Skip to main content

Provider Portal Tools for Self-Service

As the Coronavirus (COVID-19) situation continues to develop, we maintain the health and wellness of the patients and communities as our top priority.

To assist you in caring for your patients, we offer a variety of several self-service resources within our secure provider portal. Our self-service channels are a helpful way to fight the Coronavirus (COVID-19). By using our Provider Portal instead of calling to speak with a live agent, you are allowing our live customer service teams to prioritize services for providers who are actively assisting our most critical members during the pandemic.

Through our self-service channels, you have access to a host of services within our Secure Provider Portal, including:

  • My Patients: Allows you to review a member’s eligibility, benefits, and their member profile. A comprehensive member profile includes a member’s address, contact information, co-pay, plan history, coordination of benefits information, pharmacy utilization and more.
  • Authorizations: Review authorization requirements, and submit and review authorization requests, including lookup of authorization status.
  • Referrals: Submit referrals by choosing either Consult and Treat or Consult Only.
  • Claims: Submit professional and institutional claims, search and view real-time claims status, as well as dispute, appeal, correct and void claims.
  • Appointment Agenda/Visit Checklist: View and print appointment agenda/visit checklists to quickly access the information you need to review and address with your patients.
  • Care Gaps: The portal identifies members with care needs that may have not been addressed and provides status on whether the member is compliant or non-compliant.
  • Care Management: Use the Care Management section of the portal to request a medical authorization, search authorizations, request a referral, search referrals, and search drug authorizations.
  • Reports: The secure provider portal offers a wealth of reporting data. View active member reports, inpatient log reports, pharmacy utilization reports, care needs reports, and emergency room reports.
  • Training: The resources section of the portal offers users training modules on topics such as Provider Orientation, Cultural Competency and more.
Contact Us icon

ᎤᏚᎸᏓ ᎠᏍᏕᎸᏗᎢ? ᎠᎭᏂ ᎣᏤᏙ ᏂᎯ ᏳᏰᎵᏗ.

ᎢᏍᎩᏟᏃᎮᏓ ᏂᎦᏓ
Y0020_WCM_87476E Last Updated On: 4/22/2022