with which they are affiliated; this includes requests previously submitted via phone, fax and ICR.
- You have the ability to request and check the status of clinical appeals. You can use ICR to request a clinical appeal for denied authorizations and access letters associated with the appeal.
- ICR reduces the need to fax. ICR allows text detail as well as images to be submitted along with the request.
- There is no additional cost to you. ICR is a no-cost solution that’s easy to learn and even easier to use.
Follow these instructions to access ICR through the Availity Portal
First, ask your Availity administrator to grant you the appropriate role assignment.
Do you create and submit PA requests?
Required role assignment: Authorization and Referral Request
Do you check the status of the case or results of the authorization request?
Required role assignment: Authorization and Referral Inquiry
Once you have the authorization role assignment, log in to Availity with your unique user ID and password follow these steps.
- Select Patient Registration from Availity’s home page
- Select Authorizations & Referrals
- Select Authorizations (for requests) | Select Auth/Referral Inquiry (for inquiries)
Monthly ICR training
Register for one of our free webinars created to familiarize new users with ICR features and navigation. Registration link: https://anthemincub.webex.com/anthemincub/onstage/
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*Availity is an independent company that provides a secure provider portal on behalf of Empire BlueCross.
PUBLICATIONS: June 2020 Empire Provider News
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