Dear Valued Provider,
As part of our upcoming system upgrade, we want to make you aware of changes to the secure provider portal, billing, and claims submissions that will take place once the new system is live on June 28 and as we make the transition.
Please note that while our team has been working diligently on planning and testing to ensure a smooth transition, this is a major undertaking, and the timing outlined below could shift by a few days depending on various factors. Please share this with others in your practice who may need to be aware.
Pre Go-Live Portal Modifications
On Friday, June 18, the secure provider portal will be in read-only mode. This means that changes or updates, claim uploads, and other transactional activities will not be available until the new system is live on June 28. You will, however, still be able to search, look up eligibility, and look at financial transactions already in process.
The portal and website will be unavailable from June 27-28, when the new system will be live. If during the time that the provider portal is paused you need any of the information that you typically access through the portal, please contact customer service at firstname.lastname@example.org or 1-800-610-0201.
Pre Go-Live Claims Submission Modifications
An additional area that will be affected will be claim submission. The last day you will be able to submit claims in the current provider portal is June 18, and you will not be able to submit claims through the portal again until June 28. You will be able to continue to submit claims via mail and third-party clearinghouses.
Claims that are received between June 19 and June 27 will be held and processed from old to new starting June 28. You can continue to check the status of your payments on the portal, and you can contact customer service with any questions.
Changes After the System is Live
Your portal username and password will remain the same. The portal will have an updated look and feel. Watch this video for an overview on the portal.
- You may experience some delays in payment as we get caught up with our new system. You can log in to the secure provider portal to check real-time status on claims.
- Paper checks will only be processed once per week on Tuesdays instead of based on Zip Code.
- ACH payments will continue being processed daily.
- Information requests (IR) for claims will now be sent as denial for information (DFI).
- Providers will have 30 days to submit the additional information requested instead of the 90 days available now.
- You will see new template formats on documents such as ID cards, EOBs, checks, and more.
- Finally, some members will see a change to their group numbers.
- Group numbers will now be composed of an 11-digit number – group number, preceded by zeroes.
We appreciate your patience as we adapt to the change. We look forward to sharing our upgrade with you in the coming weeks!
Director of Sales Strategy and Provider Relations