PRISM Provider Training

Overviews

• Initiating a New PA Request by a Provider: Overview
• Prior Authorization Generation Process: Overview
• Performing Prior Authorization Inquiries
• How to Enter a General Prior Authorization in PRISM (Video Demo)

Initiating a New PA Request by a Provider

• Adding PA Basic Information
• Adding Beneficiary Information
• Adding Provider Information
• Adding Diagnosis Information
• Adding Procedure Information
• Uploading Documents
• Adding Supplemental Information
• Submitting a Prior Authorization Request

Overviews and Introductions

• Introduction to Claims and Encounters
• Claims and Encounters Inquiry: An Overview
• Claim Types: An Overview
• Entities Involved in Claims and Encounters: An Overview
• Introduction to Claims Adjustments

Direct Data Entry Claims Online

• Understanding Submission Channels in Claims and Encounters
• Understanding the Different Sections of a DDE Claim Form
• Creating a Professional DDE Claim
• Creating an Institutional DDE Claim
• Creating a Dental DDE Claim
• Creating a DDE Claim Based on a Template
• Modifying the Information on a DDE Claim Template

Generating Acknowledgement

• Retrieving an Acknowledgement and Response File via Web

Managing Claims Adjustments by a Provider

• Adjusting Professional Claim Information by a Provider
• Adjusting Ambulance Information by a Provider
• Adjusting Provider Service Facility Location Information on a Professional Claim by a Provider
• Adjusting Diagnosis Code List by a Provider
• Adjusting Other Payer Information by a Provider
• Adjusting Patient Code List by a Provider
• Adjusting Patient Vision Condition Information by a Provider
• Adjusting Related Causes Information by a Provider
• Adjusting Relevant Dates by a Provider
• Adjusting Service Line Drug Information by a Provider
• Adjusting Spinal Manipulation Information by a Provider
• Adjusting Institutional Claim Information by a Provider
• Adjusting Dental Claim Information by a Provider

Accessing Claims Information by a Provider

• Viewing Claims Information by a Provider
• Viewing Pharmacy Claims Header Information by a Managed Care Organization
• Viewing Ambulance Information by a Provider
• Viewing Attachments by a Provider
• Viewing Codes List by a Provider
• Viewing Cutbacks by a Provider
• Viewing Diagnosis Codes by a Provider
• Viewing Claim Enhancement Amounts by a Provider
• Viewing Claim Notes by a Provider
• Viewing the Other Payer Information by a Provider
• Viewing Patient Vision Condition by a Provider
• Viewing Patient Code Lists by a Provider
• Viewing Related Causes by a Provider
• Viewing Relevant Dates by a Provider
• Viewing Service Line Drug Information by a Provider
• Viewing Situational Information by a Provider
• Viewing Servicing Facility Locations by a Provider
• Viewing Spinal Manipulation Information by a Provider
• Viewing the Claim Spenddown List by a Provider

Aging Waiver

• Entering an Application for the Aging Waiver Program as a Provider
• Processing an Aging Waiver Initial Enrollment for a Provider
• Processing an Aging Waiver Annual Review for a Provider
• Processing Substantial Changes in Health Status for a Provider
• Processing a Care Plan Amendment for a Provider
• Processing a Disenrollment for a Provider
• Processing Inpatient Admission for a Provider
  Processing Incident Report for a Provider
• Processing Agency Transfer for a Provider
• Supporting Comprehensive Care Plan for a Provider

EPAS

• EPAS: An Overview
• Entering an Application for Employment related Personal Assistant Services (EPAS)
• Employment-related Personal Assistant Services Initial Enrollment for a Provider
• Employment-related Personal Assistant Services - Annual Review for a Provider
• Employment-related Personal Assistant Services - Substantial Change in Health Status for a Provider
• Employment-related Personal Assistant Services - Care Plan Amendment for a Provider
• Employment-related Personal Assistant Services - Disenrollment for a Provider
• Employment-related Personal Assistant Services – Supporting Information - Comprehensive Care Plan for a Provider

New Choices Waiver

• New Choices Waiver: An Overview
• New Choices Waiver Initial Enrollment for a Provider
• Entering an Application for a New Choices Waiver Not Currently Living In a Facility
• Entering an Application for the New Choices Waiver When Currently Living in an Assisted Living Facility
• Entering an Application for the New Choices Waiver When Currently Living in a Nursing Facility
• Processing Initial Enrollment for New Choices Waivers for a Provider
• New Choices Waiver Annual Review by a Provider
• New Choices Waiver – Care Amendment Plan for a Provider
• New Choices Waiver - Inpatient Admission for a Provider
• New Choices Waiver - Incident Report  for a Provider
• New Choices Waiver - Disenrollment Request for a Provider
• New Choices Waiver - Return to Community from Inpatient for a Provider
• New Choices Waiver - Change in Living Arrangement for a Provider
• New Choices Waiver - Agency Transfer for a Provider
• New Choices Waiver - Substantial Change in Health Status for a Provider
• New Choices Waiver – Adding Supporting Information in a Comprehensive Care Plan for a Provider

Technology Dependent Waiver

• Entering an Application for a Technology Dependent Waiver
  
  

Checking Status of an Application

• Accessing the Check Status Application/Referral Page
  Checking the Status and Modifying an Existing Application/Referral

• Eligibility Lookup Tool Quick Start Card
• Sample of New Medicaid Member Card
• New Medicaid Member Card FAQ’s for Providers
• New Medicaid Member Card FAQ’s for Members

• Frequently Asked Questions About Utah IDs
• Introduction and Overviews to PRISM for Providers (7 minutes)
• Logging Notes for Local Health Departments
• PRISM Account Access One Time Validation Letter (Validating Converted Medicaid Provider Information) (4 minutes)
• Provider Account Admin: Managing a Provider Domain (8 minutes)
• Viewing Archived Documents (2 minutes)
• Viewing Medicaid Code and Rate Information: Provider

• Enrolling as an Individual Sole Proprietor Provider (1 hour 36 minutes)
  • Overview: Enrolling as an Individual/Sole Proprietor Provider (7 minutes)
  • Add Basic Information (11 minutes)
  • Add Locations (11 minutes)
  • Add Specialties (5 minutes)
  • Add Provider Controlling Interest/Ownership Details (10 minutes)
  • Add License and Certifications (5 minutes)
  • Add Taxonomy Details (4 minutes)
  • Add Additional Information (5 minutes)
  • Add Mode of Claim Submission (6 minutes)
  • Associate Billing Agent (7 minutes)
  • Associate Billing Provider (4 minutes)
  • Associate MCO Plan (3 minutes)
  • Add Payment Details (3 minutes)
  • Complete Enrollment Checklist (4 minutes)
  • Upload Documents (4 minutes)
  • Submit Enrollment Application (2 minutes)

• Enrolling as an Individual Rendering Servicing Provider (1 hour)
  • Overview: Enrolling as an Individual Rendering/Servicing Provider (7 minutes)
  • Provider Basic Information (7 minutes)
  • Add Specialties (5 minutes)
  • Add Provider Controlling Interest/Ownership Details (10 minutes)
  • Add License and Certifications (5 minutes)
  • Add Taxonomy Details (4 minutes)
  • Add Additional Information (5 minutes)
  • Associate Billing Provider (4 minutes)
  • Associate MCO Plan (3 minutes)
  • Complete Enrollment Checklist (4 minutes)
  • Upload Documents (4 minutes)
  • Submit Enrollment Application (2 minutes)
• Enrolling as an Atypical Individual Provider (1 hour and 29 minutes)
  • Overview: Enrolling as an Atypical Individual Provider (7 minutes)
  • Add Basic Information (5 minutes)
  • Add Locations (10 minutes)
  • Add Specialties (4 minutes)
  • Add Provider Controlling Interest/Ownership Details (10 minutes)
  • Add License and Certifications (4 minutes)
  • Add Taxonomy Details (4 minutes)
  • Add Additional Information (5 minutes)
  • Add Mode of Claim Submission (6 minutes)
  • Associate Billing Agent (7 minutes)
  • Associate Billing Provider (4 minutes)
  • Associate MCO Plan (3 minutes)
  • 835/ERA Enrollment Form (5 minutes)
  • Add Payment Details (3 minutes)
  • Complete Enrollment Checklist (4 minutes)
  • Upload Documents (4 minutes)
  • Submit Enrollment Application (2 minutes)
• Enrolling as an Atypical Agency (1 hour and 27 minutes)
  • Overview: Enrolling as an Atypical Agency Provider (6 minutes)
  • Add Basic Information (5 minutes)
  • Add Locations (9 minutes)
  • Add Provider Controlling Interest/Ownership Details (10 minutes)
  • Add License and Certifications (4 minutes)
  • Add Taxonomy Details (4 minutes
  • Add Additional Information (5 minutes)
  • Add Mode of Claim Submission (6 minutes)
  • Associate Billing Agent (7 minutes)
  • Associate Billing Provider (4 minutes)
  • Associate MCO Plan (3 minutes)
  • 835/ERA Enrollment Form (5 minutes)
  • Add Payment Details (3 minutes)
  • Complete Enrollment Checklist (4 minutes)
  • Upload Documents (4 minutes)
  • Submit Enrollment Application (2 minutes)
• Enrolling as a Group Practice Provider (1 hour and 26 minutes)
  • Overview: Enrolling as a Group Practice Provider (7 minutes)
  • Add Basic Information (4 minutes)
  • Add Locations (11 minutes)
  • Add Specialties (5 minutes)
  • Add Provider Controlling Interest/Ownership Details (10 minutes)
  • Add License and Certifications (4 minutes)
  • Add Taxonomy Details (4 minutes)
  • Add Additional Information (5 minutes)
  • Add Mode of Claim Submission (6 minutes)
  • Associate Billing Agent (7 minutes)
  • Associate Billing Provider (4 minutes)
  • Associate MCO Plan (3 minutes)
  • 835/ERA Enrollment Form (5 minutes)
  • Add Payment Details (3 minutes)
  • Complete Enrollment Checklist (4 minutes)
  • Upload Documents (4 minutes)
  • Submit Enrollment Application (2 minutes)
• Enrolling as a Facility/Agency/Organization (FAO) (1 hour and 27 minutes)
  • Overview: Enrolling as a Facility Agency Organization Provider (7 minutes)
  • Add Basic Information (6 minutes)
  • Add Locations (11 minutes)
  • Add Specialties (5 minutes)
  • Add Provider Controlling Interest/Ownership Details (10 minutes)
  • Add License and Certifications (4 minutes)
  • Add Taxonomy Details (4 minutes)
  • Add Additional Information (5 minutes)
  • Add Mode of Claim Submission (6 minutes)
  • Associate Billing Agent (7 minutes)
  • Associate Billing Provider (4 minutes)
  • Associate MCO Plan (3 minutes)
  • 835/ERA Enrollment Form (5 minutes)
  • Add Payment Details (3 minutes)
  • Complete Enrollment Checklist (3 minutes)
  • Upload Documents (4 minutes)
  • Submit Enrollment Application (2 minutes)
• Enrolling as a Contractor/MCO (1 hour and 3 minutes)
  • Overview: Enrolling as a Contractor/MCO (7 minutes)
  • Add Basic Information (5 minutes)
  • Add Locations (10 minutes)
  • Add Provider Controlling Interest/Ownership Details (10 minutes)
  • Add Identifiers (3 minutes)
  • Add Mode of Claim Submission (6 minutes)
  • Associate Billing Agent (7 minutes)
  • Associate MCO Plan (3 minutes)
  • Add Payment Details (3 minutes
  • Complete Enrollment Checklist (4 minutes)
  • Upload Documents (4 minutes)
  • Submit Enrollment Application (2 minutes)
• Enrolling as a Billing Agent (30 minutes)
  • Overview: Enrolling as a Billing Agent (7 minutes)
  • Add Basic Information (6 minutes)
  • Add Mode of Claim Submission (4 minutes)
  • Associate Billing Agent (7 minutes)
  • Upload Documents (4 minutes)
  • Submit Enrollment Application (2 minutes)

• Managing the Information of an Atypical Individual Provider
  • Overview: Managing the Information of an Atypical Individual Provider (4 minutes)
  • Update Basic Information (5 minutes)
  • Update Locations (6 minutes)
  • Update Specialties (7 minutes)
  • Update Provider Controlling Interest/Ownership Details (6 minutes)
  • Update License and Certifications (6 minutes)
  • Update Taxonomy Details (6 minutes)
  • Update Additional Information (5 minutes)
  • Update Mode of Claim Submission/EDI (6 minutes)
  • Update Billing Agent Association (8 minutes)
  • Update Billing Provider Association (6 minutes)
  • Update MCO Plan Association (2 minutes)
  • View Servicing Provider Details (2 minutes)
  • Update 835/ERA Enrollment Form (4 minutes)
  • Update Payment Details (4 minutes)
  • Complete Modification Checklist (6 minutes)
  • Upload Documents (5 minutes)
  • Submit Modification Request for Review (3 minutes)
• Managing the Information of an Atypical Agency Provider (1 hour and 29 minutes)
  • Overview: Managing the Information of an Atypical Agency Provider (4 minutes)
  • Update Basic Information (5 minutes)
  • Update Locations (6 minutes)
  • Update Specialties (7 minutes)
  • Update Provider Controlling Interest/Ownership Details (6 minutes)
  • Update License and Certifications (6 minutes)
  • Update Taxonomy Details (6 minutes)
  • Update Additional Information (5 minutes)
  • Update Mode of Claim Submission/EDI (6 minutes)
  • Update Billing Agent Association (8 minutes)
  • Update Billing Provider Association (6 minutes)
  • Update MCO Plan Association (2 minutes)
  • View Servicing Provider Details (2 minutes)
  • Update 835/ERA Enrollment Form (4 minutes)
  • Update Payment Details (4 minutes)
  • Complete Modification Checklist (4 minutes)
  • Upload Documents (5 minutes)
  • Submit Modification Request for Review (3 minutes)
• Managing the Information of a Group Practice Provider (1 hour and 26 minutes)
  • Overview: Managing the Information of a Group Practice Provider (4 minutes)
  • Update Basic Information (6 minutes)
  • Update Locations (6 minutes)
  • Update Specialties (7 minutes)
  • Update Provider Controlling Interest/Ownership Details (6 minutes)
  • Update Taxonomy Details (6 minutes)
  • Update Additional Information (5 minutes)
  • Update Mode of Claim Submission/EDI (6 minutes)
  • Update Billing Agent Association (8 minutes)
  • Update Billing Provider Association (6 minutes)
  • Update MCO Plan Association (2 minutes)
  • View Servicing Provider Details (2 minutes)
  • Update 835/ERA Enrollment Form (4 minutes)
  • Update Payment Details (4 minutes)
  • Complete Modification Checklist (4 minutes)
  • Upload Documents (5 minutes)
  • Submit Modification Request for Review (3 minutes)
• Managing the Information of a Facility/Agency/Organization Provider (1 hour and 25 minutes)
  • Overview: Managing the Information of a Facility/Agency/Organization Provider (4 minutes)
  • Update Basic Information (4 minutes)
  • Update Locations (5 minutes)
  • Update Specialties (7 minutes)
  • Update Provider Controlling Interest/Ownership Details (6 minutes)
  • Update License and Certifications (6 minutes)
  • Update Taxonomy Details (6 minutes)
  • Update Additional Information (5 minutes)
  • Update Mode of Claim Submission/EDI (6 minutes)
  • Update Billing Agent Association (8 minutes)
  • Update Billing Provider Association (6 minutes)
  • Update MCO Plan Association (2 minutes)
  • Update 835/ERA Enrollment Form (4 minutes)
  • Update Payment Details (4 minutes)
  • Complete Modification Checklist (4 minutes)
  • Upload Documents (5 minutes)
  • Submit Modification Request for Review (3 minutes)
• Managing the Information of a Contractor/MCO Provider (1 hour and 8 minutes)
  • Overview: Managing the Information of Contractor/MCO Provider (4 minutes)
  • Update Basic Information (5 minutes)
  • Update Locations (8 minutes)
  • Update Provider Controlling Interest/Ownership Details (6 minutes)
  • Update Identifiers (5 minutes)
  • Update Mode of Claim Submission/EDI (6 minutes)
  • Update Billing Agent Association (8 minutes)
  • Update Billing Provider Association (6 minutes)
  • Update MCO Plan Association (2 minutes)
  • View Network Provider Details (2 minutes)
  • Update Payment Details (4 minutes)
  • Complete Modification Checklist (4 minutes)
  • Upload Documents (5 minutes)
  • Submit Modification Request for Review (3 minutes)
• Managing the Information of a Billing Agent (22 minutes)
  • Overview: Managing the Information of a Billing Agent (4 minutes)
  • Update Basic Information (5 minutes)
  • Update Mode of Claim Submission/EDI (5 minutes)
  • Upload Documents (5 minutes)
  • Submit Modification Request for Review (3 minutes)