Sleep Management Program Portal Training Guide February 3, 2015

2 Table of Contents Copyright Sleep Management Solutions 2015 Introduction Sleep Management Portal Overview User Guide Objectives Accessing the Portal Navigating to the Portal Logging In Registering for Portal Access Submitting an Initial Authorization Request Patient Information Diagnosis / Facility Physician / Referral Services Clinical Information Confirm Referral Request Information Tracking Previous Authorization Status Authorization Status

Copyright Sleep Management Solutions 2015 INTRODUCTION

4 The portal is a part of a Sleep Management Program, developed by Sleep Management Solutions (SMS) and its parent company CareCentrix (CCX), which is a prior-authorization program designed to improve the overall quality of sleep related services from diagnosis to therapeutic management. This portal is intended to support providers in requesting authorizations for sleep services and managing patients’ sleep service needs across the sleep management continuum. This user guide is designed for providers using the SMS portal to successfully submit authorization requests. Introduction: Sleep Management Portal Overview Copyright Sleep Management Solutions 2015

ACCESSING THE PORTAL

6 Accessing the Portal: Navigating to the Portal Access the SMS Sleep Portal by navigating to

7 Accessing the Portal: Registering for Portal Access To register for access to the portal select the “Register for Provider Portal” located in the upper right hand side of the screen.

8 Accessing the Portal: Registering for Portal Access Select your “User Type” from the drop down menu.

9 Accessing the Portal: Registering for Portal Access Depending on what “User Type” you choose, will dictate the subsequent screens. Here we chose, “Ordering Physician”. Then you will select “Find Ordering Physician”.

10 Accessing the Portal: Registering for Portal Access Enter in any information that did not auto populate. At the bottom of the screen, type in the box what is encrypted above it. Then select “Submit”.

11 Accessing the Portal: Registering for Portal Access Once the registration is complete you will receive a message that your request is being processed by an SMS representative. You will receive verification of your registration via with your username and password. You will receive a notification , once your registration has been verified.

Copyright Sleep Management Solutions 2015 SUBMITTING AN INITIAL AUTHORIZATION REQUEST

13 Submitting an Initial Authorization Request Select the “Authorizations” link located in the upper left hand corner. From the drop down menu select “Request an Initial Authorization”.

14 Submitting an Initial Authorization Request: Patient Search To conduct a patient search enter the following information: Patient’s First and Last Name Patient’s Member ID Patient’s Date of Birth Patient’s Zip Code (the city will auto populate) Authorization Request Start Date Then select the “Continue” button.

15 Submitting an Initial Authorization Request: Patient Search Copyright Sleep Management Solutions2015 The portal will identify a matching patient and display the patient’s name along with other identifying information. Click on the radio button to confirm that patient displayed is the correct patient.

16 Submitting an Initial Authorization Request: Patient Information Fill in all boxes marked with an asterisk. The left hand column will auto populate all the required information. The right hand column, you will need to fill in requested information. Click “Next” Then select the “Next” button to continue.

17 Submitting an Initial Authorization Request: Patient Information (cont.) Some patients will require clarification on services being requested. If the question regarding sleep services is shown on the Patient Information screen, answer “Yes” before selecting the “Next” button.

18 Submitting An Initial Authorization Request: Referral Source

19 Submitting an Initial Authorization Request: Diagnosis/Physician Services Selection To choose the diagnosis, click on the “Enter Diagnosis” button. A new window will pop up.

20 Submitting an Initial Authorization Request: Diagnosis/Physician Services Selection To choose the diagnosis, you can either enter the “Diagnosis Code” or “Description”. Then select the “Search Button”. A list of Diagnoses will appear and you will need to “Select” the one that applies. Then scroll to the bottom of the box, where you will see the diagnosis you selected. Then you may hit “Save” to continue. Your first Diagnosis selection will auto populate in the Primary Diagnosis. If you need to put in a Secondary Diagnosis, then just search and select another diagnosis, and it will auto populate into the Secondary Diagnosis.

21 Submitting an Initial Authorization Request: Ordering Physician Selection To search for a ordering physician select the “Find Ordering and Primary Physician” button. A new window will pop up

22 Submitting an Initial Authorization Request: Service Selection Services are organized by their Healthcare Common Procedural Code, also known as the HCPC or by their Current Procedural Terminology, known as the CPT. The Carecentrix service code and description for each service are also displayed.

23 Submitting an Initial Authorization Request: Service Selection A pop up window will appear. You will need to fill out all the requested clinical information regarding the service you have just requested. Once all is filled out, you can select “Add to Requested Services” to continue.

24 Submitting an Initial Authorization Request: Service Selection If you are requesting a lab based Polysomnography (PSG, HCPC 95810), your patient may be eligible for a substitution Home Sleep Test (HST).

25 Submitting an Initial Authorization Request: Service Selection You will see your selected service populate in the second half of the screen. Review and select “ Confirm & Submit Request”.

26 Submitting an Authorization Request: To finalize the authorization request, review all the information that you have input. If everything is correct, select “Submit Request” to finalize your request. A pop up window will ask “Are you sure you want to submit this referral?” Middle Section Removed… Continued on next page…..

27 Submitting an Authorization Request To finalize the authorization request, review all the information that you have input. If everything is correct, select “submit request” to finalize your request. A pop up window will ask “are you sure you want to submit this referral?”

28 Submitting an Authorization Request: Initial Authorization Status Once an authorization request is submitted through the portal, the request will either be approved based on clinical criteria or pended for further review by a member of the SMS utilization management staff. An approved authorization is required prior to performing any sleep service (to include Diagnostics, PAP Therapy and PAP Therapy Supplies) in order to receive claims payment.

Copyright Sleep Management Solutions 2015 TRACKING PREVIOUS AUTHORIZATION REQUESTS

30 Tracking Previous Authorization Status Select the “Authorizations” link located in the upper left hand corner of the screen. From the drop down menu select “Authorization Status” to check the status or look up details on an existing authorization.

31 Tracking Previous Authorization Request: Authorization Look-Up To look-up an authorization enter “Intake ID” and Patient’s Last Name. Then select the “Continue” button.

32 Tracking Previous Authorization Request: Authorization Look-Up The portal will then display the patient you are searching. You then can search by Auth Start and End Date or Authorization ID.

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