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This will give detailed instructions for the access of all WRHN web based tools. This simple format will help answer our most frequest asked questions, train staff, and navigate the WRHN web site. Simply select the catagory you are looking for from the drop down menu below.
WRHN member clinics and their staff are assigned secure login and password.
Contact ladean@mlrehab.com to set up new login or change your password.
LOGIN STEPS
Go the WRHN's home page. On the right
hand side of the page you will see Provider Login. Enter
your Login ID and Password and click Login.
You may also enter our Secure Login by clicking on Providers
Only at the top menu and then clicking WRHN Provider Login.
Enter your login and password.
Once your login is approved, you
will be taken to the "FUNCTIONS" page, and you will see file folder
tabs across the top of the page. These tabs will say; Registration;
Authorization; Additional; Outcomes; Patient Satisfaction; Reports.
top
Click on "REGISTRATION" (Tab should be white when you are in "REGISTRATION").
The "REGISTRATION" tab should be used when you are registering patients
for the following reasons:
Patients who do NOTneed WRHN medical necessity authorization, and
are NOT billed through WRHN. These are patients whom you are tracking
for outcomes, etc.
Patients who may not be billed through WRHN, but payments for claims
may be received by WRHN. Blue Cross secondary cross-overs, etc.
Patients whom you wish to post Outcomes/Patient Satisfaction for
as an "out of network" patient.
New Patient - Follow these simple steps:
SEARCH for Primary ICD9 code in the WRHN system. If you cannot
find the Primary ICD9 in the system then type your code in the space
listed for Primary ICD9. enter the second or third ICD9 in ths spaces
listed. All Primary ICD9 codes typed in will go to review to make
sure it is an approved code. If you do a search for Primary ICD9,
the auth will automatically come back with te auth number and number
of visits.
PATIENT'S LAST NAME
PATIENT'S FIRST NAME
PATIENT'S DATE OF BIRTH (Follow format indicated)
INSURANCE TAB (Locate the appropriate insurance carrier or catagory
and click on it)
PATIENT'S INSURANCE MEMBER CONTRACT NUMBER
PATIENT'S INSURANCE GROUP NUMBER
PRIMARY THERAPIST (Select therapist from list)
DATE OF EVALUATION (Follow format indicated)
ANTICIPATED DISCHARGE DATE (Follow format indicated)
If the patient had another auth on the system, or you registered
this patient previously and this is a return visit after the patient
discharged, mark the "ALLOW DUPLICATE" box.
OUT OF NETWORK (You are tracking this patient for
OUTCOMES/PATIENT SATISFACTION outside of the WRHN data base), place
a check in the "OUT OF NETWORK BOX".
SUBMIT REGISTRATION. You will NOT receive an auth number for those
patients that are registered on the web site. If an auth number
is needed you will need to authorize the patient.
If you wish to go to OUTCOMES (patient has discharged and you are
registering them in order to post outcomes), click on submit outcomes
and it will take you directly to OUTCOMES.
Find the WRHN web site by entering www.westernrehabnetwork.com
in your web browser. The Western Rehabilitation Health Network web
site will come up. Go to "PROVIDER LOGIN".
Enter your LOGIN and PASSWORD. Once your login is approved, you
will be taken to the "FUNCTIONS" page, and you will see file folder
tabs across the top of the page. These tabs will say: Registration;
Authorization; Additional; Outcomes; Patient Satisfaction; Reports
Click on "AUTHORIZATION" (tab should be white when you are in "AUTHORIZATION")
New Patient - Follow these simple steps:
Search for Primary ICD9 code in the WRHN system. If you cannot
find the Primary ICD9 code, then enter it in the Primary Diagnosis
section. All Primary ICD9 codes that are entered manually will to
to WRHN to determine if the code is valid. If you do a search by
ICD9 you will get the auth back automatically with the number of
visits and auth number. Enter the second, third or fourth code if
you have any.
PATIENT'S LAST NAME
PATIENT'S FIRST NAME
PATIENT'S DATE OF BIRTH (Follow format indicated)
INSURANCE TAB (Locate the appropriate insurance carrier or catagory
and click on it) If insurance carrier is First Health/CCN, enter
the EDI number from the card or name and address of claims destination
payer from the patient card. If this is a SECONDARY insurance carrier,
click on the secondary box to the side of the insurance listed.
PATIENT'S INSURANCE MEMBER CONTRACT NUMBER (Enter EXACTLY as on
patient's Insurance ID card)
PATIENT'S INSURANCE GROUP NUMBER
EVAL THERAPIST (Select therapist from the drop down list)
DATE OF EVALUATION (Follow format indicated)
ANTICIPATED DISCHARGE DATE (Follow format indicated)
SURGERY (Check box if surgery has been done)
IF THIS PATIENT HAS ANOTHER AUTH ON THE SYSTEM PRIOR TO THIS ONE,
MARK "DUPLICATE" IN THE BOX.
If the patient has an OUT OF STATE Blue Cross plan, First Health/CCN
plan, Great West plan, WISe or Beechstreet plan and an auth is required
from them, put that auth number in the non panel auth space under
authorizations. It must be 8 digits long. If it is not, add zeros
at the end of your number. If they do not require a pre auth through
them, then leave the space blank and use our auth numbers to run
the claims through our system. No visits will be given for OUT OF
STATE Blue Cross or SECONDARY plans, however, you will need the
DUMMY auth number to submit claims. You will receive the DUMMY auth
directly from WRHN.
SUBMIT AUTHORIZATION. You should get the auth number and number
of visits, or the DUMMY auth number back at this time. Some of the
authorizations will go to WRHN for review because of the diagnosis
code. You will receive the auth number and number of visits after
review is completed. The authorization can be found under REQUESTS
on the web site, usually within 24 hours or by the next working
day.
REQUESTS are located under the REPORTS tab and located at the top
of the report screen. Click on REQUESTS and then click on the IR
# and the auth should be there. Right click on the auth and print
off a copy for your files.
Find the WRHN web site by entering www.westernrehabnetwork.com
in your web browser. The Western Rehabilitation Health Network web
site will come up. Go to Provider Login.
Enter your LOGIN and PASSWORD. Once your login is approved, you
will be taken to the "FUNCTIONS" page, and you will see file folder
tabs across the top of the page. These tabs will say: Registration;
Authorization; Additional; Outcomes; Patient Satisfaction; Reports
Click on "ADDITIONAL" (Tab should be white when you are in "ADDITIONAL")
ADDITIONAL VISITS ON AUTHORIZED PATIENTS - FOLLOW THESE SIMPLE STEPS:
CLICK ON SEARCH AND ENTER PATIENT'S NAME OR AUTH NUMBER.
CLICK ON THE PATIENT'S NAME AND THE AUTHORIZATION WILL COME UP
FILL IN ALL BLANK SPACES (You can copy and paste any text from another
text file into the fields/spaces - these fields will expand to 500
characters to accomodate the text you paste)
SUBMIT THE REQUEST. Additional visit requests go to WRHN for review.
Upon review, you will receive an answer through the REQUESTS screen
under the REPORT tab. if addtional information is needed you will
be contacted through the REQUEST screen to fax office notes for
review. Fax notes to LaDean at 801-495-5315.
DO NOT EMAIL PATIENT INFORMATION THROUGH THE REGULAR EMAIL SYSTEM.
THE REGULAR EMAIL SYSTEM IS NOT HIPAA COMPLIANT.
Find the WRHN web site by entering www.westernrehabnetwork.com
in your web browser. The Western Rehabilitation Health Network Web
Site will come up. Go to Provider Login.
Enter your Login and Password. Once your login is approved, you
will be taken to the "FUNCTIONS" page, and you will see file folder
tabs across the top of the page. These tabs will say; Registration;
Authorization; Additional; Outcomes; Patient Satisfaction; Reports
Click on "OUTCOMES" (Tab should be white when you are in "OUTCOMES")
The "OUTCOMES" tab should be used when you are entering outcomes
for the following patients:
ALL patients you are seeing as a result of your contract with WRHN.
Any "OUT OF NETWORK" patients you would like to track on a separate
data base for your clinic.
CLICK ON SEARCH AND ENTER PATIENT'S NAME OR AUTH NUMBER
If there are multiple listings with that auth number or patient
name, please contact LaDean (through the REQUESTS) and have her
merge those files before doing ANY outcomes.
PATIENT DATA WILL BE FOUND (only if you registered or authorized
the patient previously)
FILL IN ALL BLANK SPACES
SUBMIT THE SURVEY WITH THE "SUBMIT" button (for patients you are
completing only OUTCOMES at this time)
SUBMIT THE SURVEY WITH THE "SUBMIT/SURVEY" button (for patients
you are completing both OUTCOMES AND PATIENT SATISFACTION at this
time) IF YOU SELECT THIS OPTION, YOU WILL AUTOMATICALLY BE TAKEN
TO THE PATIENT SATISFACTION SCREEN FOR THIS PATIENT.
IF YOU SELECTED "OUT OF NETWORK" AT THE TIME OF "REGISTRATION",
THE OUTCOMES DATA WILL BE TRACKED IN A SEPARATE DATA BASE FOR YOUR
CLINIC. YOU CAN ACCESS THIS DATA BASE THROUGH THE "REPORTS" OPTION.
Find the WRHN web site by entering www.westernrehabnetwork.com
in your web browser. The Western Rehabilitation Health Network Web
Site will come up. Go to Provider Login.
Enter your Login and Password. Once your login is approved, you
will be taken to the "FUNCTIONS" page, and you will see file folder
tabs across the top of the page. These tabs will say; Registration;
Authorization; Additional; Outcomes; Patient Satisfaction; Reports
Click on "PATIENT SATISFACTION" (Tab should be white when you are
in "PATIENT SATISFACTION"). The "PATIENT SATISFACTION" tab should
be used for the following patients:
ALL patients you are seeing as a result of your contract with WRHN.
Any "OUT OF NETWORK" patients you would like to track on a separate
data base for your clinic.
CLICK ON SEARCH AND ENTER PATIENT'S NAME OR AUTH NUMBER
If there are multiple listings with that auth number or patient
name, contact LaDean at WRHN to merge the file before doing ANY
patient satisfaction.
PATIENT DATA WILL BE FOUND (only if you registered or authed the
patient previously)
FILL IN ALL BLANK SPACES
SUBMIT THE SURVEY
IF YOU SELECTED "OUT OF NETWORK" AT THE TIME OF "REGISTRATION",
THE OUTCOMES DATA WILL BE TRACKED IN A SEPARATE DATA BASE FOR YOUR
CLINIC. YOU CAN ACCESS THIS DATA BASE THROUGH THE "REPORTS" OPTION.
Find the WRHN web site by entering www.westernrehabnetwork.com
in your web browser. The Western Reabilitation Health Network Web
Site will come up. Go to Provider Login.
Enter your Login and Password. Once your login is approved, you
will be taken to the "FUNCTIONS" page, and you will see file folder
tabs across the top of the page. These tabs will say; Registration;
Authorization; Additional; Outcomes: Patient Satisfaction; Reports
Click on "REPORTS" and you will be taken to the page that will give you access to "AUTHORIZATION DETAIL", "CLAIM DETAIL", and "POLICY DETAIL".
At the top of this new page, you will see "PATIENT", "FUNCTIONS", REPORTS", & "HELP". Click on the "PATIENT" and enter the patient's last name and click on "SEARCH". All files in your clinic's data base with the last name you submitted
will appear. Click on the file you want to open. If there are multiple
files for the same patient, you may want to request WRHN merge the
files for you before you procede. Simply send a request to LaDean
and give her the name of the files you need merged.
Once you have selected the file you want to review, your screen will re-write, populating the fields with information from the file.
Near the bottom left side of the screen, you will see three file folder tabs; Auth; Claim; Policy. Click on the "AUTH" tab (the tab should turn to white) and then click on the "DETAIL" buttom to the right to see the detail of auths in the system for this patient.
To see "CLAIM" information. Click on the "CLAIM" tab (the tab should
turn to white) and the screen will re-write with claim information.
Near the center of the screen, you should see a series of "Hide
or Show" buttons. To set your system to show you all claims information
for this patient's file, click on each "show" and wait for it to
change to "hide". Once you have set your system with the first patient
at "hide", which is actually showing you the claims data and asking
if you want it hidden again, all patient files you research will
be set until you log off again.
Above the "hide" or "show" buttons, you may see the following message:
"More items. Narrow search". This message is telling you the data
is too large to fit on your screen and you must narrow your search
by date span. Click on the "Date" button to the right othe "Hide/Show"
buttons and enter a date span (00/00/0000), usually 30 days, and
your screen will re-write to only show the claim detail for that
date span. Make sure you enter the dates in the format shown. Once
you have completed the date span search, make sure to remove all
the dates or they will appear in your next patient search function.
CLAIM STATUS - SENT - PEND - PAID - DENIED
On the left side of your screen you will see a "Status" column. If the status column says "Sent", your claim has passed through the WRHN system and gone on to the payer for processing. To the right of the "Status" column, you will see a blue "Ref ID #". That number indicates the date the item (either claim or payment) passed through the WRHN system. For example, Ref. ID #200201301004, means the claim passed through the WRHN system on Jan. 30, 2002.
If you click on the blue Ref. ID #, you will be taken to the detail of that claim. The detail will include the CPT codes and $ amount billed, as well as date of service. If there are multiple dates of service, this is exactly how your electronic claim arrived at WRHN from your billing software/translator software.
If the status of your claim is "Pend", that means your claim passed through the WRHN system and we have received an EOB back from the payer with either a partial payment or request for additional information.
If the status of your claim is "Paid", that means the claim passed through the WRHN system and we have received payment from the payer and forwarded the payment to your clinic.
If the status of your claim is "Denied", that means the claim passed through the WRHN system and we have received a denial from the payer.
Click on the blue Ref. ID # to be taken to the claim detail page, then make sure the "History" button on the top left side says "Hide". If it says "Show History?", simply click on it and it will change to "Hide History" and show how the EOB was posted. Denial or Pend codes will appear in blue and by clicking on the code itself, you will be taken to the explaination of the code. Payments will appear in red. To create a "hard copy" of any of these pages, simply right click on your mouse and select "Print".
If your claim is not showing as a "Sent" claim on the WRHN web site, we probably didn't get it. Check your WRHN Accept/Reject Report for the day you last transmitted the claim and the day after you last transmitted the claim to make sure it was not rejected. If it is not rejected, please resend your claim.
If you can see your claim on the WRHN web site and the payer states
they do not have it, send a request through the website. We will
resend your claim. Do not resend claims that you can see on the
WRHN web site, unless you need to make a correction to the claim
you previously sent. If that is the case, you must correct and resend
the claim.
This tab is not active, but will connect you to the payer for
benefit information in the future. In order to use this tab, it
is IMPERATIVE you "REGISTER" and/or "AUTHORIZE" under the EXACT
SAME PATIENT NAME AND IDENTIFICATION NUMBER ON THE PATIENT'S INSURANCE
CARD.
Find the WRHN web site by entering www.westernrehabnetwork.com
in your web browser. The Western Rehabilitation Health Network Web
Site will come up. Go to Provider Login.
Enter your login and password. Once your login is approved, you
will be taken to the "FUNCTIONS" page, and you will see file folder
tabs across the top of the page. These tabs will say; Registration;
Authorization; Additional; Outcomes; Patient Satisfaction; Reports
Click on "REPORTS" and a new screen will appear. At the top left
side of that new screen, you will see another "Reports" in blue.
Click on that "Reports" and you will be taken to the reports menu
screen.
Select the report you desire to run. Some reports are date specific
(the WRHN system only goes back to 01/01/2001), and other reports
are provider specific.
Click "OK" to create the report. Your screen will re-write and state
the report has been submitted. Click on "Continue" and you will
be taken back to the original "Report" screen. Your report is now
created and in the "Report Que". Access your report by clicking
on the "Reports" at the TOP RIGHT of your screen. The screen will
re-write with the reports listed which you have created. The most
recent report created is at the bottom of the list.
Click on the report to view and/or print it. Right click on your
mouse to print. Once you have determined you no longer need this
report, simply click on the "delete" button to the far right of
the report and it will "delete".
Many reports are based upon the discharge information you have entered
in the "OUTCOMES" and "PATIENT SATISFACTION" areas of the WRHN site.
If you are trying to run reports without first completing your "OUTCOMES"
and "PATIENT SATISFACTION", you may not see those patients which
have not been completed. The WRHN system considers a patient file
"done" when "OUTCOMES" and "PATIENT SATISFACTION" has been completed.
You should run your "Needs Outcomes" and "Needs Patient Satisfaction"
reports first, then enter data which the reports show is missing
before running other reports.
All correspondence regarding PHI must go through the request screen
on the web site. You can locate this in two areas of the reports
screen. At the top of screen and middle of screen are located blue
request buttons. If you wish to send a message to WRHN, click on
the request in the middle of the screen and type in subject along
with the message. Then submit. It should go directly to WRHN in
"real time". To find the answer to your request, or an
auth number and the number of visits authorized on a "additional"
or "review" patient, go to the request button at the top
of the request screen. Click on that button and there should be
an IR #, if there is an answer to your request. Click on the IR
# and the answer or auth will appear. You can right click on the
answer and print it off your computer for the patient's chart. Once
you received the answer to your request and printed it for your
file, delete the request from the screen. If you delete a request
prior to submitting it, it will never arrive at WRHN.
AGING REPORTS
The WRHN system is NOT a PRACTICE MANAGEMENT system, therefore,
it does not know when you have collected patient copayments or taken
contractual write-offs. The aging only understands what has or has
not come through the WRHN system, and therefore, your accounts will
not "zero" out at this time.
This feature MUST be completed by WRHN staff at this time, in
order not to lose data from your data base. Please contact LaDean
through the request screen under reports to merge files. Do not
send emails to have this done. Emails with PHI are not HIPAA compliant.
The "HELP" button simply explains the page and the function of the page.
The "FUNCTIONS" will take you back to the page you enter just after performing your secure login. The "FUNCTIONS" page has file folder tabs across the top of the page. These tabs will say; Registration; Authorization; Additional; Outcomes; Patient Satisfaction; Reports
You may "PRINT" any page from the WRHN web site by right clicking on your mouse
and then clicking print.
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