Training for provider relations representatives and PMP offices

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Presentation transcript:

Training for provider relations representatives and PMP offices Member Health Profile Training for provider relations representatives and PMP offices HHW-HIPP0516(9/17)

Member Health Profile (MHP) Overview Requesting MHP Access Agenda Member Health Profile (MHP) Overview Requesting MHP Access Member Health Profile Data Contact Information Questions

Member Health Profile Overview The Member Health Profile (MHP) is an online tool to help registered in-network PMP’s and specific Behavioral Health providers with coordination of care Allows the PMP/BH provider to view their members medical and pharmacy claims for all of doctors that see the member The information is displayed in one interface and can be printed PMP’s can use this information to identify the gaps in care and better manage the members overall care plan

Allow 5-7 business days for processing Requesting MHP Access To request access to the Member Health Profile provider will complete our online request form Only PMP NPI’s should be used, Specialists/non-PMP’s will not be able to lookup users in the Member Health Profile Allow 5-7 business days for processing If providers have technical issues getting registered or accessing the profile, please send an email to healthprofile@mdwise.org Please note this is not for claims questions Please do not send any PHI

Requesting MHP Access

Requesting MHP Access

Requesting MHP Access

Requesting MHP Access The Member Health Profile link will be at the top

Requesting MHP Access

Requesting MHP Access

Requesting MHP Access

Requesting MHP Access

Member Profile Health Data The MHP houses claims data over the last 12 rolling months It is updated when claims data is received to ensure the most recent data There is not a way to run reports from MHP as its purpose is to allow PMPs access to the member’s claims to assist in coordination of care Please educate your PMPs about MHP and encourage them to register for access

MDwise Quick Contact Guide MDwise Delivery System Contact Guide Contact Information MDwise Website http://www.mdwise.org/ MDwise Quick Contact Guide MDwise Delivery System Contact Guide

Questions