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iExchange® Enhancements Now Available!

August 11, 2016

Effective August 1, 2016, iExchange® supports direct submission and provides online approval of Predetermination requests. A Predetermination request is available as a “drop down” option. A Predetermination must be submitted with supporting medical records (clinical documentation).

In addition, providers can submit supporting medical records electronically as an attachment to support Preauthorization and Predetermination requests for faster authorizations (including extending an initial/existing authorization).

Why use iExchange® to submit Preauthorizations and Predeterminations?

  • Quicker response time
  • Supporting documentation is routed directly (eliminate handling/routing of faxes)
  • Receive immediate status notification
  • Ability to search for previously submitted requests
  • iExchange® is available 24 hours a day, 7 days a week (with the exception of every third Sunday of the month when the system is unavailable from 11 a.m. to 3 p.m., CT)

Would you like to learn more about iExchange? Join us for an upcoming iExchange webinar

iExchange Training: Predetermination Requests

Training will focus on submission of Predetermination requests for inpatient and outpatient services. In addition, we will also cover how to retrieve status of Predetermination requests via the iExchange portal. To register, select a date below:

iExchange Training: 2016 System Enhancements

Training will focus specifically on the functionality of the new system enhancements implemented in 2016 which include Predetermination requests, attachments and health summary. To register, select the date below: This is not entry level training. If you require training to learn how to submit an inpatient/outpatient request, extension, etc., please register for the iExchange New Enrollee Training.

Please note that verification of eligibility and benefits information, and/or the fact that any pre-service review has been conducted, is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member's eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered.