Portal

Provider secure website

We’re dedicated to providing great service to our providers and our members. That's why our HIPAA-compliant website is available 24 hours a day. The website supports the functions and access to information related to:

              • Member eligibility search – Verify current eligibility of one or more member.
              • Panel roster – View the list of members currently assigned to the provider as the PCP.
              • Claims status search – Search for provider claims by member, provider, claim number, or service dates. Only claims associated with the user’s account provider ID will be displayed.
              • Remittance advice search – Search for provider claim payment information by check number, provider, claim number, or check issue/service dates. Only remits associated with the user’s account provider ID will be displayed.
              • Provider prior authorization look up tool – Search for provider authorizations by member, provider, authorization data, or submission/service dates. Only authorizations associated with the user’s account provider ID will be displayed. 
              • The tool will also allow providers to
                • Search prior authorization requirements by individual or multiple Current Procedural Terminology/ Healthcare Common Procedure Coding System (CPT/HCPCS) codes simultaneously.
                • Review prior authorization requirement by specific procedures or service groups.
                • Receive immediate details as to whether the codes are valid, expired, a covered benefit, have prior authorization requirements, and any noted prior authorization exception information.
                • Export CPT/HCPS code results and information to Excel.
                • Make certain staff works from the most up-to-date information on current prior authorization requirements
              • Submit authorizations – Submit an authorization request online. Three types of authorization are available: 
                • Medical Inpatient
                • Outpatient
                • Durable Medical Equipment – Rental
              • Healthcare Effectiveness Data and Information Set (HEDIS®) – Check the status of the member's compliance with any of the HEDIS measures. A “Yes” means the member has measures that they are not compliant with; a “No” means that the member has met the requirements.

Availity Timelines

As of 1/19/2021

  • Payer Spaces
  • Claims Submission Link (Change HealthCare)
  • Contact Us messaging
  • Claims status inquiry
  • Appeals and Grievances
  • Grievance submission
  • Appeal submission
  • Grievance and appeals status

As of 1/22/2021

  • Panel Roster-Panel lookup
  • Reports
  • PDM/ProReports (Provider Deliverables Manager)
  • Ambient (business intelligence reporting)

 Future Functionality Releases

 Q1/2021

  • Prior Authorization-Submission and status lookup

 Q2/2021

  •  Eligibility and Benefits

 Q3/2021

  • Remit PDF
  • Enhanced Panel Roster
  • Enhanced G&A tool

 

  • If you are already registered in Availity, you will simply select Aetna Better Health from your list of payers to begin accessing the portal and all of the above features. (Mention Logging into Availity) 
  • If you are not registered, we recommend that you do so immediately.
  • Click here to learn more about Availity Portal Registration
  • Click here to register
  • For registration assistance, please call Availity Client Services at 1-800-282-4548 between the hours of 8:00 am and 8:00 pm Eastern, Monday-Friday (excluding holidays)
        • For access to the following features, you will need to use the Medicaid Web Portal until further notice.
          • Panel Roster
          • Remit PDF
          • Enhanced G&A Tool
          • Claim Resubmission/Dispute process

Paper Register Form - Please complete and return this form in full to complete registration. This form is for the Secure Provider Web Portal. Or fax 1-844-300-7473 or email us.

Log-in for the secure web portal.

View the provider portal navigation guide.

You may go to CHAMPS login to verify eligibility.