PROVIDER PORTAL

Speedy communications.

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The Provider Portal module of ikaPortals allows health plans to provide a flexible, Web-based platform for healthcare providers and their staff to perform processes online, lowering operating costs while creating a more collaborative environment. The portal delivers real-time, HIPAA-compliant capabilities that providers can use to check eligibility, request authorizations, and submit claims. With provider self-service, customer service representatives get fewer calls and everyone saves time.

Flexible and secure

ikaPortals is seamlessly integrated with other ikaSystems solutions and can be easily integrated with third-party systems. Also, ikaPortals can be automatically upgraded with little additional effort as updates become available.

As market demands and business needs evolve, you can easily configure the system without changing any code. This flexibility allows you to update existing plans, products, and networks yourself, significantly reducing maintenance costs.

The ikaPortals administrative suite enables you to create rules and designate role-based security, ensuring adherence to organizational and regulatory privacy policies.

The benefits speak for themselves

The Provider Portal enables you to:

  • Sign on to the system with a single sign-on for ease of use
  • Receive HIPAA-compliant emails for initial system log-in
  • Search for a member by using a wide range of criteria (member first and last names, DOB, member ID, or any other plan-specific criteria)—and easily make changes
  • Check member eligibility, including details on claims, authorizations, benefits, and COB
  • Submit authorization requests and referrals and get information about whether they have been approved, pended, or denied
  • Auto-populate claims (UB04, HCFA1500, and encounter claim forms) with member and provider information, submit claims, and view status—approved, pending, and denied
  • Correct rejected claims and resubmit online—even claims that originated from another source such as a clearinghouse
  • Easily determine how much of the claim is the patient’s responsibility versus the health plan’s, enabling real-time adjudication
  • View and print EOPs and EOBs
  • Search for providers within the network, facilitating in-network physician referrals
  • Communicate with the health plan or other providers securely—including submitting inquiries and uploading documents
  • Receive real-time claims adjudications and view projected payments
  • Contact customer service online about plan benefits, members’ benefit limitation status, and other topics, as well as submit service issues
  • Create users, manage access, and run usage summary reports

View other products in Core Administration Solutions:

Employer Portal
Member Portal
ikaClaims
ikaEnterpriseService
ikaBilling
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