Provider Web Portal

Advancing real-time access to information, our Provider Web Portal (PWP) provides an interactive forum for each network provider to access in-depth content on all aspects of the network and best practice guidelines.

Network providers can use the interactive PWP to submit authorizations and claims, sign up for and receive Electronic Funds Transfer (EFT) payments, download the Provider Manual and other educational resources, and more. This powerful online tool is configured and maintained by members of the Web Portal Team, who also coordinate and conduct in-depth end-user training on functionality. The Web Portal Team will design a branded PWP to match your corporate identity and implement advanced security settings to ensure a secure information HUB.

The PWP affords providers easy access to the information and tools needed to best serve members, and to efficiently and securely process claims and authorizations.

The functions facilitated by our secure PWP are as follows:

  • Claim Management: Submission of claims, with the ability to attach supporting documents such as x-rays, for services performed; printing or saving a list of submitted claims; and checking the status of previously submitted claims.
  • Authorization Management: Submission of authorizations and completion of any required clinical algorithms, enabling reviews prior to executing the proposed services; attaching electronic files and reviewing submitted authorizations; and monitoring the status of previously submitted authorizations.
  • Eligibility Status Inquiries: Confirming patient eligibility to receive covered benefits; and reviewing a memberís service history.
  • Benefit Limitations: Real-time access to search for and verify any given memberís benefit limitations and any amounts accrued towards their maximum. Benefit maximums are updated nightly by Scion Dental to ensure providers have access to the most updated and accurate benefit information.
  • Data Entry Shortcuts: Establishing the amounts billed for services, which are automatically applied to the appropriate procedure codes during data entry; establishing a schedule for reusing membership information to expedite eligibility inquiries and entry of claim data; updating username, email address or password.
  • Report, Document and File Manipulation: Saving and printing of reports and electronic remittances; viewing the Office Reference Manual for detailed benefit plan information; sending and receiving confidential files securely.

Please see www.wonderboxtech.com for additional details on the Enterprise System.