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Claims Search Provider Website and Online Tools User Guide An Independent Licensee of the Blue Cross Blue Shield Association © 2018 Premera. Proprietary and Confidential 036784 (09-2018)

Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

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Page 1: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

Claims Search

Provider Website and

Online Tools User Guide

An Independent Licensee of the Blue Cross Blue Shield Association © 2018 Premera. Proprietary and Confidential 036784 (09-2018)

Page 2: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

Landing Page

Simple search by claim number

Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation of Payment

Bookmark claims for easy access

Page 3: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

Search by Member

Member information is

required. Search by ID or member name

and date of birth.

Narrow search results by choosing a date range, claim

type, or provider/facility

name. (See next slide for Advanced Search.)

Page 4: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

Advanced Search

Advanced search allows you to

narrow your results by a specific

provider or facility.

Page 5: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

Search by Provider

Search by date, claim type, and claim status. Use Advanced Search to narrow your search

results.

Page 6: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

Search Results

Select the link under Member Name to view the claim you want to see.

The Explanation of Payment (EOP) may also be available if the claim has completed processing.

Page 7: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

Claim Overview

Click on the link

under Provider Name to get more

information like the pended reasons or

claim payment codes.

Page 8: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

Pended Claim Example

If the claim is pending, look at the claim pended date and the status reason to find out why.

Also check the claim receipt date to see when we received your claim before you call.

Page 9: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

Processed Claim Example

Click on the EOP Codes link for payment details. A pop-up box appears with more information.

You can also download a copy of your EOP.

Page 10: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

BlueCard, FEP, NASCO

Select Claims for

BlueExchange.

All fields required except date of birth and provider NPI.

Page 11: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

BlueCard Claim Example

Request EOP will appear when an EOP

is available to download.

Note: EOPs are not

available for FEP or NASCO

Page 12: Provider Online Tool Demo - Claims and Payments · Landing Page . Simple search by claim number . Search for claims by: • Member • BlueExchange/BlueCard • Provider • Explanation

Contact Us

OneHealthPort user ID registration www.onehealthport.com/sso/register-your-organization

Technical issues

Contact our Service Desk at 800-722-9780 or email [email protected] Feedback Visit our secure provider website and give us your feedback through our

Premera Listens link.

An Independent Licensee of the Blue Cross Blue Shield Association © 2018 Premera. Proprietary and Confidential 036784 (09-2018)