WELCOME!
Oxford Health Plans is pleased to offer you access to an enhanced payment and reconciliation solution through PNC Remittance Advantage powered by PaySpan.1 This new solution will enable you to receive faster payments through electronic deposits with complete remittance details. You will be able to access numerous online capabilities to search claims and remittance details, as well as produce custom reports. Use this guide to assist you in understanding the features available within the PNC Remittance Advantage system.
General Features of the PNC Remittance Advantage Provider Site:
· A security subsystem allows the office manager to control each user’s access to customer applications, reports and web site features. Security features include controlling access to the following functions:
§ Managing accounts
§ Reconciling payments
§ Viewing payments online
§ Viewing account configuration
§ Administering user rights
§ Accessing individual reports
§ Logging all user activity on the PNC Remittance Advantage provider site
· Online help is provided on every screen.
· A large choice of remittance advice formats is available for your selection.
· Multiple bank accounts are supported so you may assign different payers to different bank accounts if desired.
· Supports Internet Explorer 5.0 and above.
· E-mail notifications are sent when new payments have been deposited.
1PNC Remittance Advantage is controlled and operated by PaySpan, not Oxford Health Plans LLC (“Oxford”). As such, neither Oxford, nor its subsidiaries, suppliers or vendors are responsible or liable for any claims, loss or damage directly or indirectly resulting from your use of the PNC Remittance Advantage solution or the information or resources contained on or accessible through this electronic transaction service. You access and use this service solely at your own risk.
TABLE OF CONTENTS
NOTE: You may hold down the Ctrl key and click on any of the titles below to move directly to that section.
WELCOME! 1
Getting Started 3
Initial Registration 3
Login/Logout (All Users) 4
Home Page 4
New Payments Page 5
Help 5
Payments Menu 5
Account Management Page 5
Add a Receiving Bank Account 6
Edit a Receiving Bank Account 6
Receiving Bank Account Access 6
Payer Management 6
Reconciliation History 6
Report Menu 6
Running Standard and Saved Custom Reports 7
Document Archive Searches 7
Saving Document Archive Searches as Custom Reports 7
Administration Menu 8
User Administration Page 8
Security Administration Pages 8
Activity Log Page 9
E-mail Users Page 9
Preferences Menu 10
Getting Started
Initial Registration
Note: Each provider group will select an administrator (e.g., Office Manager) who will set access rights for their users according to departmental needs. The registration process will only need to be completed once by the administrator. The administrator will have the capability to add other users, if necessary.
To activate your account on Remittance Advantage powered by PaySpan, you will need the following information:
· Company’s legal name as it appears on your bank account
· PIN # (Oxford Provider ID)
· Federal Tax Identification Number (FTIN)
· Your bank account number and your bank’s routing number
· Your e-mail address[1]
· In order to download remittance information, you will need to select the accounting system your organization uses and the corresponding format[2] for download. If you will only view remittance information online, the default system selection is 835X91A.
· Create a password (your password must be composed of at least three of the following character types: upper case, lower case, numeric characters and/or symbols).
Step 1:
Log in to www.oxfordhealth.com and click on the Transactions tab and then on Remittance Advice in the Check column. When the PaySpan Health screen opens, click on the orange Secure Registration button. A registration screen will open and request your registration code.
Step 2:
Upon entry of a valid registration code, a screen will open with your practice name and address as it is on file at Oxford. For verification purposes, you will be required to enter your Oxford ID and FTIN to proceed.
Step 3:
Fill in the required fields (e.g., e-mail, password, account information). There will be an opportunity to go back and correct any errors before clicking Submit. You will receive an e-mail confirmation that registration was successful. Please see the instructions below for adding more bank accounts and/or registration codes.
If you have additional bank accounts to add:
1. Login using the username and password created during registration.
2. From the Home Page, click Payments on the menu bar and then select Account Management.
3. Click on Create a New Account and enter your banking information. Repeat this process for each bank account you wish to add.
If you have multiple registration codes:
NOTE: it is very important that you enter any additional bank accounts that you wish to use prior to entering additional registration codes.
1. Once all bank accounts have been added under the first registration code, you may enter additional registration codes in the box on the right side of the Home Page.
2. The system will prompt you to assign a bank account for each registration code. If the bank account you require is not listed (i.e., has not been added to the system) you must cancel out and add the bank account under your first registration code.
Step 4:
Within 24 hours a small payment (pre-note) will be transferred to your bank account(s) from Payformance rather than Oxford. Please make note of the exact amount(s) before logging back into Remittance Advantage. You will be required to enter the deposit amount to validate your banking information and activate your account.
If you have any questions about the registration process, please call the e-Solutions Support Team at 1-800-599-4334.
Login/Logout (All Users)
After the initial registration, users will simply log in with their registered e-mail address and password[3] by visiting www.oxfordhealth.com and signing in as a provider or facility. Click on the Transactions tab and then on Remittance Advice in the Check column. Next, click on the link to the PNC Remittance Advantage powered by PaySpan Tool that is located near the top of the page. Click on the green Secure Login button and enter your username (the e-mail address you registered with) and password.
Multiple entries of the wrong login/password combination will result in the account being locked. If this happens you will need to contact the PaySpan help line at 1-877-331-7154.
To logout, simply click Logout on the main menu bar. To prevent sensitive information from being available to unauthorized users, your session will expire, and you will be automatically logged out of the PNC Remittance Advantage system after 15 minutes of inactivity.
Home Page
The PNC Remittance Advantage home page is the first screen you will see after successfully logging in. On this screen, you can view a listing of your new Oxford payments. Clicking on the payment download link allows you to quickly download the remittance information for your newest payments.
From the home page, you can:
· View remittance details by linking to the New Payments Page
· Download a new payment file
· Run reports
· View reconciliation history
New Payments
The New Payments screen is accessed from the home page by clicking the payment detail hyperlink (e.g., 1 payment $100). The new payment date, type, account, payer, ACH#, amount and effective date are displayed in a grid. By clicking view, the remittance details will be displayed.
If you would like to download the new payment information to your accounting system or remove it from the new payment list, click Next. The New Payments Reconciliation Summary page will open. Clicking "Confirm and Download" will download the payment and remove it from the New Payments listing on the home page. If you do not want to download the remittance file, but no longer wish the selected payment to show up under New Payments, simply click "Confirm."
Note: To view payments no longer marked as new, use Payer Management or the Document Archive Search feature from the Reports menu.
Help
· In the upper right-hand corner of every screen, there is a question mark to click for “Help on this page.” For general help that is not specific to the page, use the Help Menu on the main menu bar.
· For payment inquiries, please contact Oxford Provider Services at 1-800-666-1353.
· For help downloading a remittance or with an account that has been locked, please call the PaySpan help line at 1-877-331-7154.
Payments Menu
Note: The New Payments page is accessed directly from the home page. You may use options from the Payments menu to:
· Add or edit receiving bank accounts or grant access using the Account Management page.
· Add or edit payers or view remittance information using the Payer Management page.
· View previous downloads using the Reconciliation History page.
Account Management Page
PNC Remittance Advantage organizes your incoming payments by “receiving accounts” (bank accounts). The Account Management section of the site contains information on each of the receiving bank accounts that have been set up to receive payments from registered insurance payers. This section is controlled by security access rights; your administrator may restrict your access to these pages or certain accounts.
From the Account Management screen, you are able to view active, inactive, rejected or pending receiving bank accounts. You may edit a receiving account, change access to a receiving account or search payments by clicking the corresponding links. In addition, you have the option to add a new receiving account by clicking on the New Account button.
Add a Receiving Bank Account
Access the Create Receiving Account Page by clicking New Account on the Account Management Screen. Authorized users may add additional receiving accounts by entering the account name, account description, account type, routing and account numbers, accounting system type and download format. Once the receiving bank account information has been entered, select Next to begin the account verification process and access the Confirmation page.
The Confirmation page provides you with a summary of the receiving account information for verification purposes. You may select the edit option to change any information that is incorrect or select Confirm. The new receiving account will be placed in Pending status until the bank account information has been confirmed by PNC Remittance Advantage.
Edit a Receiving Bank Account
The Edit Receiving Account screen allows authorized users to modify the receiving account name, account description, accounting system and download format. In addition, you may activate or deactivate a receiving account.
Receiving Bank Account Access
The Account Access screen gives you a system-wide view of who does and does not have access to each registered account. Authorized users may grant or revoke user access to specific receiving accounts.
Payer Management
The Payer Management screen lists all active and inactive insurance payers. To view payments from a particular payer, use the corresponding View Payments link. You will be able to view remittance information for any EFT payment you select. From the Payer Management screen you may also edit payer information or deactivate a payer, as well as add another payer by entering a registration code.
Reconciliation History
The Reconciliation History page displays previously downloaded payments by date along with the total number of payments, aggregate dollar amount and the account that the payment was sent to. Payments may also be downloaded from this page.
Report Menu
Reports allow authorized users to view historical records of payments. Standard reports are predefined and use a default set of fields. If a different layout, format or fields are desired, custom reports may be created for one time use or saved for future use. Custom reports can remain for the creator’s use only or be shared with all or select users.
Reports may be exported in a number of different formats, including Excel, Microsoft Word and PDF, for storage and printing from your local computer.
Security access to individual reports can be controlled by the administrator via the User Administration or Security Administration pages.
The report menu allows the user to:
· Run a report.
· Perform a Document Archive search and save the criteria as a new report template.
Running Standard and Saved Custom Reports
The Run Reports page displays standard reports and custom reports — those reports you have saved for your own private use or shared reports to which you have been granted access. You may run/view, edit or delete reports from this page (users will not be allowed to edit or delete reports created by others). Clicking the Add button will take you to the Document Archive page to create a new report.
You can trigger any report by clicking its corresponding Run[4] link. If the report has no data entry prompts, the Search Results will automatically display in the Report Viewer window. If the report has entry prompts, a page will display that allows you to enter values for the prompted criteria only.
Document Archive Searches
The Document Archive page provides search and viewing capabilities for all payment information that has passed through the PNC Remittance Advantage system. This includes information for payments that have been downloaded for reconciliation, as well as those that were only viewed online.
If you have more than one receiving bank account, each account will be displayed as tabs across the screen along with a Cross-Account Reporting tab for searching through all accounts. First select the required tab/receiving account and then specify as much or as little information as desired for the search. If you specify criteria for multiple fields, the system will only return results that meet all criteria. Select fewer criteria to broaden your results.
Saving Document Archive Searches as Custom Reports
You may save your document archive search criteria as a report for future use or for sharing with other users by clicking the Save button at the bottom of the Document Archive Search page. Upon selecting Save, you will be prompted with the Save/Edit Report screen. From this screen, you will specify a report name for the saved search and whether you want it to be private or shared with other users. For shared reports, users must be granted access to the report by the administrator. Users cannot be provided access to reports that have been marked private.
Next you will select an output format (e.g., Excel) from a drop-down list and schedule the report daily, weekly or monthly, if desired.
You may also specify that the new report prompt the user for one or more entries before it is run. For example, your new report may search payment information based on a particular date, but you'd like the user to specify an insurance payer when running the report. In the Search criteria grid, select the Prompt at Runtime box next to every field you want the user to enter each time the report is run.