Empowering Health-Care Professionals with Information at the Point of Service
Several years ago, representatives from a number of Arkansas health care systems and Arkansas Blue Cross and Blue Shield envisioned a statewide, seamlessly integrated health care delivery and claims processing and communication transaction system. This would enable the hospitals of the state to be connected to physicians practicing in their facilities, and the various facilities and individual physicians would be connected to each other, to major employers in their regions and to payers by way of a health-data network. Advanced Health Information Network (AHIN) is the communications tool created to implement this vision.
What Is AHIN?
AHIN is a secure web-based portal that provides real-time functionality, delivering current patient information, while helping physicians improve business functions more efficiently. It was one of the first health information networks in the United States to offer advanced functionality and continues to offer capabilities that are unique within the industry. This functionality is the primary reason hospitals and Health Networks magazine identified Arkansas Blue Cross and Blue Shield as one of the "10 Most Wired Health Plans" in the country.
How AHIN Works
Links to Arkansas Blue Cross and Blue Shield information systems provide access to eligibility, claims, claim status, remittance advices, fee schedules and detailed reporting. Links to other Blue Cross and Blue Shield plans provide similar access to this information nationwide. Inherent functionality includes electronic claim submission and real-time correction of erred claims, regardless of how they were submitted. Since users access AHIN through a secure portal using all popular Internet browsers, there is no software to purchase and install. By utilizing internet technology, everything necessary to access AHIN is already present on most personal computers.
Security of data is always a major concern, and AHIN's developers went to great lengths to limit access to patient or other data to a need-to-know basis, with full HIPAA compliance. The system operates as an extranet and uses both hardware and software controls to limit data access to users with the proper authorization. Access to data stored on the network is through a security system, which is addressable down to the object level, and individuals who have security clearance to view patient or other data are limited to viewing information specific to their organization.
AHIN functions as a repository for demographic, insurance eligibility, claims and related information. In addition, AHIN serves as a conduit through which information — such as referral/pre-certification processing, claims submission, claim status, remittance advice and claims error notification/correction/re-submission — may be sent from one point to another.
The primary functions provided by AHIN include:
- Demographics: Available for more than a million Arkansas Blue Cross and Blue Shield, Health Advantage, Medi-Pak, Medi-Pak Advantage, BlueAdvantage and USAble Administrators members and former members; updated nightly.
- Eligibility: Available for Arkansas Blue Cross and Blue Shield and out-of-state Blue Cross and Blue Shield (Blue Card) plans, Health Advantage, BlueAdvantage Administrators, USAble Administrators and Arkansas Medicaid. Eligibility information for the Arkansas Blue Cross and Blue Shield family of companies is updated nightly. All other eligibility uses real-time interfaces to the host system.
- Fee Schedules: The Arkansas Blue Cross and Blue Shield Fee Schedule is available in AHIN with two ways to access: 1) A Search and Display method from the” Home Page” and 2) A full listing of all codes.
- Claims: Received and processed for all payers, including those who do not accept electronic claims. Claims processing includes electronic error notification to submitters with the ability to perform online error correction and claims re-submission. Information related to claims processed through AHIN is on a real-time basis.
- Claims Status: Available for all Arkansas Blue Cross and Blue Shield and out-of-state Blue Cross and Blue Shield plans, Health Advantage and USAble Administrators. Arkansas Blue Cross and Blue Shield claim status is updated nightly. Information from out-of-state Blue Cross and Blue Shield plans is via real-time interfaces to the host system.
- Claim Search: Provides access to Claims Status, Claim Disposition, Paper RA, Medical Records, Refund Letters, and Overpayments all from one screen.
- File Overview: A new feature that displays a summary of claims submitted in the file as well as the date the file was submitted to AHIN and provider contact information. The Claims Tab provides a list of all claims in the file or only the claims in error. The Reports Tab provides a list of all reports associated with the file.
- Medical Edit Research: The Edit/Coverage function provides users with procedure-code-specific member coverage and licensed pre-payment edit information.
- Tutorial: The Computer Based Training (CBT) module has an easy-to-use main menu that allows the user to choose to complete each section or only those sections that pertain to their specific job duties. The lessons will allow the user to practice what is learned in each section in a realistic simulation of AHIN.
How Do I Enroll in AHIN?
AHIN Online Enrollment should only be completed for providers requesting to have access to AHIN in their offices. If you want to be added as a user to an existing AHIN provider, please contact the AHIN User Administrator (AUA) in your office; otherwise, please follow the instructions below to begin the process of enrolling in AHIN.
The AHIN User Administrator (AUA) will receive an email from AHIN when the setup is complete. The email will contain the AUA's assigned AHIN user name, password and Personal Identification Number (PIN).
If you have any questions regarding AHIN, you may contact AHIN Customer Support at 501-378-2336 or email: firstname.lastname@example.org.