Newly Contracted Provider

ProviderConnect makes routine tasks such as processing claims, obtaining claims information, and verifying eligibility status easy and convenient.

Log on or register with ProviderConnect to take advantage of our online services:

• ProviderConnect

Access the ProviderConnect Demo.

Guides

Please click on the links below to access the specific guides. Note: you will need Adobe^® Reader. If you do not have access to this software, you may download and install these applications on your computer.

The ProviderConnect User Guide outlines the steps to using the various functions within ProviderConnect. Providers are encouraged to carefully review the ProviderConnect User Guide to help answer any questions on how to use the ProviderConnect application.

The Getting Started with ProviderConnect Guide is a condensed version of the ProviderConnect User Guide but is not a substitute for the ProviderConnect User Guide. New ProviderConnect users are encouraged to use the Getting Started with ProviderConnect Guide as a way to get acclimated with the ProviderConnect application.

Disclaimer: Please note these tutorials cover ProviderConnect^SM functionality available for our national commercial contracts. ProviderConnect may look different and contain different and/or additional functionality based on individual network-specific contract need. Therefore some functions may not be available or may look different for your specific contract.

ProviderConnect

• How do I View a Member’s Eligibility?
• Submitting an Outpatient Authorization in ProviderConnect
• Submitting an Inpatient/HLOC Authorization in ProviderConnect
• How do I Submit a Psych Testing Request?
• How to Search an Authorization in ProviderConnect
• How to View Authorization Letters in ProviderConnect
• Submitting a Claim through Direct Claim Submission in ProviderConnect
• Submitting a Batch Claim File in ProviderConnect
• How to Search a Claim in ProviderConnect
• Correcting a Claim in ProviderConnect
• View Provider Summary Vouchers in ProviderConnect
• Submitting an EAP Case Activity Form in ProviderConnect
• Updating Demographic Information on ProviderConnect

audit-tools

Audit Tools

Our Quality team uses these audit tools for their audits. We are sharing these with you so you can be better prepared for audits.

• Clinical Audit Tool IOP QM
• Clinical Audit Tool SUD
• Detox Clinical Audit Tool SU QM
• Clinical Audit Tool