iNetwork User Manual Complete “How to” Guide to … User Manual Complete “How to” Guide ......

Santéch Solution, Inc. [confidential]

iNetwork User Manual

Complete “How to” Guide to use the system


TABLE OF CONTENTS

INTRODUCTION ................................................................................................................................................. 3

DOCUMENT PURPOSE .................................................................................................................................. 3

DOCUMENT SCOPE ...................................................................................................................................... 3

INTENDED AUDIENCE ................................................................................................................................... 3

EXPLANATION OF TERMS, SYMBOLS AND ICONS ................................................................................... 3

HOW TO LOG-IN ................................................................................................................................................ 4

HOW TO LOG-IN – BY UPMC CREDENTIALING STAFF ........................................................................... 4

HOW TO LOG-IN – BY PROVIDER ............................................................................................................... 6

PROVIDER REGISTRATION PROCESS ......................................................................................................... 8

PROVIDER REGISTRATION PROCESS – BY UPMC CREDENTIALING STAFF ...................................................... 8

PROVIDER REGISTRATION PROCESS – BY PROVIDER ................................................................................ 13

HOW TO VIEW LIST OF EXISTING PROVIDERS – BY UPMC STAFF ..................................................... 17

PROVIDER DATA MANAGEMENT WOKFLOW ........................................................................................... 18

MAIN INFORMATION .................................................................................................................................... 18

SUPPORTING INFORMATION ........................................................................................................................ 29

DECLARATIONS ......................................................................................................................................... 35

REVIEW AND SUBMIT .................................................................................................................................. 36

ADMIN SETUP .................................................................................................................................................. 38

DOCUMENTS .................................................................................................................................................... 39

I-ANSWER AND I-FORMS/LINKS .................................................................................................................. 40


INTRODUCTION

Document Purpose

The purpose of this document is to provide the user with a complete “How To” guide to navigate

throughout the application.

Document Scope

This document includes items such as page layout, functional requirements, field specifics, terminologies,

navigation and business rule logic (validations) required for proper usage of the application.

Intended Audience

The audience for this document is the UPMC Internal team and Provider Network.

EXPLANATION OF TERMS, SYMBOLS AND ICONS

SYMBOL DESCRIPTION

You will find this icon on the top right corner of the list/add screens where user is allowed to enter data.

User needs to click this button after entering all the mandatory information in order to “Save the entered information”

validations to let user know if any mandatory information is missing and / or inappropriately entered”

You will find this icon on the top right corner of the list/add screens where user is allowed

to view/enter data.

User can click this button if he/she doesn’t want to add/save the information.

You will find this icon on the top right corner of the application screens, clicking on which

would refresh the input values

This icon would allow user to filter/search the information at various stages

defined parameters.

You will find this icon on the top right corner of the application, clicking on which would allow the user to add the desired

* This symbol denotes the mandatory fields that must be entered by usersthe information.

Session

Timeout

The application session time out is set for 20 mins. In case the application reports

inactivity for 20 mins, the u



and business rule logic (validations) required for proper usage of the application.

The audience for this document is the UPMC Internal team and Provider Network.

, SYMBOLS AND ICONS


User needs to click this button after entering all the mandatory information in order to “Save the entered information” and at the same time “chec

validations to let user know if any mandatory information is missing and / or inappropriately entered”.


to view/enter data.



would refresh the input values and user can start entering the information

This icon would allow user to filter/search the information at various stages

defined parameters.

You will find this icon on the top right corner of the application, clicking on which would allow the user to add the desired information.

This symbol denotes the mandatory fields that must be entered by users


inactivity for 20 mins, the user will be logged off and will have to re-login.



and business rule logic (validations) required for proper usage of the application.


User needs to click this button after entering all the mandatory information in order to “check for required

validations to let user know if any mandatory information is missing and / or




and user can start entering the information afresh.

This icon would allow user to filter/search the information at various stages using pre-

You will find this icon on the top right corner of the application, clicking on which would

This symbol denotes the mandatory fields that must be entered by users before saving


login.


HOW TO LOG-IN

iNetwork provides comprehensive data security with Secure Socket Layer (SSL), Windows

Authentication, Log-in Management (username and password), and Access Rights Allocation and more,

thus allowing only authorized users to access the application information.

HOW TO LOG-IN – BY UPMC CREDENTIALING STAFF

Step 1: UPMC Credentialing Staff will go to UPMC website www.upmchealthplan.com and will click on a

link “For Internal Staff” there to get re-directed to the iNetwork Credentialing Staff Login screen as shown

below.

Step 2: Enter the Log in Name that identifies the authorized user

Step 3: Enter the Password relevant to the login name

Step 4: Click “Login” Button

� Reset – Click ‘Reset’ button, to clear the details entered in the login screen

� Home – Click on “Home” button to get re-directed to the UPMC website www.upmchealthplan.com.


� Forgot Password – Click on “Forgot Password” to retrieve your forgotten password.

� How to Login – Click on “How to Login” button to retrieve a Login User Manual (.PDF) to guide the

user across the login process.

Once you Login to the application, the home page appears as shown below.

The Home Page displays the following details:

� Menu Bar � Login User Name � Date � UPMC Logo

� Network

� Help – clicking on “Help” will open up a complete “How to navigate” user manual to guide the user

across the application.

� Home – Clicking on “Home” will bring the user back to their home page

� Logoff – Clicking on “Logoff” will take the user back to the login screen where user has to enter

their credentials to re-enter into his/her secured home page.


HOW TO LOG-IN – BY PROVIDER

Step 1: Provider will go to UPMC website www.upmchealthplan.com and will click on a link “For

Providers” there to get re-directed to the iNetwork Provider Login screen as shown below.

Step 2: Enter the Log in Name that identifies the authorized user

Step 3: Enter the Password relevant to the login name

Step 4: Click “Login” Button

� Reset – Click ‘Reset’ button to clear the details entered in the login screen

� Home – Click on “Home” button to get re-directed to the UPMC website www.upmchealthplan.com.

� Forgot Password – Click on “Forgot Password” to retrieve your forgotten password.

� How to Login – Click on “How to Login” button to retrieve a Login User Manual (.PDF) to guide the

user across the login process.

� New Registration – If you are a new user then click on “New Registration” button to get registered

with UPMC Health Plan. On the completion of registration process, you will be assigned with a user id

and password which you can use to login into the application.


Once you Login to the application, the home page appears as shown below.

The Home Page displays the following details:

� Menu Bar � Login User Name � Date � UPMC Logo

� Network

� Help – clicking on “Help” will open up a complete “How to navigate” user manual to guide the user

across the application.

� Home – Clicking on “Home” will bring the user back to their home page

� Logoff – Clicking on “Logoff” will take the user back to the login screen where user has to enter

their credentials to re-enter into his/her secured home page.


PROVIDER REGISTRATION PROCESS

Providers can be registered to the UPMC Health Plan Provider Network either by UPMC Credentialing

Staff or by Providers themselves.

PROVIDER REGISTRATION PROCESS – BY UPMC CREDENTIALING STAFF

Step 1: UPMC Credentialing Staff login into their secured home page as described in the “How to Login”

section above.

Step 2: Click on the Provider – Add/Register tab to get re-directed to the Provider Registration screen as

shown below.

Click to Add/Register

Provider


Step 3: Input the SSN and click on Begin Registration as shown below

Click to Begin

Registration


Step 4: Clicking on “Begin Registration” will initiate the following validation scenario.

Provider Data Exists

against the SSN

entered? Yes

User ID exists

against the SSN

entered?

Yes

The application will display a message “User already exists”. Please refer screen shot 1.

No

The application will open up a registration form with all the data pre-populated. User needs to enter the user id, hint question and hint answer and click on Submit. Clicking on Submit will generate the user id and password that internal staff can send to the provider for accessing the iNetwork application. Please refer screen shot 2.

No

The application will open up a screen where user can input different information for the provider like their demographics, practice information and more. User can input whole or part information to add the provider. Once the provider is added, follow Step 2, Step 3 and Step 4 to register (generate user id and password) the provider. Please refer screen shot 3 and 4.


Screen Shot 1:

Screen Shot 2:


Screen Shot 3:

Screen Shot 4:


PROVIDER REGISTRATION PROCESS – BY PROVIDER

Step 1: Provider will go to UPMC website www.upmchealthplan.com and will click on a link “For

Providers” there to get re-directed to the iNetwork Provider Login screen as shown below.

Click to start the

registration process

for a new provider


Step 2: If he/she is a new provider not registered with UPMC Health Plan, click on New Registration

(refer the screen shot above) to get re-directed to the Provider Registration Screen as shown below.

Step 3: Input the SSN and click on Begin Registration as shown below.

Click to Begin

Registration


Step 4: Clicking on “Begin Registration” will initiate the following validation scenario.

Screen Shot 1:

Provider Data Exists

against the SSN

entered? Yes

User ID exists

against the SSN

entered?

Yes

The application will display a message “User already exists”. Please refer screen shot 1.

The application will open up a registration form with all the data pre-populated. User just needs to enter the user id, hint question and hint answer and click on Submit. Clicking on Submit will generate the user id and password that provider can use to login into the iNetwork application. Please refer screen shot 2.

No

The application will open up a blank registration form where user has to enter all the mandatory information as shown in screen shot 3. User can click on submit upon entering all the information which will then generate the user id and password that provider can use to login into the iNetwork application. Please refer screen shot 2.

No


Screen Shot 2:

Screen Shot 3:


HOW TO VIEW LIST OF EXISTING PROVIDERS – BY UPMC STAFF

Step 1: UPMC Credentialing Staff login into their secured home page as described in the “How to Login”

section above.

Step 2: Click on the Provider – List tab to get re-directed to the Provider List screen as shown below.

Click to view

Provider List

Provider List View


Provider List View screen will have the following details:

� Filter Criteria – UPMC Credentialing Staff can filter provider based on their last name and first

name.

� Terminate – Clicking on “Terminate” will delete the provider(s) from the list view. User can select

single or multiple providers (using the select check box) for termination.

� Send Mail – Clicking on “Send Mail” will open an Outlook window with the email id of selected

provider pre-populated in the ‘To’ field of Outlook. If more than one provider has been selected

then UPMC Credential Staff email id will get pre-populated in the ‘To’ field and providers’ email

ids will get pre-populated in the ‘Bcc’ field of Outlook.

� Change – Clicking on “Change” will allow the UPMC staff to change/edit individual provider’s

record.

PROVIDER DATA MANAGEMENT WOKFLOW

The entire Provider Data Management Workflow consists of 4 sections – Main Information, Supporting

Information, Declarations and Review and Submit:

MAIN INFORMATION

Under Main Information section, UPMC internal staff and/or Providers can capture/enter the following

information:

• Demographics – this sub-section will capture basic details about a provider like their Last Name, First Name, SSN, NPI, Provider’s Office Contact Person, Conflict of Interest and more. Please refer the screen shot below.


• Practice – This sub-section allows the UPMC Internal Staff and/or Providers to attach multiple

practices and define multiple locations for each practice to the Provider’s record. Here is how this

entire process will work.

o Attaching Practice

Step 1: UPMC Internal Staff/Provider clicks on the Practice tab to enter into Practice Sub-section.

Step 2: Input value in the Tax ID field and click on Search. Clicking on the Search button will initiate a search for existing practice associated with that Tax Id in the database:

� If found, then it will display a message “Practice Found, Attaching Now” and that practice will get added in the Practice list screen. This list screen will show all the practices associated with this provider. Please refer screen shot 1 and 2.

� If not found, then it will open a screen along with the message on top stating “Practice not found, so adding new”. Please refer screen shot 3 and 4.

� Once the new practice is added, it will appear in the Practice list screen. Please refer screen shot 5.


o Attaching Provider Applicable Locations Against Each Practice

Step 1: Click on the Location button against the Practice for which you want to add Provider applicable locations as shown in the screen shot below. Please refer screen shot 6.

Step 2: Click on “Add” button on the Provider Location screen to open up a screen

displaying the list of all the existing locations against that Practice. Please refer screen shot 7 and 8.

Step 3: User can select the desired locations and click on “Save” on the Practice Location Screen as shown in screen shot 8. The selected locations will

get added on the Provider Location List screen as shown in screen shot 7. Step 4: If the user doesn’t find the desired location(s) in the Practice Location List screen

then he/she can click on “Add” on the Practice Location List screen to add a new location as shown in screen shot 9.

Step 5: Once user has added the applicable locations for a provider in a practice, he/she

can add the billing address, work hours and languages details at each of these locations. Please refer to screen shots 10, 11 and 12.

Screen Shot 1:


Screen Shot 2:

Screen Shot 3:


Screen Shot 4:

Screen Shot 5:

Adding new practice

New Practice Added


Screen Shot 6:

Screen Shot 7:

Click to View/Add Provider

Applicable Locations

Provider Locations

View


Screen Shot 8:

Screen Shot 9:

Select Provider Location(s) from

existing Practice Locations

Add new provider location if desired

location not found in practice location list


Screen Shot 10:

Screen Shot 11:

Add Provider Billing/Pay to

Location


Screen Shot 12:

• Specialty – this sub-section will capture different specialties for a provider. Provider can’t have more than one Primary Specialty and must select the same before saving the information. Please refer to the screen shot below.


• Licensure – This sub-section will capture different license records for a provider. User can view/change/delete existing records and/or click on “Add” button to add a new license record. Please refer to the screen shots below.

View/Change/Delete Records:

Add Record:


• Professional Liability – This sub-section will capture different professional liability carrier information for a provider. User can view/change/delete existing records and/or click on “Add” button to add a new record. Please refer to the screen shots below.


Add Record:


SUPPORTING INFORMATION

Under Supporting Information section, UPMC internal staff and/or Providers can capture/enter the

following information:

• Employment History – This sub-section will capture all the relevant work history of the provider. User can view/change/delete existing records and/or click on “Add” button to add a new record. Please refer to the screen shots below.



Add Record:

• Hospital Privileges – This sub-section will capture Hospital Privileges details of the provider. User can view/change/delete existing records and/or click on “Add” button to add a new record. Please refer to the screen shots below.



Add Record:

• Education/Training – This sub-section will capture the Education and Training details of the provider. User can view/change/delete existing records and/or click on “Add” button to add a new record. Please refer to the screen shots below.



Add Record:

• Certification – This sub-section will capture the Certification details of the provider from various boards. It will also capture whether the provider is pursuing any board certification and the expected test date (if pursuing). User can view/change/delete existing records and/or click on “Add” button to add a new record. Please refer to the screen shots below.



Add Record:

• Documents – This sub-section will provide the ability to capture/upload relevant

documents/images (license, DEA, certifications, W-9 form and more). User can view/delete existing documents/images and/or click on “Add” button to add a new document/image. Please refer to the screen shots below.

View/Delete Records:


Add Record:


DECLARATIONS

This section allow the providers and/or internal staff (on behalf of provider) to enter (or provide) their

declarations and give them an ability to attach notes for any “Yes” answers to the different Declarations’

questions. Please refer to the screen shot below.


REVIEW AND SUBMIT

This is the last step of the Provider Data Management Workflow. Once the provider and/or internal staff

(on behalf of provider) have submitted the Main Information, Supporting Information and Declarations

then the user can enter into this tab, click on review icon to review the application form with all the data

pre-populated into it. Once the user has reviewed the application, they can either print it and/or close it to

do a final submit.

For form submission, user is required to enter their name as electronic consent that user has reviewed

the application and that he/she is authorized to submit the application. User has to enter his/her name

and can then click on “Submit” to complete the application submission process. Please refer to screen

shots below for details.


ADMIN SETUP

This function will be available with the UPMC credentialing staff giving them an ability to view/email the

user credentials (login id and password) of all the users (providers and other internal staff members)

using the iNetwork application.


DOCUMENTS

It is a central document repository that stores all the documents/images uploaded/exchanged in the

application and allows the UPMC credentialing staff to access all these documents/images at any given

point of time.


I-ANSWER AND I-FORMS/LINKS

Provides a structured mechanism to the credentialing staff to share/upload useful user

information/documents with the providers to make them more informed and reduce repetitive calls from

them. At the same time, it provides a structured way for the providers to view/download useful

information/document/links and more.

Add: It will add Question/Answer to i-Answer:

List: It will List all the existing Question/Answer to I-Answer


Form(s) Add:

Form(s) List:


Link(s) Add:

Link(s) List:

iNetwork User Manual Complete “How to” Guide to … User Manual Complete “How to” Guide ......

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