|
September 2015
Resolving your issues: Self-service tools can help
Self-service tools and resources
Here are several self-service tools and resources that may provide you with the answers you need:
Web-DENIS — Provides information on medical policy, fees, claims and benefits, Clear Claim Connection
Provider Automated Response System — PARS offers information on Benefit Explainer, deductibles, cost share by voice response, fax and email.
Provider manuals — There are customized provider manuals for each provider type. To learn how to use them more effectively, see the March Record article, part of our “Training Tips and Opportunities” series.
Training and online resources — There are a variety of learning opportunities and online resources designed to give you the information you need. For an overview, see the May Record article, part of our “Training Tips and Opportunities” series.
This is the second article in a series providing guidance on the best way to get your questions answered.
As we informed you in the August Record, it’s usually quicker and more efficient to call Provider Inquiry for answers to your questions rather than write. See last month’s article for details on when to call and when to write.
When you call Provider Inquiry to resolve an issue, you may be instructed to provide specific written documentation that supports the review of your claim. You should send this information, along with your inquiry, to the appropriate written inquiry unit for handling. (For more information on contacting Provider Inquiry, click here.)
We may ask you, for example, if you have an issue with 10 or more claims, to send information to us on a spreadsheet with the contract ID, name, service date and procedure code, along with a description of the issue.
If your inquiry results in a payment, your voucher will indicate our response. If the claim disposition doesn’t change or results in another rejection, you will receive a phone call or letter outlining the final disposition.
Note: For inquiries related to Federal Employee Program® members, you would call the FEP customer service number at 800-482-3600.
Don’t forget that in addition to contacting us by phone or in writing, there are self-service options that may help you. See sidebar at right. Many of these tools are available on web-DENIS.
If you aren’t yet registered to use web-DENIS or want training on how to get the most out of it, contact your provider consultant. Don’t know who that is? Visit the Contact Us page on our website.
| 