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4(d) Authorizations – Simple SearchThere are several ways to search for authorizations.If you have the authorization number, you can enter that into the search bar. CCA usually provides anauthorization number once a decision has been made on the request.You will be brought to the results page. Click View to see the details of the authorization.First LastCCA IDPage 27 of 63

4(e) Authorizations – Advanced SearchIf you do not have an authorization number or wish to search by one of the following criteria, you canuse the Advanced Search.On the search page, you can search by: Requesting provider;Servicing provider;Request number;Date range;Request service type; andStatus.It is recommended that you search by multiple fields to narrow the results.Click Search Requests.Page 28 of 63

You will be brought to the results page. Click View to see the details of the authorization.On any search results page, you can click Modify Search to change your search criteria and update theresults.First LastCCA IDFirst LastFirst LastModify your search and then click Search Requests again.########First Last########Page 29 of 63

4(f) Saved SearchesIf there is a search you frequently perform, you can access it more easily by entering your search criteriaand then clicking Save.Name your search and click Save.Enter name herePage 30 of 63

You will then find your saved searches on your Referral & Authorization dashboard. Click the name ofyour saved search to be brought to the results page.If you are already in the Advanced Search, you can click Load to select one of your previously savedsearches.Page 31 of 63

5. Payment & RemittanceIn the Remittance Advice section of the portal, you can: Search for payment and remittance information;View payment and remittance information; andDownload copies of payment and remittance.5(a) Searching for Remittance AdviceThere are several ways to access payment and remittance information.The best option is to select the Remittance Advice tile from the homepage. You will be brought to thesearch page.Page 32 of 63

On the search page, you can search by: Provider;Tax ID;Practice;Patient;Check number or Claim number; and/orCheck date or date of service.Alternative Search OptionAlternative Search OptionPage 33 of 63

You will see your search results.Click on View under View EOP to display the remittance on your screen. You will be able to see the checkdate and total paid. You will see each claim number and limited details for each item adjudicated as partof that check number.########DD MM YYYYVendor Name#########Downloador printYou can view, download, or print this document.DD MM YYYY######## ##.##Recipient AddressPage 34 of 63

6. Document ManagerIn the Document Manager section of the portal, you can: View documents shared by Commonwealth Care Alliance;Search for documents; andDownload copies of documents shared by Commonwealth Care Alliance.6(a) Viewing DocumentsThere are several ways to access the Document Manager.The best option is to select the Document Manager tile from the homepage. You will be brought to theMy Documents page.Page 35 of 63

You can search for a document or scroll down to see or sort all of the available documents. The searchfunction will pull results from the document name but is not able to pull results from the contents of thedocument.Click the red download iconto download and view the document.Search optionAll shared documents will display here.If you performed a search, results will display.Icons KeyHovering over the icon will indicate how many comments are on this document.Hovering over the icon will indicate how many times this document has been shared.Hovering over the icon will indicate if this document is linked elsewhere in the portal.Hovering over the icon will indicate how many times this document has been downloaded.Click this icon to download the document.Page 36 of 63

7. FormsIn the Forms section of the portal, you can: Download a blank copy of the HCAS Provider Enrollment Form, andDownload a blank copy of the Provider Medical Roster Template, andDownload a blank copy of the Provider Information Change Form.7(a) Locating the Forms PageThere are several ways to access authorization information.The best option is to select the Forms tile from the homepage. You will be brought to the Forms page.Page 37 of 63

On the Forms page you can see the available options. Click the option you need.Page 38 of 63

7(b) HCAS Provider Enrollment FormYou can download a blank copy of the HCAS Provider Enrollment Form from this page to complete.Please only use this form if you are adding a new provider to an existing contracted group practice.Once downloaded and the required information is filled out,1. Click Add Attachment to select the document from the location in your files; and then2. Click Submit to send to Commonwealth Care Alliance Provider Credentialing team.TIP: A copy of your submitted form will appear in your Sent messages in the Messaging Center.Download blank copyAttach completed copyPage 39 of 63

7(c) Provider Medical Roster TemplateYou can download a blank copy of the Provider Medical Roster Template from this page to complete.Please only use this form to add 10 or more providers to an existing contracted group practice.Once downloaded and the required information is filled out,1. Click Add Attachment to select the document from the location in your files; and then2. Click Submit to send to Commonwealth Care Alliance Provider Credentialing team.TIP: A copy of your submitted form will appear in your Sent messages in the Messaging Center.Download blank copyAttach completed copyPage 40 of 63

7(d) Provider Information Change FormYou can download a blank copy of the Provider Information Change Form from this page to complete.Please only use this form to ensure that CCA has the most up-to-date information about your practice.Once downloaded and the required information is filled out,1. Click Add Attachment to select the document from the location in your files; and then2. Click Submit to send to Commonwealth Care Alliance Provider Credentialing team.TIP: A copy of your submitted form will appear in your Sent messages in the Messaging Center.Download blank copyAttach completed copyPage 41 of 63

8. Secure MessagingIn the Messaging Center section of the portal, you can: Send a message, including attachments, to Commonwealth Care Alliance’s Provider ServicesTeam;Send a message, including attachments, to Commonwealth Care Alliance’s Provider NetworkStrategy Department;Receive messages and responses from these teams; andView past sent, received, and archived messages.8(a) Accessing the Message CenterTo access the Messaging Center, click Messages at the top of the homepage. In the red bubble you willsee the number of unread messages in your inboxes.Page 42 of 63

If you have more than one mailbox, you will see an overview of each mailbox, including the totalnumber of messages and the number of unread messages in each.Click the name of the mailbox you wish to view.Mailbox 1Mailbox 2Page 43 of 63

8(b) Navigating the InboxFrom your inbox you have access to your inbox and folders, start a new message, perform a search, orarchive old messages. The search bar will pull results from the subject line, but not the body of themessage.Start a newmessageFoldersSearch barClick From, Subject or Received headerto sortCheck boxesto selectmultiple andarchiveIcons KeyUnread messageRead messageMarked as UrgentNote: Please call Provider Services with urgent mattersat 1-866-420-9332.Has attachmentPage 44 of 63

8(c) Reading and Replying to a MessageClick a message from the inbox to open it.Go to Inbox, Sent orArchived foldersArchive or Print this messageSubject LineReply or ForwardClick to open attachmentBody of MessageReturn to InboxTo reply to a message, click the Reply To drop down and select Reply, Reply All or Forward.In your reply you can: Remove or add recipients;Add attachments to the reply;Add a message; andAdd text formatting to the message.Page 45 of 63

Adding recipientsPage 46 of 63

8(d) Sending a New MessageTo send a new message, click the New Message button.After clicking New Message, you will be directed to the Compose Message screen. Please make sure toonly select one team to receive the message, based on your needs: Provider Network Strategy; orProvider ServicesThe table below outlines which team to contact for which request, and the expected turnaround time.Send to Provider ServicesProvider Network Strategy If your question is about AuthorizationsMember EligibilityPortal registration questionsTrainingOrientationGeneral questionsPage 47 of 63Hear back within 1 business day / 24 businesshours from the time the requestwas received by the department2 business days / 48 businesshours from the time the requestwas received by the department

Click to open attachmentPage 48 of 63Click AddRecipients toopen windowand select oneteam

9. Tools for the Office ManagerIf you are the office administrator or manager, there will be additional tools available to you. These toolswill help you manage the other users at your site.9(a) Adding New UsersUsers with the Office Manager role will be able to add additional users at their site.From the Administration menu, click User Maintenance.You will see a list of current users. Click on a user to update their information (Name, email, etc.)To add a new user, scroll to the bottom of the screen and click Add User.Page 49 of 63

Complete the form with the new user’s information and click Add.Create a username with the format[First Initial] [Last Name]Create a temporarypassword. The new user willchange this the first time theylog inLocal Administrator is greyed out andwill not be an option at this timePage 50 of 63

Next to Roles, select Provider – CWCA Office User.Next to Entity Lists you will only be able to assign the same access you have.Click Select Role.Review the information you have entered and then click Submit.You will receive a confirmation page and a confirmation email.The user will receive an email with instructions on how to login.Confirmation PageConfirmation EmailLocationPage 51 of 63

9(b) Non-Utilizer ReportThe office manager or administrator will be able to run this report to see if users from their practice areusing the Provider Portal.To run this report, click Reports from the Office Management menu.From the list of available reports, select Non-Utilizer Report.Enter the number of days since last login (e.g.: 60).Page 52 of 63

Optional: Select the practice or location from ACL ID drop down;Check the box to show users who are locked out of the portal.Click Continue to display results.Results will display on the page. You have the option to export to CSV or PDF.You will be able to view: Access list name- this is the location you are viewing;Access ID- this is the ID associated with the Access list;User Name, ID and email;Role Name;Last activity date;Days since last use; andStatus (this field will indicate if user has been locked out).Downloadto PDFPage 53 of 63Downloadto CSV

9(c) User Account Revalidation & ReportRevalidation is required every 180 days. Revalidation begins 30 days prior to the due date. Users will benotified by email 14, 7 and 3 days prior to revalidation due date. Users need to be either revalidated orshould be deleted if they no longer need access to the portal.Office managers can revalidate users at their site. When users are due for revalidation, this page willdisplay when you log into the portal.Click tovalidate singleuserClick to deletesingle userfrom portalClick to selectall users on listClick to validateall usersselectedClick to delete allusers selectedfrom portalClick to skip this page andproceed to homepage.This will not be an option ifuser’s access has expired.When you select Validate you are brought to a confirmation page. To proceed, click Validate.Page 54 of 63

If you select Delete, you will be required to select a reason. Then click Delete.You can also pull a report of users and their revalidation status.Click Reports from the Office Management menu.Page 55 of 63

Click User Account Revalidation Report.Select if you wish to view All users;Confirmed users, or users whose revalidation is complete;Users for whom validation is required; orUsers for whom validation is expired.Click Continue.AlternativeSearch OptionPage 56 of 63

Your results will display. You can export to PDF or CSV.Downloadto PDFPage 57 of 63Downloadto CSV

10. Resources for the Office ManagerIf you are the office administrator or manager, there will be additional resources available to you. Theseresources will help you access training and educational materials.10(a) HEDIS and MassHealth EducationAll portal users can access HEDIS and MassHealth documentation related to improvementmeasurements and reporting tools covering a wide range of topics.Page 58 of 63

You can view anddownload thesedocuments by clickingthe red links underthis columnReference guide can be found and downloaded herePage 59 of 63

10(b) Provider Tr

1. Login Page On the login page, you can: Register to use the portal Login to the portal Quick Access Links to other provider tools including o Claims portals; o Skygen Dental Benefits Portal; o Navitus Pharmacy Benefits Portal; o Provider Portal User Guide (this guide); and o Registration Guide.