On March 30, 2020, we introduced the Interactive Care Reviewer (ICR) — a self-service prior authorization (PA) tool that will improve the efficiency of your authorization process for Empire BlueCross BlueShield HealthPlus members. ICR offers a streamlined process to request and check the status of medical and behavioral health inpatient and outpatient procedures. You can easily access ICR through the Availity Portal.*

 

What benefits/efficiencies does the ICR provide?

  • You can determine if PA is needed. For most requests, when you enter patient, service and provider details, you will receive a message indicating whether review is required.
  • You receive a comprehensive view of all your PA requests. You have a complete view of all the utilization management requests you submitted online, including the status of your requests and specific views that provide case updates and a copy of associated letters.
  • You will have inquiry capability. Ordering and servicing physicians and facilities can locate information on PA requests for those with which they are affiliated; this includes requests previously submitted via phone, fax and ICR.
  • You have the ability to request and check the status of clinical appeals. You can use ICR to request a clinical appeal for denied authorizations and access letters associated with the appeal.
  • ICR reduces the need to fax. ICR allows text detail as well as images to be submitted along with the request.
  • There is no additional cost to you. ICR is a no-cost solution that’s easy to learn and even easier to use.

 

Follow these instructions to access ICR through the Availity Portal

First, ask your Availity administrator to grant you the appropriate role assignment.

 

Do you create and submit PA requests?

Required role assignment: Authorization and Referral Request

 

Do you check the status of the case or results of the authorization request?

Required role assignment: Authorization and Referral Inquiry

 

Once you have the authorization role assignment, log in to Availity with your unique user ID and password and follow these steps:

  1. Select Patient Registration from Availity’s home page.
  2. Select Authorizations & Referrals.
  3. Select either Authorizations for requests or Auth/Referral Inquiry for inquiries.

 

Monthly ICR training

Register for one of our free webinars created to familiarize new users with ICR features and navigation. Registration link: https://anthemincub.webex.com/anthemincub/onstage/
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NYE-NU-0219-20 May 2020

 



Featured In:
July 2020 Empire Provider News