1	Update on Central Bill Pay and Medical Authorization
2	Topics Accessing ACS Web Portal via AQS Prior Authorization Process Walk-Thru ACS Web Portal How Employing Agencies Can Help Providers How Employing Agencies Can Help Injured Workers
3	ACS Web Portal – Employing Agency Access Easiest way to access is through AQS Provides information on Eligibility Authorizations Payments Can access via https://owcp.dol.acs-inc.com
4	Accessing the ACS Web Portal via AQS Bring up desired case in AQS Click on Bill Inquiry
5	Accessing the ACS Web Portal via AQS There are 3 types of inquiry options Eligibility Inquiry Bill Status Inquiry Medical Authorization Status Inquiry Click on desired inquiry
6	Prior Medical Authorization Process Using the ACS Web Portal to Check Eligibility Services Requiring Authorization Using The ACS Web Portal To Check Authorization Status Timeframes For Completion
7	Services Requiring Authorization Eligibility status available via AQS access to the ACS web portal http://owcp.dol.acs-inc.com Level 1 - procedures do not require authorization (for example, Office Visits, MRIs, Routine Diagnostic Tests) Level 2 - procedures can be authorized by ACS – often over the phone with ACS Level 3 and 4 - procedures require authorization by a Claims Examiner but initiated via fax from provider to ACS
8	Using the ACS Web Portal to Check Eligibility Check service eligibility without calling ACS by entering valid case number valid procedure (CPT) or revenue code approximate date of service
9	Using the ACS Web Portal to Check Eligibility If the procedure entered is related to the accepted condition, the user will see a message indicating the approval level of the procedure and other case-specific information:
10	Using the ACS Web Portal to Check Eligibility If the procedure entered into the Eligibility Inquiry doesn’t match the accepted condition, the user will see the following message:
11	When Accepted Condition and Procedure Don’t Match Advise that provider needs to complete the Authorization Request Process Claims Examiner will determine if claim can be expanded for new condition based on information in file and information submitted with request Claims examiner will determine if additional development is needed to determine if claim can be expanded to include new condition
12	Timelines for Prior Medical Authorizations Level 2 procedures that ACS can authorize take an average of 3.5 days All spinal surgery and many other surgery authorizations require District Medical Advisor (DMA) approval and take about 30 days In some instances, additional development of the claim by the Claims Examiner is needed to approve or deny an authorization request. Case complexity, claimant responsiveness, employing agency responsiveness, and other factors impact the timeline for authorization.
13	Notifications Regarding Authorization Request Within 2 business days, the authorization request is logged into the system, forwarded to the Claims Examiner if necessary, or returned to provider if incomplete If a request for authorization is approved, the requesting provider is notified via mail If a request cannot be approved because additional information is needed, requesting provider is notified via mail If a request is denied, the Claims Examiner issues an official denial letter to claimant Authorization status available via AQS or direct access to ACS web portal http://owcp.dol.acs-inc.com or via the ACS IVR at 866-335-8319
14	Authorization Letter Requesting Provider receives authorization via U. S. Mail But…No need to wait for the mail. Check authorizations via AQS or direct access to ACS web portal http://owcp.dol.acs-inc.com
15	Using the ACS Web Portal to Check Authorizations Click on Medical Authorization Inquiry
16	Using the ACS Web Portal to Check Authorizations Enables users to check authorization status without calling ACS Limit the number of authorizations returned by entering dates of service range
17	Using the ACS Web Portal to Check Authorizations
18	Using the ACS Web Portal to Check Bill Status Choose to see Resolved or In Process bills Dates of Service is optional Can search for a particular provider number Can search for a particular TCN
19	Using the ACS Web Portal to Check Bill Status Displays information on bills submitted bills Returns a maximum of 200 bills – message tells if there are more than 200 bills matching search criteria To view description of billed diagnosis (ICD9), click on hyperlink To view line items for a specific bill, click on the hyperlinked TCN
20	Using the ACS Web Portal to Check Bill Status All line items for the selected bill appear To view descriptions for Procedure (CPT), Revenue, or EOB codes, click on hyperlink
21	Using the ACS Web Portal to Check Bill Status It is possible for some line items to pay on a bill and others not
22	How Employing Agencies Can Help Providers Encourage providers to register/enroll Encourage providers to use ACS web portal http://owcp.dol.acs-inc.com for Eligibility status Authorization status Bill payment status Link to FAQs Encourage providers to bill electronically Give Providers accepted condition information – ICD9s and descriptions – when they request it Don’t submit bills for providers Don’t complete med auths for providers
23	How Employing Agencies Can Help Injured Workers Encourage Injured Workers to use ACS web portal http://owcp.dol.acs-inc.com for Eligibility status Authorization status Bill payment status Link to FAQs Forms Give Injured Workers their accepted condition information – ICD9s and descriptions – a screen shot from AQS works for this Advise/Encourage Injured Workers to give their accepted condition information to their treating physicians Educate Injured Workers about the authorization and bill pay processes
24	We appreciate your willingness to work with us to create a system that works for all of our customers – Injured Workers, Providers, and Employing Agencies