First Coast Advantage (FCA) hosted it's 5th Provider In-service May 18-20, 2010.
Below is the information that was provided at the in-service. Please share this information with your staff.
Provider In-Service Information
Provider In-Service Presentation Slides (All) - May 2010
Welcome Slide
Introduction of Staff Presenters
Contact Information for Contract Manager
Provider Relations Visits
Website Demo
Contact Information for Provider Relations
APEX (TPA) - Website Enhancements Slides
Auth Enhancements - Lookup
Approved Auth
New-Pended Auth
New-Partial Denial Auth
New-Denial Auth
Future Enhancements - Remarks
Contact Information for APEX Provider Services
Member Disenrollment & Transfer Process Slides
Types of Members
For Cause Disenrollment Reasons
Without Cause Disenrollment Reasons
Types of Disenrollment/Transfers
Voluntary Disenrollments
PCP Transfer
Involuntary Disenrollment
Behavioral Disenrollments
Disenrollment Exceptions
Contact Information for Technical Reporting Analyst
Medical Management/Pre-Authorization Slides
Friendly Reminders - PreAuthorization Information
Pre-Authorization Turnaround Time Frames
Pre-Authorization Process
Pre-Authorization Form
Incomplete Pre-Auth Form
Pre-Authorization List & Changes
Authorization Process for OMFS
Authorization Process for OB
Authorization Process for Circumcisions
DME Reminders
Outpatient Case Management
Contact Information for Medical Management/Pre-Authorization
Verification
EBA-Enhanced Benefit Program
FCA Eligibility Request Form Example
Non-FCA Eligibility Request Form Example
Contact Information for Eligibility - Claims Manager
EDS Now HP
Direct Submission of Claims to HP
Behavioral Health Address for Claims Submission
Address for Claims Submission of Vendors
Child Health Check-Up Reminder
Paper Claims & Paper Claims Policy
HP Processing of Direct Submission Claims
Adjustments & Voids for Direct Submitters
Payments
Claims Status Check with FCA
Hospital OP Claims Denial 2091
ER Claims Denied in Error
Hospital In-Patient and Observation Admits
In-Patient BBA Exceptions
Timely Filing Limit
HP Known Issues Log
Medicare Secondary Claims
HP ICN Region Codes
HP Denial Codes
HP Enterprise Services Local Rep
Contact Information for Billing & Claims