Provider Access Online Resources

Provider Access Online User Roles

To fully benefit from Provider Access Online, it’s important to grant the right access to your staff. The following represents the current available portal role options that can be added or removed from a user account: 

• Account Administrator: Full access & user management role
• Authorizations Viewer: Access to view & create authorization requests
• Claims Information Viewer: Access to claims search functions
• Clinical Information Viewer:  Access to view clinical data
• Patient Information Viewer: Access to search patient data
• Patient Roster Viewer: Access to review a patient roster (Primary Care)
• Remittance Advice Viewer: Access to downloadable remittance advice file

Confirm Patient Eligibility and Benefits

One of the most powerful features on Provider Access Online is the patient search tool.  This feature allows providers and your assigned staff to check a patient's eligibility and benefits quickly and easily.

• Watch this informational video to learn how to navigate the patient menu, perform search functions, and review patient details:
• Please remember, a user needs Patient Information Viewer status to access this data after signing in.

Locate and Review a Claims Status

Once logged in, use the left menu to navigate to the claim screen select.

PAO offers a variety of ways for Providers to search for a claim in the dropdown menu, including:

• Subscriber ID
• Claim ID
• Medicaid ID / CIN
• Medicare ID
• Patient Account #
• Provider NPI

Accessing the Claims Summary, Payment Details, and Claim Line Items

• Simply enter the date range for the claims that you want to check and click on “search.”
• All claims for the date range that you selected will be listed as well as the statuses of the claims.  
• From here, Providers can click on an individual claim ID for more information, including the claim summary, payment details and file claim appeals.
• Claim appeals can now be submitted electronically by clicking on an individual claim. With this easy-to-use tool, providers are able to submit COB resubmissions, claims appeals, or claims reconsiderations. For further instructions, please watch the Claims Appeal video on this page.
• Providers can also click on a claim line item, getting the full details on the line item, including any reasons for disallowed claims.

Accessing and Submitting Authorization Appeals

• To access authorization status for non-urgent appeal denied for the first time, users must be account administrators or have authorization viewer access roles.
• We will review all procedures eligible for appeal within the submitted authorization number, but users may list any specific codes and rationale to consider for the specific appeal.
• All supporting documentation for a single appeal should be uploaded before submitting for review. If an authorization appeal request already has an appeal on file, another appeal cannot be submitted.
• Please note: Emergency admissions for inpatient appeal authorizations need to be submitted by fax. The direct fax is 1-800-710-2226.