Dear Provider,

Trust your day is going well.

Please find your portal login details below:

USERNAME:

PASSWORD: Hospital@1

Please find below link for your portal use and kindly ensure you bookmark it.

https://toshfa.avonhealthcare.com/AVONHMOLIVEProviderlogin/Index.aspx

Kindly fill the below link, this is to update our records on the portal.

PROVIDER PAYMENT DATA PORTAL UPDATE (office.com)

Please be informed that you are expected to generate your Pa codes for all secondary services,

Steps:

1. Input the member number of enrollee and find.
2. Select inpatient or outpatient based on nature of request(IPD/OPD)
3. Select non-emergency for all non-emergency case and emergency for all emergency cases at REQUEST NATURE
4. Using your Benefit dictionary, search the service to know the correct benefit name to select example, all drugs are found under the benefit name of PRESCRIBED DRUGS AND INFUSION, all general consultations are found under CONSULTATION GENERAL, lab investigations under LAB INVESTIGATIONS and so on. NB; ALWAYS REFER TO THE BENEFIT DICTIONARY.
5. Input the diagnosis in the diagnosis description box and click on search, diagnosis type is ICD, a variety of diagnosis will display on your screen ,click on the one which matches the enrollee’s diagnosis and click on add to grid.

Depending on the number of diagnosis and enrollee has ,keep searching and adding to grid until its complete.

6. All lab investigations , ultrasound scans ,x-rays can be found under the service type ; SERVICE, all drugs can be found under the service type ;SUPPLY, Admissions under ROOM.
7. Click on submit and your PA request will be submitted and generated automatically.

CLAIMS SUBMISSION USING PORTAL STEPS FOR ALL PRIMARY CARE SERVICES

1. Generate a batch number for the month you are billing for at claim batch.
2. Go to claims submission.
3. Select the batch number you want to work on
4. A tab will display showing the summary for the batch.
5. Enter the enrollee’s member number ,please note this is not what you are going to input e.g. (AVH/AHL/149067/A), what you are using is 149067.
6. Click on find and the details of the enrollee will display.
7. Select claim type as outpatient.
8. Benefit name, select primary care.
9. Input enrollee’s diagnosis, search and add to Grid.
10. Input the invoice number as the date you are claiming for that bill example, 14072023 without /
11. Most cases of primary care are mostly consultation and drugs or consultation, investigation, and drugs, at the service type depending on what you would like to start with ,when you are done with each e.g., you are done with consultation ,you switch to the next on like supply for drugs or service for lab when you are done inputting , you submit. And move to the next claim by clicking on claims submission all over with the same process.

CLAIMS SUBMISSION USING PORTAL STEPS FOR ALL SECONDARY CARE SERVICES WITH PA CODE.

1. Click on claims submission.
2. Select the batch number you want to work on
3. A tab will display showing the summary for the batch.
4. Enter the enrollee’s member number ,please note this is not what you are going to input e.g. (AVH/AHL/149067/A), what you are using is 149067.
5. Click on find and the details of the enrollee will display.
6. Input enrollee’s PA code given for service e.g., AVH/999999 make sure there is no space between your cursor and the last figure of the approval code and click on approval check.
7. All services approved will be displayed on the screen.
8. Input the invoice number and click on submit.

Please note, in an event you find the portal not displaying the services , you can input them manually using the service type and adding to your bill.

9. Click on submit.
10. When done submitting all your claims , click on claims submission.
11. Scroll down to Edit and click.
12. Scroll back up and select on the batch number you would like to submit .
13. Click on finalize ,the batch number details will appear, and you have successfully submitted your claims to us.

Please feel free to reach out to us for assistance or questions also find attached the benefit dictionary.

Please note that for all optical, dental and referral you get your PA code from @callcentre@avonhmo.com