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Optical provider user guide

1. E AN ID ATAA P http orovider ab bluecross ca optical Fasy steps to submit and process a claim for group or individual plan members or Optical Assistance for Seniors program O Select the appropriate group In the sidebar on the left choose the coverage type for the member The instructions in this section are for Group and Individual plans or Optical Assistance for Seniors claims 2 Enter the patient s information If you chose Group and Individual plans in the sidebar navigate to the Enter claim menu option and enter the patient s ID number and group number exactly as they appear on their Alberta Blue Cross or ASEBP ID card Then ask the patient for his or her date of birth enter the date and click the Search button If you chose Optical Assistance for Seniors in the sidebar navigate to the Enter claim menu option and enter the patient s Personal Health Number PHN and date of birth and click the Search button ALBERTA BLUE CROSS PROVIDER services ENTER CLAIM eee predetermination and processing nd Group a Individual plans Enter patient COB information Enter details Patient information Optical Provider Online Services Predetermine Process claim ID number Group number Alberta Human Services and AISH programs Date of birth Government of the YYYYMMDD Northwest Territories
2. ALBERTA BLUE CROSS PROVIDER servicss ENTER CLAIM hig ari predetermination and processing Group and Ses Enter patient COB information Enter details Patient information Optical Provider Online Services Predetermine Process claim ID number Optical Assistance for Seniors Program gt Group number Alberta Human s ervices and AISH programs Date of birth Government of the YYYYMMDD Northwest Territories Required Change password ALBERTA BLUE CROSS PROVIDER services ENTER CLAIM predetermination and processing Site overview Group and Individual plans Optical Assistance for a r Alberta Human AISH programs Government of the Northwest Territories Enter patient COB information Patient information 7 PHN number Date of birth Optical Providf Online Servic Enter details Predetermine Process claim Group number YYYYMMDD Change password The remaining steps apply for both claim types Verify whether the patient has Coordination of Benefits Confirm whether the patient has other active coverage and whether payment has been made by another benefit carrier or provincial plan If No continue to next page If Yes continue to page 6 Enter CLAIM predetermination and processing Enter patient COB information John Smith ID number 1234567 01 Group number 99 COB de
3. We re serious about privacy and security The confidentiality of your records is very important to you and to us You are responsible for your login ID and password They are intended for your office s use only We protect your information in various ways including encrypting all information securely delivering your login ID and password denying access to web site users after five consecutive unsuccessful sign in attempts automatically signing site users out after 30 minutes of inactivity and requiring written authorization before granting access to the Optical Services Provider web site http orovider ab bluecross ca optical ALBERTA BLUE CROSS For more information about access to the Optical Provider web site contact Alberta Blue Cross Health Services Provider Relations at e 780 498 8083 Edmonton and area e toll free at 1 800 588 1195 all other areas or e e mail at healthinq ab bluecross ca http provider ab bluecross ca optical The online claims submission system is available Monday to Sunday 8 a m to 9 30 p m Mountain Time Our regular office hours are Monday to Friday 8 30 a m to 5 p m Mountain Time eThe Blue Cross symbol and name are registered marks of the Canadian Association of Blue Cross Plans an association of independent Blue Cross plans Licensed to ABC Benefits Corporation for use in operating the Alberta Blue Cross Plan ABC 82439_optical guide 2014 02
4. Calgary and area 403 234 9666 Toll free 1 800 661 6995 8 a m 5 p m MT www ab bluecross ca Patient name Smith John ID number 1234567 01 Group 99 Section Vision claim summary Total amount claimed Total amount not paid Amount paid 40 00 Details Each claim you submit is assessed according to the rules of your benefit plan Please refer to the explanations near the end of this statement for descriptions of terms and to your benefit booklet for plan details Patient John Service provider ABC Optical 1234 Service date Product or service Claimed amount Eligible amount Other plan paid This plan paid Explanation YYYY MM DD number 2014 01 01 Eye Exam Routine 55 00 55 00 15 00 40 00 Total 55 00 55 00 15 00 40 00 Acknowledgement By accepting this claim summary certify that the information on this daim summary is complete and accurate and the services and or products listed have been received by the patient indicated also acknowledge that by presenting my Alberta Blue Cross identification card or my identification number for a benefit plan administered by Alberts Blue Cross to the named Service Provider consent and agree to The Service Provider submitting a claim containing my personal information to Alberta Blue Cross on my behalf and authorize payment of this claim by Alberta Blue Cross directly to the Service Provider Alberts Blue Cross using my personal information to determine my e
5. You can view payment history for the last six month Patient Claim Statements This allows you to print a copy of the patient claim statements Note Sort This is currently available for Outstanding Payment Reports You can sort the column by clicking on the double headed arrow located beside the column title 7i REPORTS for viewing your transachon Details 2013 11 08 9014 01 13 Alberta Human Services and AISH Programs Payment Reports and Outstanding Preauthorizations Outstanding Preauthorizations You can view or cancel claims from within this report Start Date YYYYMMDD End Date YYYYMMDD Create Report Outstanding Payment Report View all claims remaining to be paid as of 2014 01 13 You can view or cancel claims from within this report Only Claim Statements obtained by the patient within the last year will appear Create Report Payment History Report Only date ranges within the previous six months can be entered Start Date 2014 01 13 E YYYYMMDD End Date 2014 01 13 E YYYYMMDD Create Report View claim statement Preauthorization number Product or serviche Smith John Frame amp case smith John Repairs hinge http orovider ab bluecross ca optical EO Claim 100 00 35 35 liberta Blu Cross pa 0 0 6 11 Help For additional information click on the help button blue button with a question mark The help button has answers to questions
6. Routine 0 00 47763002 Product or service What is the reason for cancelling the claim Please enter the other reason REPORTS for viewing your transactions Information Document number 47762938 for John Smithhas been cancelled ABC Optical 1234 10009 108th Street NW Edmonton AB T5J3C5 Details Need help cancelling a claim amp Amount Alberta Blue Cancel Claimed Cross paid Preauthorization No claim Frame amp case 100 00 0 00 46480215 Cancel Service date YYYY MM DD Patient 2013 11 08 Smith John Product or service http orovider ab bluecross ca optical Easy steps to cancel a preauthorization for Alberta Human Services Report Create an Outstanding REPORTS Preauthorization Report by entering a the date range Alberta Human Services and AISH Programs Payment Reports and Outstanding Preauthorizations Outstanding Preauthorizations You can view or cancel claims from within this report Start Date E End Date E YYYYMMDD YYYYMMDD 2 Cancel Select the preauthorization _ Reports ys for viewing your transac tions number and click cancel oe 10009 108th Street NW Edmonton AB T5J3C5 Outstanding Preauthorizations Click the button beside the perauthorization number that you wish to submit If a preauthorization needs to be cancelled click the Cancel button A preauthorization cannot be cancelled Scie ogee ae Sc NM Sr oon mona number date if any associa
7. appear Payment Report and will appear on the Payment History Report You can view payment history for the last six months Patient Claim Statements This allows you to print a copy of the patient claim statements gt Sort For the Outstanding Payment Details Report you can sort the column by clicking on the double headed arrow Need located beside the column title Service date Amount Alberta Blue YYYY MM D Patie Product or servi Claim Cross pai 2013 06 05 Smith John Contact Lenses 120 1 120 2014 01 01 Smith John Eye Exam Routine 55 00 0 00 Help For additional information click on the help button blue button with a question mark The help button has answers to questions that are frequently asked about the section http orovider ab bluecross ca optical Easy steps to cancela claim for group or individual plan members or Optical Assistance for Seniors program Report Create an Outstanding O Payment Report services REPORTS for viewing your transactions Site overview Group and Individual plans Group Individual and Optical Assistance for Seniors Program Payment Reports Enter claim Reports ical Assistance for T Outstanding Payment Report Alberta Human View all claims remaining to be paid as of January 15 2014 Services and You can view or cancel claims from within this repag AISH programs overnment of the hwest Territories program O To cancel a claim
8. click the Ronn hyperlin k for viewing your transactions ABC Optical 1234 10009 108th Street NW Edmonton AB T5J 3C5 Details Need help cancelling a claim 27 Service date Amount Alberta Blue Cancel YYYY MM DD Patients Product or service Claimed Cross paid Document No claim 2013 06 05 Smith John Contact Lenses 120 12 120 12 46480198 ancel 2014 01 01 Smith John Eye Exam Routine 55 00 0 00 47763002 CD gt Reports for viewing your transactions Ifa payment run is in progress you Information will receive notification that the claim corey nur herbs esto aaa ieee eae cannot be cancelled ABC Optical 1234 10009 108th Street NW Edmonton AB T5J 3C5 If the cancellation hyperlink is inactive either the payment run is in progress rtnrcca ca or the document has exceeded the Service date pe aoe e YYYYIMM DD Patients Product or services Claimed Cross paid DocumentNo cla cancellation timeframe and the claim 2013 06 05 Smith John Contact Lenses 120 12 120 12 46480198 cannot be cancelled online Please refer to the help icon for further instructions about how to cancel your claim http orovider ab bluecross ca optical Cancellation review If you choose E to cancel a claim you will be asked for the reason A drop down menu lists common reasons When cancelling a claim all claims associated with the document number must be cancelled If you select Other p
9. your records Enter Clam locate a preauthorization for processing Enter preauthorization Enter details Process claim John Smith ID number 1234567 01 This claim has been submitted to Alberta Blue Cross successfully ABC Optical 1234 Statement date January 24 2014 10009 108 Street NW Edmonton AB T3J3C5 Patient name John Smith ID number 1234567 01 Service date January 13 2014 Preauthorization number 99999999 3040 Repairs hinge 8 11 27 24 12983 12983 The claimed amount is greater than the eligible amount allowed by your plan for this product PROVIDER COPY ONLY Please retain for your records http orovider ab bluecross ca optical O Easy steps to access reports for Alberta Human Services Reports This screen allows you to view all outstanding preauthorizations claims waiting to be paid history of settled claims and individual statements Outstanding Preauthorization Report he Outstanding Preauthorization Report lists all outstanding preauthorizations submitted by your office Outstanding Payment Report Alberta Blue Cross will make payments to your office once every two weeks The Outstanding Payment Report lists all transactions that are remaining to be paid and allows you to cancel a claim Payment History Report Once the transactions have been paid they will be removed from the Outstanding Payment Report and will appear on the Payment History Report
10. 00 0 00 46480215 Cancel icon for further instructions about how to cancel your claim http orovider ab bluecross ca optical Cancellation Review f you choose to cancel a claim you will be asked for the reason A drop down menu lists common reasons When cancelling a claim all claims associated with the document number must be cancelled If you select other please provide the reason Cancellation Once a claim has successfully been cancelled red text appears at the top of the screen as confirmation gt Cancelling a claim does not cancel a preauthorization associated with the claim The preauthorization must be cancelled separately or it can be used to process a new claim mgs BLUE CROSS Cancellation Review Please review claims listed below Enter a cancellation reason and press the Ok button to submit for cancellation If you no longer wish to cancel the claims listed below press the Back button Details Service date YYYY MM DD Patient 2014 01 13 Smith John Amount Alberta Blue Preauthorization claimed Cross paid No 36 35 8 11 477629386 Product or service Repairs hinge What is the reason for cancelling the claim Select one Lv Select one Additional services provided Claim entered in error m Client returned product Other Service date YYYY MM DD Patient 2014 01 01 Smith John Amount Alberta Blue claimed Cross paid Document No Eye Exam
11. A e ae O k j s ai I EA ae K D S N P Optical provider user guide online claims submission convenient service delivered through an easy to use secure web site htto provider ab bluecross ca optical ALBERTA BLUE CROSS February 2014 Optical provider user guide ALBERTA BLUE CROSS online claims submission Alberta Blue Cross is pleased to offer online claims submission for optical providers This convenient service is delivered through an easy to use secure web site and is available at no cost to all optical providers across Alberta Online submission provides the convenience of direct billing for eligible services for your customers with coverage through Alberta Blue Cross group and individual benefit plans ASEBP Optical Assistance for Seniors Program and Alberta Human Services program You are assured of prompt payment directly from Alberta Blue Cross while retaining existing customers and gaining a competitive advantage over providers who may choose not to submit claims online When submitting claims online this service will predetermine the patient s coverage and confirm the amount Alberta Blue Cross will pay to your office and the amount you will need to collect from the patient Registering for site access To register for online claims submission please complete the Request for Secure Web Site Access form If you want payments to be dep
12. Claim details Product Choose one gt Price Other Plan Paid Other Plan Paid 15 00 Claim information Service date 2014 01 01 E YYYYMMDD http orovider ab bluecross ca optical Process claim You will receive a confirmation from Alberta Blue Cross within seconds of your submission Print summary A printable copy of the patient s Claim Statement is displayed Click the Print command on the screen You must provide the patient with a printed copy of the Claim Statement preaetermination and processing Enter CLAIM Enter patient COB information Enter details Predetermine John Smith ID number 1234567 01 Group number 99 Summary Process claim Predetermination results as of January 28 2014 11 10 AM Mountain Time Please note that eligibility of coverage may change based on the date of service change in benefit maximum being reached coordination of benefits or coverage terminates Service date January 1 2014 Total amount submitted 55 00 Plan s will pay 40 00 Balance remaining 15 00 This is not a receipt Details Product Amount claimed Plan s will pay Balance remaining Eye Exam 55 00 40 00 15 00 Total 55 00 40 00 15 00 Click here to print Please click below to print both of the patient s Claim Statements ALBERTA Date January 28 2014 LU C R O S Se Document number 99999999 We re here to help Edmonton and area 780 498 8000
13. MT www ab bluecross ca Patient name Smith John ID number 1234567 01 Group 99 Section Print summary You must provide Total amount claimed the patient with a printed copy of the aanhaal i Claim Statement ount paid C ic k t h e Prin t b utton ocate d at Each claim you submit is assessed according to the rules of your benefit plan Please refer to the explanations near the end of this statement for descriptions of terms and to your benefit booklet for plan details Patient John th e to of th e SC ree N A eari cok ABC Optical 1234 Service date Product or service Claimed amount Eligible amount Other plan paid This plan paid Explanation YYYY MM DD number 2014 01 01 Eye Exam Routine 55 00 55 00 15 00 40 00 Total 55 00 55 00 15 00 40 00 http orovider ab bluecross ca optical Easy steps for online submission with Coordination of Benefits between Alberta Blue Cross and another benefit carrier Enter details Click yes if a portion of this claim has already been paid by another benefit carrier and if you would like to submit the remaining amount to this plan benefit carrier for each claim line If payments have been made by two or more other benefit carriers Combine the amount paid and enter one total for each claim line and click add claim Enter the amount paid by the other Repeat the same process until all lines have been entered then click Predeterm
14. ation ID number 1234567 01 Enter patient Date of birth 1966 12 06 YYYYMMDD Is the patient entitled to receive comparable benefits from any other insurance company health benefits company or Alberta Blue Cross Plan gt Yes No Select benefit Enter details Preauthorize Enter patient Required CD PREAUTHORIZE Submit a preauthorization John Smith ID number 1234567 01 Enter patient Select benefit Enter details Preauthorize Repair code Choose one Repairs Repairs hinge ABC Optical http orovider ab bluecross ca optical Preauthorize his is the screen where you will be provided the preauthorization results You can print this page or find the preauthorization result in the reports section Ifa claim has been approved on an exception basis by the program sponsor one of the Health Services Provider Relations representatives will contact you to set up the preauthorization Please submit a fully completed claim form once the claim has been authorized gt Preauthorizations are valid for 180 days PREAUTHORIZE Submit a preauthorization Enter patient Select benefit Enter details Preauthorize John Smith ID number 1234567 01 Preauthorization results Provider ABC Optical 1234 Patient name John Smith Identification number 1234567 12 Preauthorization number 99999999 Preauthorization date 2014 01 13 Preauthoriza
15. d predetermining or preauthorizing results as confirmed by the patient you simply submit the claim for processing Within seconds of submission results are displayed The patient will be required to pay only the portion not covered under their benefit plan The transaction is then complete Alberta Blue Cross has designed separate processes for entering claims for group and individual plan members page 3 members covered under the Optical Assistance for Seniors Program page 3 and members covered under Alberta Human Services page 11 There are differences in the screen requirements so please ensure patient information is entered on the correct screens If a member has Coordination of Benefits COB between a group or individual plan and an Alberta Human Services program please enter the claim through the group and individual plan area of the site If there is a remaining balance that may be considered under the Alberta Human Services program please complete and submit a claim form to Alberta Blue Cross for assessment Similarly if primary payment has been made by another insurer a completed claim form will be required to consider the balance under the Alberta Human Services program Please note that payments for group individual and Optical Assistance for Seniors Program participants will be issued on the same statement Payments for Alberta Human Services programs will be issued on a separate statement on alternate weeks Si V
16. equent sign ins will only require your login ID and password Ih SLOE crosse Home PROVIDER wees Secure Site En New registrant Products amp Services Signin Contact us Optical Provide Login ID Demonstration only Q Need help our Login iD Please us directly by e mail or fox contact inte Passw ord nformation listed kkaa TTTTTT 27 Your password Click here Ior call us using the Contact information listed delow Optical Provider Relation S Team Health 10009 108 Street tamonton we Ti AONTA Blue Cross E mail Opica Provideri NOMad divecross ca Cail 780 498 8083 Eamon RH for tol fae Gorana aepeeit The Bive Cross ebsite Policy and Online Billing Agreement A symbol and name ay a independent Bive Cross plans Licensed to ase ee Of the Canadian Association of Blue Cross Benefits Comoration for use in Operating the Alberta Blue Cross Puan Claiming online IS QUICK easy and secure Alberta Blue Cross has separate processes for entering claims for group and individual plan members and for members covered under the Optical Assistance for Seniors Program or Alberta Human Services Help IF you have questions about a screen click on the blue button with a question mark The help button has answers to questions that are frequently asked about the section Claiming online is quick easy and secure After validating a patient s identity an
17. ine ALBERTA BLUE CROSS Online Sorice AN PROVIDER services ENTER CLAIM PETIA predetermination and processing rim Enter patient COB information Enter details Predetermine Process claim John Smith ID number 1234567 01 Reports Group number 99 Optical Assistance for Seniors Program Enter claim Alberta Human Services and AISH programs COB details s the patient entitled to receive comparable benefits from any other insurance company health benefits company or Alberta Blue Cross Plan If the claim was submitted through another benefit carrier or provincial plan would you like to submit the remaining amount to this plan Logged in as ABC Optical 1234 ite Poli line Billi The Blue Cross symbol and name are registered marks of the Canadian Association of Blue Cross Plans an association of independent Blue Cross plans Licensed to ABC Benefits Corporation for use in operating the Alberta Blue Cross Plan Enter CLAIM predetermination and processing Enter patient COB information Enter details Predetermine Process claim John Smith ID number 1234567 01 Group number 99 Claim details Product Price 55 00 Other Plan Paid 45 90 Claim information Service date 2014 01 01 E YYYYMMDD Required Enter CLAIM predetermination and processing Enter patient COB information Enter details Predetermine Process claim John Smith ID number 1234567 01 Group number 99
18. lease provide the reason successfully been cancelled red text appears at the top of the screen as confirmation Cancellation Once a claim has ee BLUE CROSS Cancellation Review Please review claims listed below Enter a cancellation reason and press the Ok button to submit for cancellation If you no longer wish to cancel the claims listed below press the Back button Details Amount Alberta Blue claimed Cross paid Document No 47763002 Service date YYYY MM DD Patient 2014 01 01 Smith John Product or service Eye Exam Routine 55 00 0 00 Select one Select one Additional services provided Claim entered in error a Client returned product Other What is the reason for cancelling the claim Amount Alberta Blue claimed Cross paid Document No 55 00 0 00 47763002 Service date YYYY MM DD Patient 2014 01 01 Smith John Product or service Eye Exam Routine What is the reason for cancelling the claim Please enter the other reason REPORTS s TOF viewing your transachons Information Document number 47763002 for John Smith has been cancelled ABC Optical 1234 10009 108th Street NW Edmonton AB T5J 3C5 Details Need help cancelling a claim Amount Alberta Blue Cancel Product or service Claimed Cross paid Document No claim Contact Lenses 120 12 120 12 46480198 Cancel Service date YYYY MM DD Patients 2013 06 05 Smith John http o
19. ligibility for benefits to adjudicate pay claims to administer the terms of my benefit plan and to verify sudit paid claims ss described in the Alberts Blue Cross Privacy Policy posted st www sb bluecross ca and The Service Provider disclosing my personal information to Alberta Blue Cross for the above purposes Please retain for your records http orovider ab bluecross ca optical Easy steps to access reports for group or individual plan members or Optical Assistance for Seniors program Reports Th is screen allows you to moor manni pull up all claims waiting to be paid teoveniew for viewing your transactions history of settled claims and individual Sour iniisa Statements cia Optical Assistance for Seniors Program Payment Reports Outstanding Payment Report Seniors Program Outstanding Payment Report Alberta Blue Cross will make payments sree on Cecateacenttiuiwiaasea to your office once every two weeks pvernment of the The Outstanding Payment Report lists Payment History Report all transactions that are remaining to be bi Only date ranges within the previous six months can be entered paid and allows you to cancel a claim aa Start Date 2014 01 15 End Date 2014 01 15 YYYYMMDD YYYYMMDD Payment History Report Once Croata Report ogged in as the transactions have been paid they Optical 1234 Patient Claim Statements will be removed from the Outstanding T pieg ardent AiE the last year will
20. number 1234567 01 Group number 99 Summary Predetermination results as of January 15 2014 11 10 AM Mountain Time Please note that eligibility of coverage may change based on the date of service change in benefit maximum being reached coordination of benefits or coverage terminates Service date January 1 2014 Total amount submitted 55 00 Plan s will pay Balance remaining This is not a receipt ae E Details You can click Modify to go u i Amount claimed Plan s will Balance remainin back to step 2 Cancel to exit _ without saving or Process claim _ to submit the claim online to ie Gai Pocoma aan Alberta Blue Cross for immediate Snn processi ng Website Policy and Online Billing Agreement The Blue Cross symbol and name are registered marks of the Canadian Association of Blue Cross Plans an association of independent Blue Cross plans Licensed to Af Corporation for use in operating the Alberta Blue Cross Plan http orovider ab bluecross ca optical Pro cess cla i m Yo U wi rece ive a Please click below to print the patient s Claim Statement confirmation from Alberta Blue Cross C Print Alberta Blue Cross within seconds of your submission SIE CROSS a A printable copy of the patient s Claim We re here to help Statement is displayed Edmonton and area 780 498 8000 Calgary and area 403 234 9666 Toll free 1 800 661 6995 8 a m 5 p m
21. osited directly into your bank account please complete the Application for Direct Deposit of Funds form These forms can be accessed through our public web site at www ab bluecross ca Please mail or fax your completed form to Health Services Provider Relations Alberta Blue Cross 10009 108 Street Edmonton ABT 5J 3C5 Fax 780 498 3544 The Health Services Provider Relations team at Alberta Blue Cross will create your web site access based on your completed registration form To protect your security a login ID and temporary password will be sent in two separate e mails to the e mail address provided on your registration form Once you have received both of these e mails you can begin serving your customers through online claims submission http orovider ab bluecross ca optical Getting started online Please refer to the information in the e mails Alberta Blue Cross sends you when your initial registration is approved These e mails will contain your login ID and temporary password Navigate to the Optical Provider Online Services web site at http provider ab bluecross ca optical and enter the login ID and password in the applicable fields You will be asked to agree to the Web Site Policy and Online Billing Agreement set up your two Reminder Questions and change your temporary password This information will be used to verify your identity if you forget your password or require information about your account Subs
22. rovider ab bluecross ca optical Fasy steps to submit and process a claim for Alberta Human Services 9 Preauthorizing benefits Enter the patient s information Choose Alberta Human Services and AISH programs in the sidebar on the left Navigate to the Preauthorize menu option and enter the patient s ID number and date of birth exactly as it appears on their ID card Answer the question about Coordination of Benefits information and click the Search button Select benefit Choose a benefit type from the drop down menu and select Next Enter details Choose the applicable product code from the drop down menu If required please include prescription information You will be asked to enter the applicable information For example if you are claiming a lens you will choose the body side lens code and vision code When entering the prescription details with positive values the plus sign is not required Click the Preauthorize button ALBERTA BLUE CROSS PROVIDER SERVICES Site overview Group and Individual plans Optical Assistance for Seniors Program AISH programs Preauthorize Enter claim Reports Submit a preauthorization John Smith ID number 1234567 01 Benefit details E Benefit type Optical Provider Online Services PREAUTHORIZE Submit a preauthorization Select benefit Enter details Preauthorize Patient inform
23. tails s the patient entitled to receive comparable benefits from any other insurance company health benefits company or Alberta Blue Cross Plan Required http orovider ab bluecross ca optical Enter details Required Predetermine Process claim If Yes and the patient has active coverage with another benefit carrier continue to the COB section on page 6 predetermination and pi a price then click Add claim Repeat 1g these steps for each product being Enter patient COB information Enter details John Smith considered ID number 1234567 01 Group number 99 4 Enter details Select a product enter When you are satisf ed with the details you have entered click the Claim details Predetermine button Product Choose one aia Product Please refer to article 4 4 in your Online Eye Exam Services Billing Agreement for more information regarding the service date Claim information Note There may be some Service date 20140101 B YYYYMMDD circumstances when a claim cannot be processed electronically You will receive a notification on this screen and these claims will have to be Submitted manually by the patient to Alberta Blue Cross Predetermine his is a simple inquiry into the patient s benefit plan s to determine the coverage available 3t lot pezen TEE p Predeterminarion ana prot Predetermine John Smith ID
24. ted claims are still active a 2014 01 13 Smith John 1234567 Repairs hinge 99999999 Confirm You will be asked to REPORTS amp gt confirm that you want to cancel the s Pr visting your transactions preauthorization ABC Optical 1234 10009 108th Street NW Edmonton AB T5J3C5 Outstanding Preautho Click the button beside the perautho Are you sure you would like to cancel this preauthorization o be cancelled click the 7A Cancel button OK Cancel Preauthorization Patient date YYYYIMM DD 2014 01 13 Smith John 1234567 Repairs hinge 99999999 Cancellation A message is displayed Reports at the top of the screen when the _ for viewing your transactions Information preauthorization has been cancelled successfully Preauthorization 99999999 for John Smithhas been cancelled ABC Optical 1234 10009 108th Street NW Edmonton AB T5J3C5 Outstanding Preauthorizations Click the button beside the perauthorization number that you wish to submit If a preauthorization needs to be cancelled click the amp Cancel button Preauthorization Patient ID number Benefit type Preauthorization number http orovider ab bluecross ca optical Technical information Using the Optical Services Provider web site an Internet connection and your browser you can submit claims online at your convenience Most computer systems today have everything required to use this web site successfully
25. that are frequently asked about the section Easy steps to cancela claim for Alberta Human Services Report Create an Outstanding Outstanding Payment Report Payme nt Re port View all claims remaining to be paid as of 2014 01 13 You can view or cancel claims from within this report Only Claim Statements obtained by the patient within the last year will appear Cancel To cancel a claim click the REPORTS hyperlin k for viewing your transactions ABC Optical 1234 10009 108th Street NW Edmonton AB T5J3C5 Details Need help cancelling a claim 27 Service date Amount Alberta Blue Cancel YYYY MM DD Patients Product or service Claimed Cross paid Preauthorization No claim 2013 11 08 Smith John Frame amp case 100 00 0 00 46480215 Cancel 2014 01 13 Smith John Repairs hinge 35 35 8 11 47762938 Ca Note for viewing your transactions Information If the cancellation hyperlink is inactive anpara pradei arepane m a aaa iaiaaeaia either the document has exceeded the ABC Optical 1234 cancellation timeframe or the payment 10009 108th Street NW T5J3C5 run is in progress and the claim cannot be cancelled online If a payment run is Details O in progress you will receive a red text ea Service date Amount Alberta Blue ance notification Please refer to the help YYYY MM DD Patients Product or services Claimed geen Preauthorization No claim 2013 11 08 Smith John Frame amp case 100
26. tion will remain valid for 180 days from the preauthorization date Repairs hinge PROVIDER COPY ONLY Please retain for your records Click here to print http orovider ab bluecross ca optical Entering claims O Enter the preauthorization number in the field provided To view all preauthorizations affiliated with your office simply select View All Enter preauthorization Enter details Process claim Enter the preauthorization number Preauthorization number 99999999 claim details will be populated in the Enter Claim screen If there are vas Me Sree P John Smith additional products select the product ID number 1234567 01 code and body side Then click Add product Repeat these steps for each Description product being added Repairs hinge D Enter details Your preauthorized Some products may require medical information for eligibility From the Claim information drop down menu choose the patient s Service date 201410113 fj YYYYMMDD applicable medical condition Once all products have been selected l Process claim X enter the corresponding amounts Click the Process Claim button http orovider ab bluecross ca optical Process claim Once the claim has been processed you will receive notification that the claim has been successfully submitted View claim statement You O will receive confirmation of your submission You may save a copy for

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