ValueOptions’ E-Commerce Initiative: Electronic Solutions
The following electronic solutions are available to assist providers in complying with ValueOptions’ e-commerce requirements:
- Authorization requests
- Re-credentialing applications
- Updating of provider information
- Provider claims and authorization status checks
- Claim Submission
- Electronic Fund Transfer
- Re-credentialing and Credentialing applications
ProviderConnect is a secure, HIPAA-compliant ValueOptions website that enables participating ValueOptions network providers to conduct online claims and authorization transactions accurately and efficiently, verify member eligibility and update their provider information in real time.
Electronic claim submission is also accepted through clearinghouses.
When using the services of a clearinghouse, providers must reference ValueOptions’ Payer ID to ensure ValueOptions receives those claims. ValueOptions’ Payer ID is FHC &Affiliates.
ValueOptions Electronic Data Interchange (EDI) Claims Link for Windows® Software
The EDI Claims Link for Windows® application is another tool providers or their designated representatives have to submit HIPAA compliant electronic claims. This tool requires installation on a computer and creation of a database of providers and members. Refer to the EDI Claims Link for Windows User Manual located on ValueOptions.com.
PaySpan Health is an online tool that enables providers to receive payments automatically in their bank account of choice, receive email notifications immediately upon payment, view remittance advices online, and download an 835 file to use for auto-posting purposes.
Council for Affordable Quality HealthCare (CAQH)
Providers can utilize CAQH’s Universal Provider Datasource (UPD) for initial or recredentialing processes. The CAQH UPD gives providers a rapid and simple solution to securely submit credentialing information to multiple health plans and networks by entering information one time only. A CAQH ID is required for those providers interested in participating with CAQH. Providers must also give authorization to ValueOptions to release their application.View CAQH Provider Credentialing and Recredentialing FAQs