1. Online Claim Submission – Enhancements/Internal Training
November 29, 2018

2. Secure member portal: Claims submission and status update

3. Member submits the claim form with attachments and receives confirmation

4. The claim submitted online now appears immediately in claims status

5. Actisure: Update to claims process

6. Step 1: An e-claim is received.
Step 1: When an e-claim is received go to the business file share and load the .htm file along with all other business documents in to DME.
Please be sure to load the .htm file in addition to the claim documents so you have the reference tracking number captured.

7. Step 2: Open the treatment screen and click on the “Notes” section at the bottom of the screen.
Step 2: In Actisure, open the treatment screen and click on the “Notes” section at the bottom of the screen. Note: Open the notes section within the treatment screen not on the assessment screen.

8. Step 3: In the notes window choose “Portal Reference Number” from the drop down menu.
Step 3: In the notes window choose the keyword “Portal Reference Number” from the drop down menu.

9. Step 4: In the Note Text section, enter the claim invoice number & the tracking id. These numbers need to be separated by a dash.
Portal Reference Number
Step 4: In the Note Text section, enter the claim invoice number & the reference tracking number. These numbers need to be separated by a dash. The note section cannot contain any spaces, underscores or special characters.

10. Step 4: In order to enter the correct Reference Tracking Number, open the .htm file, copy and paste into the notes section.
Step 4: In order to enter the correct Reference Tracking Number, open the .htm file, copy and paste into the notes section. Note: If the “Reference Tracking Number from associated prior submission” at the bottom of the page is displayed copy that number.

11. Step 5: Here’s a closer look at the format of the claim invoice number, a dash (-) and the reference tracking number. Make sure there are no spaces or underscores.
Claim invoice number – (dash) reference tracking number
Step 5: Here’s a closer look at the format of the claim invoice number, a dash (-) and the reference tracking number. Make sure the note section does not contain any spaces, underscores or special characters.

12. Step 6: Click Save.
Step 6: After the note text is entered, click Save.

13. OH+: Update to claims process

14. Step 1: An e-claim is received.
Step 1: When an e-claim is received go to the business file share and load the .htm file along with all other business documents in to the work queue.
Please be sure to load the .htm file in addition to the claim documents so you have the reference tracking number captured.

15. Step 2: Open the OH+ claim invoice screen.
Step 2: In OH+, open the claim invoice screen.

16. Step 3: In the Web Reference Number field, enter the reference tracking number.
Step 3: On the right side of the screen, enter only the reference tracking number in the field “ Web Reference Number”.
This field cannot contain any spaces or special characters.

17. Step 4: In order to enter the correct Reference Tracking Number, open the .htm file, copy and paste into the notes section.
Step 4: In order to enter the correct Web Reference Number in OH+, open the .htm file from the work queue, copy and paste into the Web Reference Number field. Note: If the “Reference Tracking Number from associated prior submission” at the bottom of the page is displayed copy that number.

18. Step 5: Here’s a closer look at the field with the reference tracking number. Make sure to only enter the reference tracking number.
Step 5: Here’s a closer look at the format of the reference tracking number. OH+ users, please be sure to enter the reference tracking number only.

19. Member portal: Updated claims submission status

20. Member portal - Claims center
Here’s an overall view of the claims center in the member portal. Members will now see an enhanced description in the claims status section before the claim is processed. That section will now show a claim that is submitted but not yet processed.

21. Member portal - Claim detail
Here’s a closer look at the claim detail screen that now displays the Web Reference Number that was entered in Actisure or OH+.

22. Thank you