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User Administration Console (UAC) Training Guide Version 1.17 February 8, 2016

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Page 1: User Administration Console (UAC) Training Guide · The User Administration Console (UAC) is the Magellan Health, Inc. (hereafter referred to as “Magellan”) web-based enterprise

User Administration Console (UAC) Training Guide Version 1.17 February 8, 2016

Page 2: User Administration Console (UAC) Training Guide · The User Administration Console (UAC) is the Magellan Health, Inc. (hereafter referred to as “Magellan”) web-based enterprise
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Revision History

Document Version Date Name Comments

1.0 02/21/07 Training Department, Documentation Mgmt. Team

Initial Creation of Document

1.1 03/16/07 Training Department Revision

1.2 05/01/07 Training Department Revision due to v2.1 upgrade of application

1.3 06/26/07 Training Department Revision due to additional v2.1 enhancements

1.4 10/24/08 Training Department Revision to update Password Management screens and comply with corporate documentation standards

1.5 09/24/09 Training & Development Department and Documentation Management Team

Updated screen shots and changed order

1.6 10/29/09 Training & Development Updated information and order to steps

1.7 06/30/10 Training and Development Updated name change and screen shots

1.8 07/23/10 Training and Development Updated URL addresses

1.9 07/14/11 Training and Development Updated steps in Sections 4.2.2 & 7.3. Updated screen shots and steps in Section 6.0.

1.10 08/22/11 Training and Development; Documentation Management

Updated Sections 1.2, 3.1.3, 4.2.5, 4.3.1, 4.3.2, and 5.2

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Document Version Date Name Comments

1.11 01/10/12 Training and Development; Documentation Management

Updated to new format

1.12 05/24/12 Training and Development Updated screenshots

1.13 11/05/12 Documentation Mgmt Rebranded

1.14 06/03/13 Training and Development Updated Password Management Steps and screenshots

1.15 02/01/15 Training and Development Updated password criteria on pg. 25, 35, & 47. Updated screen shot of Alternate Address window.

1.16 01/20/16 Training and Development Updated screen shot of Alternate Address window.

1.17 02/08/16 Training and Development Updated Password Management

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Table of Contents Table of Contents ...............................................................................................................................5 1.0 Introduction ..........................................................................................................................7

1.1 Who is Considered a User? .......................................................................................................... 7 1.2 Types of User Access ................................................................................................................... 7 1.3 Key Components .......................................................................................................................... 9 1.4 Web Registration Process .......................................................................................................... 10 1.5 Navigation .................................................................................................................................. 11

2.0 Logging In/Out ..................................................................................................................... 13 2.1 Login .......................................................................................................................................... 13 2.2 Log Out ...................................................................................................................................... 16

3.0 Request Access .................................................................................................................... 17 3.1 New User ................................................................................................................................... 17

3.1.1 Register with PIN ................................................................................................................... 25 3.1.2 Activate the User Account..................................................................................................... 31 3.1.3 Initial Logon ........................................................................................................................... 34

4.0 User Administration Console ................................................................................................ 42 4.1 Assigning Roles for Current User ............................................................................................... 43 4.2 User Tab ..................................................................................................................................... 47

4.2.1 Creating a User Profile .......................................................................................................... 47 4.2.2 Creating a Local Administrator .............................................................................................. 57 4.2.3 Acquiring Users ..................................................................................................................... 60 4.2.4 Viewing/Editing User Details ................................................................................................. 63 4.2.5 Discarding a User Profile ....................................................................................................... 72

4.3 Organizations Tab ...................................................................................................................... 78 4.3.1 Viewing Organizations Tab .................................................................................................... 78 4.3.2 Removing an Organization .................................................................................................... 82 4.3.3 Request PIN ........................................................................................................................... 84 4.3.4 Register with PIN ................................................................................................................... 87

4.4 Roles Tab ................................................................................................................................... 93 4.4.1 Viewing/Editing Roles ........................................................................................................... 93

5.0 Upgrade to Delegated Administrator .................................................................................... 96 5.1 Request PIN ............................................................................................................................... 96 5.2 Register with PIN ..................................................................................................................... 102

6.0 Password Management ...................................................................................................... 108 6.1 Obtaining Forgotten Password ................................................................................................ 108

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6.2 Changing Password .................................................................................................................. 112 6.3 Password Expired .................................................................................................................... 114

7.0 Web Provisioning Frequently Asked Questions (FAQs) ........................................................ 115 7.1 PIN Letter Call Scenarios .......................................................................................................... 115 7.2 Registration Call Scenarios ...................................................................................................... 115 7.3 Password Call Scenarios .......................................................................................................... 118 7.4 Navigation Call Scenarios ........................................................................................................ 120 7.5 Maintenance Call Scenarios .................................................................................................... 121

8.0 Glossary............................................................................................................................. 125 8.1 Acronyms ................................................................................................................................. 137

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1.0 Introduction The User Administration Console (UAC) is the Magellan Health, Inc. (hereafter referred to as “Magellan”) web-based enterprise solution to web registration and security. It is designed to allow

One way to register; One presentation to our clients; and One way to administer web users.

This web-based platform was deployed across all Magellan web applications and allowed a single login username and password for each user to access applications for multiple providers.

1.1 Who is Considered a User?

The term “user” refers to the person who accesses any of the Magellan web applications on behalf of an organization. The term “organization” refers to any facility that is enrolled as a provider conducting business with Magellan, such as hospitals, pharmacies, nursing homes, or any individual provider, such as doctors or Magellan State clients. The user registers on behalf of his/her organization to access any of Magellan web applications and conducts business on behalf of Medicaid recipients.

1.2 Types of User Access

Within the User Administration Console, there are four levels of user access:

User Access Description

Delegated Administrator

Manages the entire organization’s access and use of any Magellan web-based application: FirstHCM℠, Pharmacy Web Prior Authorization (PA), Web Claims Submission, Web RA, etc. The Delegated Administrator is the one to initially register on behalf of the organization and can assign Local Administrators and/or Users to work on behalf of the organization. He/she authorizes and registers Local Administrators and can register and assign users to certain roles and limit their access to specific Magellan applications and/or providers.

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User Access Description

Local Administrator Manages application access and security for a local unit or organization. The Local Administrator can enroll users, maintain user profiles, and can assign user roles within the scope of his/her access rights.

Upgrade Access This option is utilized when an existing user wishes to become a Delegated Administrator.

New User This option is utilized when a new user wishes to begin utilizing the application to manage his/her organization’s access and use of any Magellan web-based application.

The Who are you? window is utilized to distinguish between the types of access. See Figure 1.2.1.

Figure 1.2.1 – Who Are You? Window

• If you click the first or second option button, the Login window appears. See Figure 2.1.2.

• If you click the third option button, the Welcome window appears. See Figure 1.2.2.

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Figure 1.2.2 – Welcome Window

1.3 Key Components

The three key components of the User Administration Console are

User Registration; User Security Authentication; and User Administration.

The User Registration component allows anyone to request access for the respective organization(s). However, with this process, the organization ultimately determines who registers and accesses this system as a Delegated Administrator on their behalf. The menu options are

Request PIN; and Register with PIN.

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Request PIN is used to request a personal identification number (PIN) for each organization and context. PINs are sent directly to the organization, not the requestor. Once the organization receives the PIN letter, they can pass this information to the user(s) in their facility to register with the PIN as the Delegated Administrator. This individual will be asked to create a unique user ID and password.

User Security Authentication provides a separate secure login webpage with control and authentication management, access control, user identities, and licensing. Some features of this application include

Time restrictions; Grace logins; Password expiration; and Forced password change

The User Administration component includes functions to manage and maintain user IDs and passwords, such as create Local Administrators to manage subsets of users, add users, assign roles, change passwords, and delete inactive users.

1.4 Web Registration Process

Due to the private nature of information that can be obtained via this application, organizations and their respective staff must register as users prior to gaining access to the User Administration Console. By requiring you to register with the information received by the organization in the PIN letter, the system can validate your identity.

The new web registration process consists of a few steps that must be completed prior to gaining access to Magellan’s web-based applications with a patient’s private health information (i.e., FirstHCMsm and Pharmacy Web PA). The steps required for registration are

Step 1 – Request PIN; Step 2 – Register with PIN; and Step 3 – Activate (new users only)

In Step 1, the user requests a PIN to be assigned to an organization. The PIN letter is generated within two business days and mailed by the United States Postal Service (USPS). In Step 2, the user is able to complete the registration process with the information from the PIN letter. In Step 3, the user activates his/her account.

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1.5 Navigation

There are four tabs on the Welcome window used to navigate within the User Administration Console:

Home: The Welcome window appears by default. Provides a general application overview and features an Alerts window where important information can be shared with all Delegated or Local Administrators upon initial login.

Users: The tab used to create, modify, or discard individual user profiles and manage passwords. There are tabs to windows where an Administrator can assign which organizations’ users may work with and delegate which functions or roles users may perform. Delegated Administrators can also acquire users from this tab.

Organizations: The tab where an Administrator views, adds, modifies, or deletes organization profiles. The Administrator can make mass updates for a single organization by accessing this tab.

Roles: The tab where application specific roles are assigned to each user to allow him/her to work within that application on behalf of the organization. The Administrator can make mass updates to the roles of user profiles by accessing this tab.

The User Administration Console also is equipped with tooltip pop-ups that display when the mouse cursor rolls over a selected area, to provide detailed descriptions of various fields and drop-down lists.

• The User Administration Console times out after 15 minutes of inactivity. You will be required to log in again to continue your work.

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2.0 Logging In/Out

2.1 Log In

To log in to the User Administration Console as a Delegated Administrator or a Local Administrator, please use the following steps:

1. Open the Internet browser.

2. Access the User Administration Console hyperlink. The Who are you? window appears. See Figure 2.1.1.

• This webpage is typically accessed through the User Administration Console hyperlink on the Home window of the Magellan Medicaid Administration website for your state/program. Example: http://client.fhsc.com or http://client.magellanmedicaid.com.

• If you have not yet registered as a Delegated Administrator or a Local Administrator, continue to Section 3.0 – Request Access.

Figure 2.1.1 – Who Are You? Window

3. Click the appropriate option button and click Continue. The Login window appears. See Figure 2.1.2.

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• Click the first option button if you are a Delegated Administrator or a Local Administrator. Click the second option button if you are a User or Local Administrator and need to upgrade your account.

Figure 2.1.2 – Login Window

4. In the User ID and Password boxes, enter your user ID and password.

5. Click Submit. The Welcome window appears. See Figure 2.1.3.

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• For information on changing the password, refer to Section 6.1 – Obtaining Forgotten Password.

Figure 2.1.3 – Welcome Window

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2.2 Log Out

To exit the User Administration Console, click Logout in the top right-hand corner of the window. The Who are you? window appears. See Figure 2.2.1.

Figure 2.2.1 – Who Are You? Window

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3.0 Request Access

3.1 New User 1. To request access as a new user, click I do NOT have a User ID and need to initiate

or complete registration to become a Delegated Administrator from the Who are you? window. See Figure 3.1.1.

Figure 3.1.1 – Who Are You? Window

2. Click Continue. The Welcome window appears. See Figure 3.1.2.

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Figure 3.1.2 – Welcome Window

3. Click the Request PIN tab. The Request PIN window appears. See Figure 3.1.3.

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Figure 3.1.3 – Request PIN Window

4. In the First Name, Last Name, and Work Phone boxes, enter your first name, last name, and work phone number (without parentheses or dashes) and click Continue. The Validate Organizations window appears. See Figure 3.1.4.

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Figure 3.1.4 – Validate Organizations Window

5. In the Organization Type list, select an organization type.

Provider State

6. In the State list, select a state.

7. In the Org ID Type list, select an organization ID type.

Medicaid FEIN NPI/API (National Provider Identifier/Atypical Provider Identifier) State License

• The Org ID Type list options vary by contract.

8. In the Org ID box, enter an organization ID.

9. Click Validate Org. The organization appears in the results window. See Figure 3.1.5.

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Figure 3.1.5 – Validate Organizations Window

10. Verify that the organization information is accurate.

• If the incorrect organization is returned, click the Trash Can icon under the Discard column to delete the record.

11. Complete Steps 5–10 for each organization for whom you are requesting Delegated Administrator status.

• If the organization address needs to be updated, click the Alt Address Info hyperlink under the Use Alternate Address column. A window appears with instructions on how to update the organizations address. See Figure 3.1.6.

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Figure 3.1.6 – Use Alternate Address Column

12. Click Submit. The Confirmation window appears. See Figure 3.1.7.

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Figure 3.1.7 – Confirmation Window

A unique PIN is generated and a PIN letter is sent to the address of each requested organization. The PIN letters are processed within two business days and mailed first class by the USPS. See Figure 3.1.8 to view a sample of a PIN letter.

The PIN letter provides the following information:

The date the registration request was made The name and phone number of the person who requested the PIN The PIN Steps to activate the PIN Contact instructions for assistance

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Figure 3.1.8 – Sample PIN Letter

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3.1.1 Register with PIN

The organization(s) for whom UAC access was requested will receive the PIN letter in the mail. The organization(s) will assign an individual as the Delegated Administrator of web access for their facility. The organization(s) will give the PIN letter to the Delegated Administrator so he/she can continue the registration process.

To continue the registration process, please use the following steps:

1. Access the User Administration Console website. The Who are you? window appears. See Figure 3.1.1.1.

Figure 3.1.1.1 – Who Are You? Window

2. Click I do NOT have a User ID and need to initiate or complete registration to become a Delegated Administrator and click Continue. The Welcome window appears. See Figure 3.1.1.2.

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Figure 3.1.1.2 – Welcome Window

3. Click the Register w/PIN tab. The User Info window appears. See Figure 3.1.1.3.

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Figure 3.1.1.3 – User Info Window

4. In the First Name, MI, and Last Name boxes, enter your first name, middle initial, and last name.

5. In the User ID box, enter a user ID.

Should be 6 to 12 characters in length. Not case sensitive. Alpha-numeric only. No symbols or dashes. If the user ID selected has already been assigned to another user, a window

appears advising you to select another user ID. You will need to enter a new user ID.

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6. In the Password box, enter a password.

Must be at least 8 characters long, maximum of 16 characters. May use numbers as well as letters. Should not use words in any language, slang, dialect, jargon, etc. Should not be based on personal information such as family names. Should never be written down or stored online.

7. In the Confirm Password box, enter the password again to confirm the password.

8. In the Email Address box, enter an e-mail address.

9. In the Email Address box, enter the e-mail address again to confirm the e-mail address.

10. In the Address box, enter an address. These fields are not required.

11. In the Phone number box, enter a phone number without parentheses or dashes.

12. In the Fax number box, enter a fax number without parentheses or dashes.

13. Click Continue. The Validate PIN window appears. See Figure 3.1.1.4.

• If any field results in an error, you will need to re-enter the password before you can click Continue.

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Figure 3.1.1.4 – Validate PIN Window

14. In the Organization Type list, select an organization type.

Provider State

15. In the State list, select a state.

16. In the Org ID Type list, select an organization ID type.

Medicaid FEIN NPI/API (National Provider Identifier/Atypical Provider Identifier) State License

• The Org ID Type box options will vary by contract.

17. In the Org ID box, enter an organization ID.

18. In the PIN box, enter a PIN.

19. Click Validate Org. The organization appears in the Results window. See Figure 3.1.1.5.

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Figure 3.1.1.5 – Validate PIN Window

20. Repeat Steps 14–19 for each organization a PIN letter was received.

• If you choose not to register for this organization at this time, click the Trash Can icon under the Discard column to delete the record.

21. Click Submit. The PIN Registration Confirmation window appears. See Figure 3.1.1.6.

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Figure 3.1.1.6 – PIN Registration Confirmation Window

3.1.2 Activate the User Account

The Success window advises you that an e-mail will be sent to the e-mail address you entered during the registration process. The e-mail will provide valuable information that is needed to activate your account. The e-mail will come from [email protected] with the subject “Magellan Medicaid Administration New Delegated Administrator Activation.” You should click the hyperlink provided in the e-mail to activate the user account. See Figure 3.1.2.1.

Figure 3.1.2.1 – Web Registration E-mail

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Once you click the hyperlink, you will be directed to the Account Activation window to activate your user account. See Figure 3.1.2.2.

Figure 3.1.2.2 – Account Activated Successfully

Your account is now activated. You can click the hyperlink or click the Home icon to be routed to the User Administration Console Who are you? window. You will need to assign a role to your profile prior to accessing the state-specific web application desired, such as Web PA, ARS, etc.

• If you have previously activated your user ID, an E-mail Activation Confirmation window appears advising to go directly to the User Administration Console website to log in. See Figure 3.1.2.3.

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Figure 3.1.2.3 – E-mail Activation Confirmation

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3.1.3 Initial Logon

1. From the Who are you? window, click I am a Local or Delegated Administrator and need to perform user administration work, and click Continue. See Figure 3.1.3.1.

Figure 3.1.3.1 – Who Are You? Window

2. In the User ID and Password boxes, enter your user ID and password. Click Submit. The Login window appears. See Figure 3.1.3.2.

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Figure 3.1.3.2 – Login Window

3. On the initial login, the Password Expiration Check window appears. See Figure 3.1.3.3.

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Figure 3.1.3.3 – Password Expiration Check Window

• You will have six grace logons before you will be forced to change your password.

4. Click Password Maintenance. The Password Self Service window appears. See Figure 3.1.3.4.

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Figure 3.1.3.4 – Password Self Service Window

5. Enter new password in the New Password field.

6. Type password again in the Confirm Password field.

7. Click Change Password. Refer to Figure 3.1.3.4.

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The Password Self Service application has strict guidelines for passwords, which are:

• Passwords are case sensitive; • Must be at least eight (8) characters long; • Cannot include the word password or test; • Cannot include a part of your name or username; • Must not include a common word or commonly used sequence

of characters; and • Must have at least three types of the following characters:

− Uppercase (A-Z)

− Lowercase (a-z) − Number (0-9) − Symbol (!, #, $, etc.)

• Users can select a system-generated password by clicking Auto-generate a new password.

8. It can take several minutes for the system to change the password. While the system is changing the password, users will receive a Please Wait notice. See Figure 3.1.3.5.

Figure 3.1.3.5 – Please Wait Notice

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9. Once the password is changed, users will receive a Success notification. Click Continue to log out. See Figure 3.1.3.6.

Figure 3.1.3.6 – Success Notification

10. Once this window appears, you will need to close out the screen and go back to UAC by clicking the UAC hyperlink on the state’s website.

11. Return to the Who are you? window. Select I am a Local or Delegated Administrator and need to perform user administration work and click Continue. See Figure 3.1.3.7.

Figure 3.1.3.7 – Who Are You? Window

12. The Welcome window appears. See Figure 3.1.3.8.

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Figure 3.1.3.8 – Welcome Window

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4.0 User Administration Console There are four tabs that appear on the Welcome window:

Home Users Organizations Roles

If you have the role of Local Administrator for an organization and Delegated Administrator for another organization, you will need to select the appropriate role from the Select Admin Role list and click Go. Once the appropriate role is selected, the tabs will become enabled. See Figure 4.0.1. If you have only the role of Local Administrator or Delegated Administrator, the Welcome window appears with the tabs already enabled. See Figure 4.0.2.

Figure 4.0.1 – Welcome Window

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Figure 4.0.2 – Welcome Window

4.1 Assigning Roles for Current User 1. Click the User ID hyperlink at the top-right of the window. The General Info

window appears. See Figure 4.1.1.

• Delegated Administrators do not have to assign themselves roles in order to assign them to additional users.

• Delegated Administrators will only assign themselves roles if they use the specific web application. For example, Web PA, Web RA, Web Claims Submission, etc.

• Local Administrators have to assign themselves to a specific role if they want to assign the specific role to another user. If the Local Administrator is not assigned to the specific role, he/she cannot assign that specific role to another user.

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Figure 4.1.1 – General Info Window

2. Click the Roles sub-tab. The Roles window appears. See Figure 4.1.2.

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Figure 4.1.2 – Roles Sub-Tab

3. In the Application list, select the appropriate application. The window refreshes. See Figure 4.1.3.

4. In the Organization (ID) list, select an organization ID, if applicable. See Figure 4.1.3.

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Figure 4.1.3 – Roles Sub-Tab

5. Click Get Roles. All applicable roles for the application appear. See Figure 4.1.4.

Figure 4.1.4 – Roles Sub-Tab

6. Select the roles and click Save. Repeat Steps 2–6 for each role desired.

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4.2 User Tab

4.2.1 Creating a User Profile

You will need to create a user profile for each user that will access the system on his/her organization’s behalf. If you do not want this responsibility, you can create Local Administrators to access the User Administration Console to create all necessary users.

To add users, please use the following steps:

1. Click the Users tab.

2. Click Add New User. The Enter New User Info window appears. See Figure 4.2.1.1.

Figure 4.2.1.1 – Enter New User Info Window

3. In the First Name, MI, and Last Name boxes, enter the user’s first name, middle initial, and last name.

4. In the User ID box, enter a user ID.

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5. In the Password box, enter a password and enter it again in the Confirm Password box.

• All Passwords:

− Must be at least 8 characters long, maximum of 16 characters. − May use numbers as well as letters. − Should not use words in any language, slang, dialect, jargon,

etc. − Should not be based on personal information such as family

names. − Should never be written down or stored online.

6. In the Email Address box, enter an e-mail address.

7. In the Phone box, enter a phone number. Do not enter parentheses or dashes.

8. In the Fax box, enter a fax number. Do not enter parentheses or dashes.

9. Click Save. An Information Saved message appears. See Figure 4.2.1.2.

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Figure 4.2.1.2 – Edit User Name – Information Saved

10. Click the Organizations sub-tab. The Organizations window appears. See Figure 4.2.1.3.

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Figure 4.2.1.3 – Organizations Sub-Tab

11. Select the check box(es) next to the appropriate organization(s). This selection(s) is/are the organization(s) the user will work on behalf of. The row will be highlighted once selected.

12. Click Save. An Information Saved message appears. See Figure 4.2.1.4.

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Figure 4.2.1.4 – Organizations Sub-Tab – Information Saved

13. Click the Roles sub-tab. The Roles window appears. See Figure 4.2.1.5.

Figure 4.2.1.5 – Roles Sub-Tab

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14. In the Application list, select an application. The window refreshes. See Figure 4.2.1.6.

Figure 4.2.1.6 – Application Roles

15. In the Organization (ID) list, select an organization ID, if applicable.

16. Click Get Roles. All application roles that are associated with the organization assigned appear. See Figure 4.2.1.7.

• An organization must be assigned to the user profile prior to the role assignment. If no organizations have been assigned to the user profile, the Roles sub-tab will not display any available roles when Get Roles is clicked.

17. Select the check box(es) next to the appropriate role(s).

18. Click Save. An Information Saved message appears. See Figure 4.2.1.7.

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Figure 4.2.1.7 – Information Saved Message

For each new user that the Delegated Administrator or Local Administrator wants to add, repeat all steps in Section 4.2.1 – Creating a User Profile.

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4.2.1.1 Managed Users Sub-Tab

The Managed Users sub-tab appears for the user profile that you are currently viewing. All user profiles associated with the Delegated Administrator or Local Administrator appear. The user profiles assigned to the Delegated Administrator or Local Administrator are highlighted and have a check in the box next to their record. When you are initially setting up your user profile, you will not see any information on this tab. See Figure 4.2.1.1.1. Once you begin to add users, you will see information appear. See Figure 4.2.1.1.2.

Figure 4.2.1.1.1 – Managed Users Sub-Tab, Setting Up a Profile

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Figure 4.2.1.1.2 – Managed Users Sub-Tab, Adding Users

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4.2.1.2 Administered By Sub-Tab

The Administered By sub-tab appears all Administrators who manage the user profile. The Administrator’s name, phone, fax, and e-mail information are displayed. See Figure 4.2.1.2.1.

Figure 4.2.1.2.1 – Administered By Sub-Tab

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4.2.2 Creating a Local Administrator

To create a Local Administrator, please use the following steps:

1. Complete the steps in Section 4.2.1 – Creating a User Profile.

2. When you add roles on the Roles sub-tab, from the Application list, click User Administration Console. See Figure 4.2.2.1.

Figure 4.2.2.1 – Roles Sub-Tab

3. In the Organization (ID) list, select an organization ID and click Get Roles. See Figure 4.2.2.2.

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Figure 4.2.2.2 – Roles Sub-Tab, Edit User Info

4. Select the UAC Local Administrator check box and click Save. See Figure 4.2.2.3. The Information Saved window appears.

Figure 4.2.2.3 – Roles Sub-Tab, UAC Local Administrator

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If you are a Delegated Administrator and would like to assign user profiles to a Local Administrator, please use the following steps:

1. Click the Managed Users sub-tab within the Local Administrator’s profile.

2. Select the check box next to the appropriate user ID(s). See Figure 4.2.2.4.

Figure 4.2.2.4 – Managed Users Sub-Tab

3. Click Save.

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4.2.3 Acquiring Users

Once you have successfully completed the registration process, you will be able to acquire users to administer. You will be able to acquire users to associate with the organization(s) you registered to work on behalf of.

1. From the Users tab, click Acquire User. The Acquire Users window appears. See Figure 4.2.3.1.

Figure 4.2.3.1 – Acquire Users Window

2. Select the ID Type by clicking the appropriate option button. Users can be acquired by Organization ID, Administrator ID, or User ID.

3. In the Org (ID) list, select the organization ID.

• Step 3 is written as if the Organization ID option button was chosen in Step 2. If Administrator ID is selected in Step 2, the Administrator ID and Phone Number boxes would need to be completed. If User ID is selected in Step 2, the User ID and Phone Number boxes would need to be completed.

4. Click Get Users. A list of all available users appears below the search criteria. See Figure 4.2.3.2.

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Figure 4.2.3.2 – Acquire Users Search Results

5. Select the check box(es) next to the user record(s) that need to be acquired or select the first or last check box to select all the user profiles. The user record(s) highlights.

6. Click Submit. The Acquire Users Confirmation window appears. See Figure 4.2.3.3.

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Figure 4.2.3.3 – Acquire Users Confirmation Window

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4.2.4 Viewing/Editing User Details

You can view or edit user profile information by clicking the View Details hyperlink under the Details column of the User tab. See Figure 4.2.4.1.

Figure 4.2.4.1 – Users Tab, View Details

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4.2.4.1 General Info Sub-Tab

The General Info sub-tab appears the user profile’s first name, middle initial, and last name, user ID, e-mail address, and phone and fax number. The password is not shown. See Figure 4.2.4.1.1.

Figure 4.2.4.1.1 – General Info Sub-Tab

To change a user’s password, please use the following steps:

1. Click Modify. The Password and Confirm Password boxes are activated. See Figure 4.2.4.1.2.

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Figure 4.2.4.1.2 – Modify Password

2. In the Password box, enter your password.

3. In the Confirm Password box, enter the password again to confirm.

4. Click Save.

• If you wish to update your own user profile, you should click the User ID hyperlink located in the top right-hand corner of the window. Refer to Figure 4.2.4.1.2.

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4.2.4.2 Organizations Sub-Tab

The Organizations sub-tab appears the organization(s) you have the ability to work on behalf of. You can work on behalf of the organization(s) that has/have a check mark next to the record. See Figure 4.2.4.2.1.

Figure 4.2.4.2.1 – Organizations Sub-Tab

To assign Organizations to a user profile, please use the following steps:

1. Select the check box next to the appropriate Organization Name. Refer to Figure 4.2.4.2.1.

2. Click Save.

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4.2.4.3 Roles Sub-Tab

The Roles sub-tab appears which roles the user has been assigned for the appropriate application. See Figure 4.2.4.3.1.

Figure 4.2.4.3.1 – Roles Sub-Tab

To view and assign roles to a user profile, please use the following steps:

1. In the Application list, select an application.

2. In the Organization ID list, select an organization ID, if applicable.

3. Click Get Roles. All available roles appear. See Figure 4.2.4.3.2.

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Figure 4.2.4.3.2 – Roles Sub-Tab

4. Select the check box next to the appropriate Role(s). Refer to Figure 4.2.4.3.2.

5. Click Save. The Information Saved window appears. See Figure 4.2.4.3.3.

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Figure 4.2.4.3.3 – Information Saved Window

4.2.4.4 Managed Users Sub-Tab

The Managed Users sub-tab appears for the user profile that you are currently viewing. All user profiles associated with the Delegated Administrator or Local Administrator appear. The user profiles assigned to the Delegated Administrator or Local Administrator are highlighted and have a check in the box next to their record. When you are initially setting up your user profile, you will not see any information displayed on this tab. See Figure 4.2.4.4.1. Once you begin to add users, you will see information appear. See Figure 4.2.4.4.2.

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Figure 4.2.4.4.1 – Managed Users Sub-Tab

Figure 4.2.4.4.2 – Managed Users Sub-Tab

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To assign user profiles to a Local Administrator, please use the following steps:

1. Click the Managed Users sub-tab within the Local Administrator’s profile.

2. Select the check box next to the appropriate user ID(s). See Figure 4.2.4.4.3.

Figure 4.2.4.4.3 – Managed Users Sub-Tab

3. Click Save.

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4.2.4.5 Administered By Sub-Tab

The Administered By sub-tab appears all Administrators who manage the user profile. The Administrator’s name, phone, fax, and e-mail information are displayed. See Figure 4.2.4.5.1.

Figure 4.2.4.5.1 – Administered By Sub-Tab

4.2.5 Discarding a User Profile

You have the ability to discard user profiles when necessary. When a user profile is discarded, it is removed from your assigned user pool but is not permanently deleted from the User Administration Console. This user can still work on behalf of an organization(s). You could acquire the user again at a later time or another Delegated Administrator could acquire the user. If a Local Administrator discards a user profile by mistake, he/she will need to contact the Delegated Administrator to reacquire the user profile.

If the employee is no longer with the organization, you should first remove his/her organization(s) and role(s). To make these adjustments, please use the following steps:

1. From the Users tab, click the View Details hyperlink of the desired user profile. See Figure 4.2.5.1.

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Figure 4.2.5.1 – Users Tab, View Details

2. The General Info tab appears. See Figure 4.2.5.2.

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Figure 4.2.5.2 – General Info Sub-Tab

3. Click the Organizations sub-tab. See Figure 4.2.5.3.

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Figure 4.2.5.3 – Organizations Sub-Tab

4. Select the check box(es) to deselect the organization(s).

5. Click Save.

6. Click the Users tab to return to the list of user profiles. See Figure 4.2.5.4.

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Figure 4.2.5.4 – User List

To discard a user profile, please use the following steps:

1. From the Users tab, select the check box next to the user profile(s) that you wish to discard.

2. Click Discard User. A Confirm Discard User(s) window appears. See Figure 4.2.5.5.

• If the user is no longer working for the organization, contact the Web Support Call Center at 1-800-241-8726 between the hours of 8:00 a.m.–8:00 p.m. (ET), Monday–Friday to have the user profile deleted.

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Figure 4.2.5.5 – Confirm Discard User(s) Window

3. Click Discard User.

• You cannot discard your own user account. The same logic applies if the Local Administrator is logged in to the User Administration Console.

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4.3 Organizations Tab

You can view and remove an organization you are registered to work on behalf of. If you are a Delegated Administrator, you can request access to work on behalf of an additional organization(s). If you are a Local Administrator who needs to be upgraded to a Delegated Administrator, refer to Section 5.0 – Upgrade to Delegated Administrator.

The Administrator can make mass updates for a single organization by accessing this tab.

4.3.1 Viewing Organizations Tab

To view the organizations a user profile can work on behalf of, please use the following steps:

1. Click the Organizations tab. The Organizations window appears. See Figure 4.3.1.1.

Figure 4.3.1.1 – Organizations Window

2. In the Organization Type list, select an organization type.

Provider State

3. Click List Orgs. All organizations available to the Administrator appear. See Figure 4.3.1.2.

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Figure 4.3.1.2 – Organizations Window

To view which users have access to an organization, please use the following steps:

1. Click the View Details hyperlink of the desired organization. The Assign Users window appears. See Figure 4.3.1.3.

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Figure 4.3.1.3 – Assign Users Window

2. In the Organization list, select desired organization.

3. Click Get Users. A list of all users assigned to you appears. See Figure 4.3.1.4.

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Figure 4.3.1.4 – Assigned Users Window

4. Select the check box next to the User ID to assign the user to the Organization. Clear the check box next to the User ID to remove a user’s access.

5. Click Save.

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4.3.2 Removing an Organization

To remove an organization, please use the following steps:

1. Click the Organization tab.

2. Click List Orgs. Refer to Figure 4.3.1.1.

3. Select the check box of the desired Organization. Refer to Figure 4.3.1.2.

4. Click Remove Org. The Confirm Organization Removal window appears. See Figure 4.3.2.1.

Figure 4.3.2.1 – Confirm Organization Removal Window

5. Click Remove Org. An Organization Removed window appears. See Figure 4.3.2.2.

• If the organization(s) is/are removed, you will have to repeat the Request PIN and Register w/PIN processes to add the organization back to your access.

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Figure 4.3.2.2 – Organization Removed Window

6. Click Continue. The application logs you out to reset your organization access.

• You need to log back in to continue using the UAC application.

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4.3.3 Request PIN

You have already utilized the User Administration Console to register to work on behalf of at least one organization. If you did not request PIN letters for all organizations at that time or now need to work on behalf of an additional organization, you must request a PIN to use the web application(s) for each organization you represent.

To request a PIN, please use the following steps:

1. Click the Organizations tab. The Organizations window appears. See Figure 4.3.3.1.

2. Click Request PIN. The Request PIN window appears See Figure 4.3.3.1.

Figure 4.3.3.1 – Provider Information

3. In the Organization Type list, select an organization type.

4. In the State list, select a state.

5. In the Org ID Type list, select an organization ID type.

• The Org ID Type list options will vary by contract.

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6. In the Org ID box, enter an organization ID.

7. Click Validate Org. A results window appears under the search criteria. See Figure 4.3.3.2.

Figure 4.3.3.2 – Request PIN

8. Verify the information listed is accurate. If address updates are needed, select the Alt Address Info check box in the Use Alternate Address column. If the correct organization was returned, click Submit. The PIN Request Confirmation window appears. See Figure 4.3.3.3.

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Figure 4.3.3.3 – PIN Request Confirmation Window

9. Repeat Steps 2–8 for each provider that you access.

The PIN will be mailed to the organization. Once the organization receives the PIN letter, they should give the letter to you. You will return to the User Administration Console website and complete the registration process.

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4.3.4 Register with PIN

The organization(s) for whom access was requested to the User Administration Console will receive the PIN letter in the mail. The organization(s) will assign an individual as the Delegated Administrator of web access for their facility. The organization(s) will give the PIN letter to the Delegated Administrator so he/she can continue the registration process.

To finish the registration process, please use the following steps:

1. Access the User Administration Console website. The Who are you? window appears. See Figure 4.3.4.1.

Figure 4.3.4.1 – Who Are You? Window

2. Click I am a Local or Delegated Administrator and need to perform user administration work and click Continue. The Login window appears. See Figure 4.3.4.2.

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Figure 4.3.4.2 – Login Window

3. In the User ID and Password boxes, enter your user ID and password. Click Submit. The Welcome window appears.

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Figure 4.3.4.3 – Welcome Window

4. In the Admin Role box, enter the administration role and click Go, if applicable.

5. Click the Organizations tab.

6. Click Register w/PIN. The Register w/PIN window appears. See Figure 4.3.4.4.

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Figure 4.3.4.4 – Register w/PIN Window

7. In the Organization Type list, select an organization type.

8. In the State list, select a state.

9. In the Org ID Type list, select an organization ID type.

• The Org ID Type list options vary by contract.

10. In the Org ID box, enter an organization ID.

11. In the PIN box, enter the PIN from the PIN letter received by the organization.

12. Click Validate Org. A Search Result window appears below the search criteria. See Figure 4.3.4.5.

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Figure 4.3.4.5 – Register w/PIN Results

• If the incorrect organization is returned, click the Trash Can icon under the Discard column to delete the record.

13. Repeat Steps 6–11 for every organization you will need to access.

14. If the correct organization appears, click Submit. The PIN Registration Confirmation window appears. See Figure 4.3.4.6.

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Figure 4.3.4.6 – PIN Registration Confirmation Window

You will now be able to work on behalf of the added organization(s) in the various web applications on their state-specific websites.

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4.4 Roles Tab

You can view, add, and remove users to/from specific roles they are assigned. The administrator can make mass updates for a single organization by accessing this tab.

4.4.1 Viewing/Editing Roles

To view/edit the user profiles associated to an application, please use the following steps:

1. Click the Roles tab. The Roles window appears. See Figure 4.4.1.1.

Figure 4.4.1.1 – Roles Window

2. In the Application list, select an application. The window refreshes.

3. In the Org ID box, enter an organization ID.

4. In the Role box, enter a role.

5. Click List Users. The search results appear under the criteria chosen. See Figure 4.4.1.2.

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Figure 4.4.1.2 – Roles

6. Deselect a user profile by clearing the check box. The user profile row is no longer highlighted.

7. Click Save. The Information Saved message appears. See Figure 4.4.1.3.

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Figure 4.4.1.3 – Information Saved

8. Click OK to return to the Roles tab.

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5.0 Upgrade to Delegated Administrator If you are an existing user and wish to be upgraded to a Delegated Administrator, you will need to complete a two-part process:

Request a PIN Register with the PIN

5.1 Request PIN

To request a PIN, please use the following steps:

1. Log in to the User Administration Console. The Who are you? window appears. See Figure 5.1.1.

Figure 5.1.1 – Who Are You? Window

2. Click I have a User ID and need to be upgraded to a Delegated Administrator from the Who are you? window and click Continue. The Login window appears. See Figure 5.1.2.

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Figure 5.1.2 – Login Window

3. In the User ID and Password boxes, enter your user ID and password. Click Submit. The Welcome window appears. See Figure 5.1.3.

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Figure 5.1.3 – Welcome Window

4. Click the Request PIN tab. The Request PIN window appears. See Figure 5.1.4.

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Figure 5.1.4 – Request PIN Window

5. In the Organization Type list, select an organization type.

Provider State

6. In the State list, select a state.

7. In the Org ID Type list, select an organization ID type.

Medicaid FEIN NPI/API (National Provider Identifier/Atypical Provider Identifier) State License

• The Org ID Type list options vary by contract.

8. In the Org ID box, enter an organization ID.

9. Click Validate Org. The organization appears in the Results window. See Figure 5.1.5.

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Figure 5.1.5 – Request PIN Window

10. Repeat Steps 5–9 for each organization access is desired.

• If the organization address needs to be updated, select the Update check box under the Use Alternate Address column. This keeps the letter from going out to the address on record.

11. Click Submit. The Confirmation window appears. See Figure 5.1.6.

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Figure 5.1.6 – Confirmation Window

A unique PIN is generated and a PIN letter is sent to the address of each requested organization. The address is obtained from the provider database. The PIN letters are processed within two business days and mailed first class by the USPS. Refer to Figure 3.1.8 to view a copy of a PIN letter.

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5.2 Register with PIN

When the PIN letter(s) are received, you will need to return to the User Administration Console to finish the upgrade process.

To register with the PIN letter, please use the following steps:

1. Log in to the User Administration Console. The Who are you? window appears. See Figure 5.2.1.

Figure 5.2.1 – Who Are You? Window

2. Click I have a User ID and need to be upgraded to a Delegated Administrator and click Continue. The Login window appears. See Figure 5.2.2.

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Figure 5.2.2 – Login Window

3. In the User ID and Password boxes, enter the user ID and password. Click Submit. The Welcome window appears. See Figure 5.2.3.

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Figure 5.2.3 – Welcome Window

4. Click the Register w/PIN tab. The Register w/PIN window appears. See Figure 5.2.4.

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Figure 5.2.4 – Register w/PIN Window

5. In the Organization Type list, select an organization type.

Provider State

6. In the State list, select a state.

7. In the Org ID Type list, select an organization ID type.

Medicaid FEIN NPI/API (National Provider Identifier/Atypical Provider Identifier) State License

• The Org ID Type list options vary by contract.

8. In the Org ID box, enter an organization ID.

9. In the PIN box, enter a PIN.

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10. Click Validate Org. The organization appears in the Results window. See Figure 5.2.5.

Figure 5.2.5 – Register w/PIN Results

11. Repeat Steps 5–10 for each organization access is desired.

• If you choose not to register for this organization at this time, click the Trash Can icon under the Discard column to delete the record.

12. Click Submit. The Confirmation window appears. See Figure 5.2.6.

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Figure 5.2.6 – Confirmation Window

13. Click the URL hyperlink. The Who are you? window appears. Refer to Figure 5.2.1.

14. Click the default option button and click Continue. The Welcome window appears and you are now logged in as a Delegated Administrator. See Figure 5.2.7.

Figure 5.2.7 – Welcome Window

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6.0 Password Management Magellan’s Password Self Service tool allows you to change your password and obtain a forgotten password for any of the web applications. Passwords for Magellan’s web applications expire every 41 days. When you try to log in to the desired application and your password has expired, you are automatically taken to the Password Self Service tool. The web address for the Password Self Service tool is http://pwm.fhsc.com/pwm.

6.1 Obtaining Forgotten Password

To obtain a forgotten password, please use the following steps:

1. From the Login window, click the Forgot Your Password hyperlink. See Figure 6.1.1.

Figure 6.1.1 – Password Self Service Login Window

2. The Forgotten Password window appears. Enter your username in the User Account ID field and click Search. See Figure 6.1.2.

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Figure 6.1.2 – Forgotten Password Window

3. An auto-generated e-mail will be sent to the e-mail address associated with your logon. Keep the Password Reset Self Service Code page open while retrieving the e-mail. See Figures 6.1.3.

Figure 6.1.3 – Password Reset Self Service Code Page

4. In the e-mail, click the Click Here hyperlink. You will be taken to the Change Password window. See Figure 6.1.4.

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Figure 6.1.4 – Auto-generated Email

• If a user is not taken to the Change Password window after clicking the Click Here hyperlink, he or she can copy the URL and paste the URL in the Password Reset form and click Check Code. Users will be taken to the Change Password window.

5. On the Change Pasword window, type the new password in the New Password field. Re-enter the new password in the Confirm Password field and then click Change Password. See Figure 6.1.5.

Figure 6.1.5 – Change Password Window

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6. It can take several minutes for the system to change the password. While the system is changing the password, users will receive a Please Wait notice. See Figure 6.1.6.

Figure 6.1.6 – Please Wait Notice

7. Once the password is changed, users will receive a Success notification; click Continue. See Figure 6.1.7.

Figure 6.1.7 – Success Notification

• If a user does not receive an e-mail or is unable to change his or her password, the Web Support Call Center is available to assist. The Web Support Call Center phone number is (800) 241-8726.

• Users must have a valid e-mail address on record to use the Forgotten Password option. If a valid e-mail is not on record, users will be directed to call the Web Support Call Center.

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6.2 Changing Password

To change a password, please use the following steps:

1. In your web browser, enter http://pwm.fhsc.com/pwm in the address bar. The Password Self Service Main Menu window appears. Click Change Password. See Figure 6.2.1.

Figure 6.2.1 – Password Self Service Main Menu

2. The Change Password window appears. Type the new password in the New Password field and Confirm Password field then click Change Password. See Figure 6.2.2.

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Figure 6.2.2 – Change Password Window

3. It can take several minutes for the system to change the password. While the system is changing the password, users will receive a Please Wait notice. Refer to Figures 6.1.6 and 6.1.7.

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6.3 Password Expired

You will need to change your password approximately every 41 days. You will not be permitted to log in until the password is changed successfully. The new password cannot be the same as a previous password. If your password has expired, you will be redirected to the Password Self Service Login window.

To change the password, please use the following steps:

1. In the User ID and Password boxes, enter your user ID and password.

2. Click Submit. The Change Password window appears. See Figure 6.3.1.

Figure 6.3.1 – Change Password Window

3. In the New Password box, enter a new password.

4. In the Confirm Password box, enter the new password again to confirm then click Change Password.

5. It can take several minutes for the system to change the password. While the system is changing the password, users will receive a Please Wait notice. Refer to Figures 6.1.6 and 6.1.7.

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7.0 Web Provisioning Frequently Asked Questions (FAQs) This section outlines some of the frequently asked questions we expect to receive from users who attempt to use the User Administration Console.

7.1 PIN Letter Call Scenarios

Q: Where is my PIN letter? I never received it.

A: PIN letters are processed within two business days of the request and mailed first class by the USPS. PIN letters should arrive by mail within 7–10 business days of the request. Contact the Web Support Unit at 1-800-241-8726 between the hours of 8:00 a.m.–8:00 p.m. Eastern Time, Monday–Friday for assistance.

7.2 Registration Call Scenarios

Q: I am a new user and have completed the Request PIN process. What do I do next?

A: The registration process should only be completed if the provider chose you to be the Delegated Administrator. The Delegated Administrator should log in to the User Administration Console website. From the Secure Login window, log in with the user ID and password created during registration. This will bring you to the Welcome window. Click the Register w/PIN tab and enter all required information. Once this information has been submitted, you will receive a confirmation e-mail that will allow you to activate your account. When you click the hyperlink within the activation e-mail, you will be directed to the Login window. Once you log in, you can create new users and assign roles and providers to that user. Refer to Section 4.0 – User Administration Console for more detailed instructions.

Q: I upgraded from a User to an Administrator and have completed the Request PIN process. What do I do next?

A: The registration process should only be completed if the provider chose you to be the Delegated Administrator. The Delegated Administrator should log in to the User Administration Console website. From the Secure Login window, log in with the user ID and password created during registration. This will bring you to the Welcome window Click the Register w/PIN tab and enter all required information. Once this information has been submitted, you will receive a confirmation window advising that the PIN registration process has been completed. You can now administer for the added organization(s).

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Q: I am a Delegated Administrator and have completed the Request PIN process. What do I do next?

A: The registration process should only be completed if the provider chose you to be the Delegated Administrator. You should log in to the User Administration Console website. From the Secure Login window, log in with the user ID and password created during registration. This will bring you to the Welcome window. Click the Register w/PIN tab and enter all required information. Once this information has been submitted, you will receive a confirmation window advising that the PIN registration process has been completed. You can now administer for the added organization(s).

Q: I requested access to your online system and received an e-mail to complete the registration process. What do I do now?

A: Open the e-mail and click the hyperlink to our website. From here, enter the user ID and password that was created during registration and agree to the Privacy and Security Statement. You will now be able to administer for the organization(s) requested.

Q: Can I register with the same login as another user?

A: No. Every user will have a unique user ID and password.

Q: Can I register to work on behalf of a provider that practices in a different state?

A: Yes.

Q: I haven’t received my e-mail with the hyperlink to activate my account. I think I gave you the wrong e-mail address. Can we correct this?

A: Contact the Web Support Unit at 1-800-241-8726 between the hours of 8:00 a.m.–8:00 p.m. (ET), Monday–Friday for assistance.

Q: How do I add users?

A: The Delegated and Local Administrators can add users by following the steps below:

1. From the Welcome window of the User Administration Console, in the Administrator list, select the administrator role, if applicable.

2. Click the Users tab.

3. Click Add New User.

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4. In the First Name, MI, and Last Name boxes, enter the user’s first name, middle initial, and last name.

5. In the User ID box, enter your user ID.

6. In the Password box, enter a password and in the Confirm Password box, enter the password again to confirm.

7. In the Email Address box, enter an e-mail address.

8. In the Phone number box, enter a phone number. Do not enter parentheses or dashes.

9. In the Fax number box, enter a fax number. Do not enter parentheses or dashes.

10. Click Save.

11. Click the Organizations tab.

12. Select the organization(s) to assign to the user by clicking the selection box next to the appropriate record.

13. Click Save.

14. Click the Roles tab.

15. In the Application list, select an application.

16. Click Get Roles.

17. Select the role(s) to assign to the user by clicking in the selection box next to the appropriate record.

18. Click Save.

19. Repeat Steps 15–18 for each application the user needs to access.

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7.3 Password Call Scenarios

Q: I have lost/forgot my password/login ID. What do I do?

A: If the user registered properly, this can be done without the assistance of Magellan. To change your password, please use the following steps:

1. Open the Internet browser.

2. Type the state/program specific web address (format for web address is http://client.fhsc.com or http://client.magellanmedicaid.com) into the URL Address bar and press ENTER.

3. Highlight Automated Response System and select Secure Logon.

4. Click the Forgot Your Password? click here hyperlink.

5. In the Magellan Login ID box, enter your login ID.

6. Click Submit.

7. In the Response to the Challenge Questions box, enter responses for the challenge questions.

8. Click Check Responses.

9. In the Password box, enter a new password. All passwords must be at least eight characters in length and should not include any dashes, punctuation, etc.

10. In the Confirm Password box, enter the new password again to confirm.

11. Click Change Password. A window appears advising that the password has been changed successfully.

12. Click Continue. The Password Management Servlet window appears.

13. In the URL Address bar, enter the state-specific website and press ENTER.

14. In the Login ID and Password boxes, enter your login ID and new password.

15. Click Submit.

Q: I want to change my password before the expiration date. How do I do this?

A: To change your password before the expiration date

1. From the Secure Login window, click the Need to Change Your Password? click here hyperlink. The Password Management Utilities window appears.

2. In the User ID and Password boxes, enter your existing user ID and password. The Change Password window appears.

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3. In the New Password box, enter a new password. All passwords must be at least eight characters in length and should not include any dashes, punctuation, etc.

4. In the Confirm Password box, enter the new password again to confirm.

5. Click Change Password. The Success window appears.

6. Click Continue.

Q: My password expired a while ago. How do I change it now?

A: If the password has expired, the user will be redirected to the Password Management Utilities Login window. To change the password

1. In the User ID and Password boxes, enter your user ID and password. The Change your Password tab appears.

2. In the New Password box, enter a new password. All passwords must be at least eight characters in length and should not include any dashes, punctuation, etc.

3. In the Confirm Password box, enter the new password again to confirm.

4. Click Change Password. The Success window appears.

5. Click Continue.

Q: I accessed the User Administration Console to Add a User. I was asked to create a User ID and Password for the new user. Why can’t I e-mail the password to the user?

A: Unfortunately, due to HIPAA regulations, you are prohibited from e-mailing the user’s password to him/her. May we suggest that you relay this information to him/her verbally?

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7.4 Navigation Call Scenarios

Q: Where can I locate the Training Guide?

A: The User Administration Console Training Guide will be located on the state-specific website and on the Welcome window of the User Administration Console via a hyperlink. If you are having trouble locating the training guide, please contact the Web Support Unit at 1-800-241-8726 between the hours of 8:00 a.m.–8:00 p.m. (ET), Monday–Friday for assistance.

Q: What Magellan programs can I access?

A: This will vary from state to state. Contact the Web Support Unit at 1-800-241-8726 between the hours of 8:00 a.m.–8:00 p.m. (ET), Monday–Friday for assistance.

Q: I am receiving a message that reads “You are not authorized to access this application.”

A: This message appears if the user attempting to log in to User Administration Console is not a Delegated or Local Administrator.

Q: I am receiving a 403 Forbidden error message when trying to access a Magellan web-based application. How do I resolve this?

A: A 403 error message usually is the result of not having the proper role assignment or access privileges. Contact your Local or Delegated Administrator for assistance.

Q: How does single sign-on work?

A: For users accessing the Microsoft® Internet via Internet Explorer, please use the following steps:

1. Access the Magellan Health Services website for the appropriate state/program; i.e., http://client.fhsc.com, or http://client.magellanmedicaid.com (where client = Nebraska, Nevada, etc.).

2. Select a secured application from the lists and log in. Secured applications include User Administration Console (UAC), Pharmacy Web PA, Web Inquiry (EVS), Web Claims Submission, Web RA, and FirstHCM℠. When you select one of these applications from the menus, a new browser window opens, leaving the original browser window with the state Magellan website intact.

3. Go back to the browser window with the state Magellan website and select another secured application from the menus. This application opens in a new window, but

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should bypass the login window and take you directly to the first window (generally a Welcome window or Home window) of the application.

4. Repeat Step 3 for each secured application for which you are registered.

• Users who access the Internet via Microsoft Internet Explorer: Using Start/Internet Explorer or a shortcut on your desktop prompts you to log in, even though you may already have logged in from a previous browser window. This is because of the way Microsoft Internet Explorer handles session information.

For users accessing the Internet via Firefox, once you are logged in to one secured web application, you can bring up a new browser window by any available method and single sign-on recognizes that you are already logged in.

• Regardless of which browser you use, if you log out of one application, you will be logged out of all Magellan web applications open in other browser windows. If you attempt to access a feature from one of the other browser windows after logging out, you will receive a 409 Conflict error message. You will need to log back into the application(s) you wish to use.

7.5 Maintenance Call Scenarios

Q: How do I discard an Administrator (or User)?

A: The Delegated Administrator can discard a Local Administrator by clicking the Users tab and clicking the selection box next to the appropriate user ID and clicking the Discard User button. When discarding a user, this will remove your access to that user but their profile will still exist and they will still have access to any applications and roles. Refer to Section 4.2.5 – Discarding a User Profile for more detailed instructions.

Q: How do I delete an Administrator?

A: You do not have this ability. Only a Global Administrator can perform this function. Please call the Web Support Unit at 1-800-241-8726 between the hours of 8:00 a.m. to 8:00 p.m. (ET).

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Q: If the Administrator removes an organization, will this affect the other users registered under that Administrator?

A: Yes. If an Administrator removes an organization from their access, it will also remove that organization from the users in his/her group unless a user has access to that organization under another Administrator.

Q: I accidentally removed an organization from my access. I am a Delegated Administrator. What do I do?

A: You will have to request a PIN and register with the PIN all over again before you can access that organization’s information. Refer to Section 5.1 – Request PIN and Section 5.2 – Register with PIN.

Q: I accidentally discarded an organization from my access. I am a Local Administrator. What do I do?

A: Contact your Delegated Administrator. He/she will be able to grant you access to this organization’s information again.

Q: I accidentally discarded a user from my access. I am a Delegated Administrator. What do I do?

A: You can acquire the discarded user from the user pool. Refer to Section 4.2.3 – Acquiring Users for more detailed instructions.

Q: I accidentally discarded a user from my access. I am a Local Administrator. What do I do?

A: Contact your Delegated Administrator. He/she will be able to grant you access to that user again.

Q: I need to work on another organization’s behalf. How do I do this? I am a Local Administrator.

A: The Delegated Administrator can request access to this organization via the Request PIN and Register w/PIN tabs on the Welcome window. If the Delegated Administrator requests access, he/she can assign this organization to the Local Administrator’s profile. Refer to Section 4.3 – Organizations Tab for more detailed instructions.

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Q: There is a user in my office that I need to maintain. He/she already has a user ID. How do I get access to his/her user profile?

A: The Delegated Administrator can acquire an existing user and assign to the Local Administrator. If this is a new user, the Local or Delegated Administrator can create the user profile.

Q: How do I assign an organization to an existing user?

A: To add an organization to a user

1. From the Welcome window, click the Users tab.

2. Locate the user record and click the View Details hyperlink.

3. Click the Organizations sub-tab.

4. Click the selection box(es) next to the organization(s) that the user needs to access.

5. Click Save.

Q: How do I assign roles to an existing user?

A: To assign a role to a user

1. From the Welcome window, click the Users tab.

2. Locate the user record and click the View Details hyperlink.

3. Click the Roles sub-tab.

4. In the Application list, select an application.

5. Click Get Roles.

6. In the Organization ID list, select an organization ID, if applicable.

7. Click the selection box(es) next to the role(s) that the user needs.

8. Click Save.

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8.0 Glossary Adjudicate – Magellan runs claim data through a series of edits. Based on client guidelines, the claims data must pass specified edits in order to return a favorable (paid) response. If the edits cannot be passed, Magellan will return a denied response. The process of determination is called the adjudication process.

Algorithm – Formula used to determine reimbursement.

Allowed Amount – The total amount payable for a claim before any deduction (i.e., co-pay and or deductible) determined by the program benefits.

Average Wholesale Price (AWP) – The suggested wholesale price of a drug obtained from the manufacturer/labeler or from a price survey of wholesalers.

Bank Information Number (BIN) – A National Council for Prescription Drug Programs (NCPDP) assigned number used to track payees.

Benefit – The amount to the payee that may be paid by the third-party administrator or insurance company.

Brand Drug – The drug name that appears on the package label. A product that is available by only one manufacturing source or under patent protection (trademark) by one manufacturer.

Cardholder – The person who is receiving the benefits of the program. Typically, we use the term “member” or “subscriber” to refer to persons in a commercial-type program. Persons in a Medicaid-type account are usually referred to as “recipients.”

Client – Typically, we use the term “client” to describe the State/or State User.

CII – A drug that has been assigned a Drug Enforcement Administration (DEA) Code value of “2,” indicating high abuse potential. No refill allowed.

Compound Drug – A compound is made up of two or more ingredients or drugs. Typically, compound drugs are processed differently than noncompound drugs.

Controlled Substance – A drug that is determined by the Drug Enforcement Administration (DEA) to be subject to possible abuse. The DEA applies a numeric schedule indicating the different degrees of possible abuse.

Coordination of Benefits (COB) – A method of integrating benefits payable under more than one group, not to exceed 100 percent of the claim. COB determines the order in which multiple carriers pay benefits.

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Co-pay – The amount that the member/cardholder must pay toward the entire cost of the prescription claim. This may be a fixed dollar amount or a percentage amount. It may vary depending on whether the drug is a brand or a generic and may be influenced by the selected Dispense As Written (DAW) code.

Date of Service (DOS) – The date the prescription is dispensed to the member/recipient. This is also known as DOS or refill date.

Days Supply – The duration (in number of days) that a prescription should last. Most plans have a maximum days supply limit per claim.

Deductible – Amount the member must pay before they are eligible for program benefits.

Delegated Administrator – Manages an organization’s access and use of any Magellan web-based application such as FirstHCM℠ or Pharmacy Web PA. The Delegated Administrator is the one to initially register on behalf of the organization and can assign Local Administrators and/or users to work on behalf of the organization. The Delegated Administrator authorizes and registers Local Administrators and can register and assign users to certain roles and limit their access to specific Magellan applications and/or providers.

Denied – “Denial” refers to a claim status. Claim denials occur if edits are not resolved during claims processing.

DESI – FDA Drug Efficacy Study Implementation program indicator declaring a less than effective drug.

Department of Justice (DOJ) Price – Fair market price set by the Department of Justice.

Dispensed as Written (DAW) – It is also known as the Product Selection Code. The code indicates whether or not the prescriber’s instructions regarding generic substitutions are allowed. Use of the different DAW codes may affect the inclusion of certain products and/or co-pay in claims processing.

Dispensing Fee – The amount, in addition to the ingredient price, paid to the pharmacy for the actual dispensing of the prescription drug.

Dispensing Limits – The amount of therapy (quantity and days’ supply) allowed for a specific benefit program.

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Drug Efficacy Study Implementation (DESI) Drug – These are drugs that were introduced into the market as new drugs from 1938–1962, which were submitted for review by the National Academy of Sciences-National Research Council Drug Efficacy Study Group and still considered by the FDA as less-than-effective meeting their manufacturer’s claims. Most plans do not cover DESI drugs.

Drug Enforcement Administration (DEA) Code – The numeric code denoting the degree of abuse and Federal Control of the drug.

Drug Enforcement Administration (DEA) Number – Unique identification number assigned to a physician/pharmacy by the DEA. The number must accompany a prescription for a controlled substance. The format for this number is always two alphas followed by seven numeric (AANNNNNNN).

Drug Form – A drug form is the method by which a drug is administered. Some common forms include aerosol, vial, cream, syrup, needle, powder, lotion, oil, spray, capsule, tablet, elixir, solution, shampoo, etc.

Drug Utilization Review (DUR) – This is a method by which drug use/therapy is monitored against predesigned standards for utilization.

Durable Medical Equipment (DME) – Typically applies to supply-type products that traditionally are not billed as prescription pharmacy.

Effective Date – The date coverage goes into effect.

ePrescribing – ePrescriptions are computer-generated prescriptions created by your doctor and sent directly to your pharmacy.

Error Claim – A claim that does not go through the adjudication process. This means the provider is submitting a claim that is missing the required data elements.

Example: M/I Group Number

First DataBank (FDB) – FDB is a company that provides both standard and detailed drug-processing data to government and health care organizations. They also provide drug-pricing changes.

Formulary – A listing of covered drugs or products for a particular program.

Generic Differential – The difference between the calculated allowed amounts for the brand and the generic of the indicated products. In the case of a DAW of “2,” where the patient is requesting the brand, the generic differential may be assessed in addition to the co-pay amount.

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Generic Drug – A drug considered to be therapeutically equivalent to the brand name drug but produced by other manufacturers. The generic drug is usually less expensive than the brand name drug. Once a drug has been formulated, the manufacturer will obtain a patent that will not expire for approximately 17 years. During the 17-year period, the drug is sold as a brand name drug allowing the manufacturer to recoup most of the cost for research and development. After the patent expires, other manufacturers can duplicate the drug. The significant difference between a brand name drug and a generic drug is the components that hold the formula together. As a result, generics are graded and classified by how well they duplicate the brand name drug.

Generic Sequence Number (GSN) – A five-digit code that groups together all NDCs that have the same generic chemical composition in the same strength and form.

Gross Amount Due – The total prescription price or expected reimbursement from all sources.

Hardware – Consists of the physical equipment of a computer.

Example: Wires, disks, chips, circuit boards, etc.

HCFA 1500/CMS 1500 Form – A form developed for use typically with the processing of durable medical equipment (DME).

HCIdea℠ – The HCIdea℠ product is a relational database containing prescriber DEA numbers, state licenses, NPIs, multiple addresses, and other prescriber information. It obtains prescriber NPIs from the CMS National Plan and Provider Enumeration System (NPPES) only, the supplier of prescriber NPIs and primary data source. Providing NPPES data in a format useful for those processing Medicaid prescription drug claims solves a nagging problem for the prescription drug benefit industry, which in many cases has been unable to obtain the correct NPI for prescribers.

HIC3 – The specific therapeutic class of the selected drug and is the first three characters of the HICL.

HICL – A unique and randomly assigned six-character number providing a link from either an NDC or a GCN sequence number record to the hierarchical ingredient list.

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HIPAA – A law passed in 1996 that is also sometimes called the Kassebaum-Kennedy law. This law expands your health care coverage if you have lost your job, or if you move from one job to another. HIPAA protects you and your family if you have pre-existing medical conditions, and/or problems getting health coverage, and you think it is based on past or present health. HIPAA also

Limits how companies can use your pre-existing medical conditions to keep you from getting health insurance coverage

Usually gives you credit for health coverage you have had in the past May give you special help with group health coverage when you lose coverage or have a

new dependent Generally guarantees your right to renew your health coverage. HIPAA does not

replace the states’ roles as primary regulators of insurance and guarantees patients new rights and protections against the misuse or disclosure of their health records

Hospice – A facility that treats terminally ill patients.

Host – A computer that allows users to communicate with other computers on a network.

Ingredient Cost – The submitted cost of the drug dispensed.

Innovator – This means that the manufacturer is the first to manufacture the drug.

Legend Drug – Any drug that requires a written prescription from a physician before it can be dispensed. It is also known as Federal Legend.

Local Administrator – Manages application access and security for a local unit or organization. The Local Administrator can enroll users, maintain user profiles, and can assign user roles within the scope of their access rights, which are assigned by the Delegated Administrator.

Lock-In – A recipient is “locked” into using an assigned pharmacy, physician, drug, and/or class of drugs.

Long-Term Care (LTC) – Typically used to denote a long-term facility. Claims processing requirements may differ for LTC processing versus regular retail claims processing.

Maintenance Drug – A medication that is taken to maintain wellness over long periods of time.

Example: High-blood pressure medicine

Managed Access Care Program (MAP) – Magellan pharmacists and technicians review and evaluate DUR criteria based on client guidelines. Criteria are established for use in the

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online adjudication process. Claims will deny if criteria are not met. The staff pharmacists and technicians will evaluate and override requests on a case-by-case basis.

Managed Care – Any system of delivering health services in which care is delivered by a specific network of doctors and hospitals, who agree to comply with the care approaches established by a care management process.

Managed Users – Within the UAC, when a Delegated Administrator views the profile details for a Local Administrator, this tab allows the Delegated Administrator to assign or remove access to users for the Local Administrator selected. This is helpful when a facility has a large number of users to maintain and a Delegated Administrator wishes to “delegate” responsibility of this maintenance to several individuals (Local Administrators) as a way of distributing the workload.

Mandatory Generic Program – A program requiring a generic substitution for brand drugs when the generic is available and the physician has not written “Brand Medically Necessary” on the script.

Mandatory Point-of-Sale – A claims submission program that requires that all claims be submitted online at point-of-sale. Member/recipients are required to use a participating pharmacy and have their claims submitted online.

Manufacturer – Name of the company that produces the medication.

Maximum Allowable Cost or Change (MAC) Penalty – An amount used to determine a patient’s monetary responsibility for a prescription. The patient’s responsibility would be the difference between the cost of the brand name drug and the cost of the generic equivalent (plus co-payment, if any.)

Metric Decimal Quantity – The amount of tablets, capsules, grams, etc., prescribed by the doctor, including fractions or decimals.

Metric Quantity – The amount of tablets, capsules, grams, etc., prescribed by the doctor in whole numbers.

Multi-source – A drug that is produced by more than one manufacturer. Multi-source drugs have both a brand and therapeutically equivalent generic product.

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National Association for the Board of Pharmacy (NABP) Number – A unique identification number assigned to every operating pharmacy. It is a seven-digit number. The first two numbers represent the state in which the pharmacy resides. This number is also referred to as the NCPDP number.

National Council for Prescription Drug Programs (NCPDP) – An organization that sets the standards for automated pharmacy claims processing. NCPDP developed a standard format for electronic claims submission between pharmacy providers, insurance carriers, and third-party administrators. NCPDP standards encompass the data format and field content (field requirements and usage), the transmission protocol (specifications), and other telecommunication requirements.

National Drug Code (NDC) – Every drug is assigned an 11-digit NDC number. This includes OTC products as well as Legend products. The 11-digit number represents 3 sections of information. The first 5 numbers represent the labeler or manufacturer. The next 4 digits represent the product code. The last 2 digits represent the package size.

National Provider Identifier (NPI) – A HIPAA Administrative Simplification Standard. It is a unique identification number for covered health care providers. It is a ten-position intelligence-free numeric, meaning it does not carry over any state or specialty information.

Network – A network (switch) connects the pharmacy via telephone line to Magellan in order to process point-of-sale claims. When a provider submits a POS claim, the data are transmitted through the telephone line to a network (switch). The network captures and sorts the information. The network reads the processor control number then directs the claim to the claims processor. After Magellan adjudicates (processes) the claim, the appropriate response is sent back through the network to the provider.

New User – The third option on the Who are you? window. This option is utilized when a new user who does not have a Magellan login ID wishes to begin utilizing the application to manage his or her organization’s access and/or use any Magellan web-based application.

Non-Participating Pharmacy – When a pharmacy is not part of the client’s pharmacy network.

Obsolete Date – The manufacturer-assigned termination date of an NDC, plus one year.

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Organization – Refers to any facility that is enrolled as a provider conducting business with Magellan, such as hospitals, pharmacies or nursing homes; or any individual provider, such as doctors or Magellan State clients that have a Business Associates Agreement with Magellan to provide Fiscal Agent Services, Pharmacy Services, and/or UM/Prior Authorization Services for the Medicaid population.

Organization ID (Org ID) – The number used initially to identify the organization for which the user wishes to register. Depending on your state’s requirements, this could be a Medicaid ID, NPI/API, or state license number. The Org ID is also used throughout the UAC, along with the organization's name, to further identify the organization when making organization and role assignments to managed users.

Organization Type – Provider – An individual or organization that provides health care services or works on behalf of a health care provider/organization.

Organization Type – State – A state agency that has a Business Associates Agreement with Magellan to provide Fiscal Agent Services, Pharmacy Services, and/or UM/Prior Authorization Services for the Medicaid population.

Out-of-Pocket (OOP) – Maximum amount of dollars the member/recipient is required to pay before receiving a 100 percent reimbursement.

Over-the-Counter (OTC) Drug – These drugs traditionally can be purchased without a doctor’s written prescription. Programs that allow reimbursement for OTC products may require a physician’s written script in order for claim reimbursement through the program.

Package Size – The labeled quantity provided by the manufacturer from which the pharmacist can dispense different amounts of medication.

Example: A patient takes a prescription to the pharmacy for 10 tablets of Tagament. The pharmacist fills the prescription from a Tagament package size containing 1,000 tablets.

Paid Amount – The amount paid by the insurance or third-party administrator to the payee.

Payment Methodology – A pricing or reimbursement formula by which claims are priced according to the program’s guidelines. Typically, there may be several different formulas and the system returns an allowed amount based on the lesser of the formulas calculated by price.

Pharmacy Network – Pharmacies (interconnected or interrelated) that are linked together in relation to payment disbursement.

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Protected Health Information (PHI) – Individually identifiable health information transmitted or maintained in any form or medium, which is held by a covered entity or its business associate.

Personal Identification Number (PIN) – A case-sensitive alphanumeric code generated by the User Administration Console application that is used to verify the identity of an individual attempting to use the application. After the PIN request is made through the UAC, a letter containing the PIN will be mailed to the address of record for that organization. See “Use Alternate Address” for information regarding incorrect mailing addresses. It is the organization’s responsibility to safeguard this information and only distribute it to the appropriate personnel. The PIN can only be used once to complete the registration process.

Point-of-Sale (POS) – Describes a real-time online claims processing environment.

Pop-ups – A separate window that appears as the result of clicking a link or button on the window, and contains supplemental information or options related to the item clicked. Usually the pop-up window is smaller than the original window and may appear without any toolbar or menu options. Sometimes a pop-up window can be resized and/or repositioned to allow comparison between the contents of the pop-up and the original window. At other times, the pop-up window may be a fixed size and will not allow you to reposition its placement. UAC makes limited use of pop-ups.

Practitioner Number – The practitioner number is a unique identification number assigned to prescribers. The number may be assigned by client but is typically the DEA number, State License Number, or NPI. Is also known as the Physician ID.

Preferred Drug List (PDL) – A list of preferred and non-preferred drugs. This list is determined by the client. Drugs are selected first by clinical efficacy and safety, and second by cost effectiveness.

Primary Carrier – The plan or insurance carrier that has the responsibility to pay first on incurred charges. The primary carrier always pays its normal liability without regard to other available coverage.

Prior Authorization (PA) – An override put into the system to allow a previously denied claim to pay. PAs must be issued within the guidelines designated by the client.

Processor Control Number (PCN) – A 10-digit number maintained by Magellan that is used for internal record keeping.

Provider Number – Magellan typically considers the pharmacy to be the provider. The pharmacy provider must be assigned a provider number for a specific client to process a

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claim. The format of the number varies by client. In some cases, the provider number is the pharmacy NABP number or NPI number.

Qualifier – A field that describes the information that will be populated in the corresponding field.

Example: Product/Service 03-NDC

Rebate – A price incentive returned to buyer as specified by a contractual agreement between the purchaser and manufacturer of drugs.

Recipient – Person receiving the benefits of a Medicaid-type program.

Remittance Advice (RA) – A summary listing of claims submitted to and received by Magellan. This summary is sent to participating providers.

Roles – Used to assign access privileges to users. Some applications may have View Only roles versus Submit/Edit roles. The UAC allows Administrators to assign the appropriate role to the users they manage.

Rx Number – A number assigned to a prescription by the provider to identify the claim.

Secondary Carrier – The plan or insurance carrier that pays after the primary plan has paid its benefits. The secondary carrier always considers any benefits paid by the primary carrier when calculating a payment.

Single Sign-On – Makes it possible for a user to log in just once in order to gain access to multiple applications, platforms, and even Internet domains, instead of having to enter a user ID and password for each.

Single-source – A drug that is produced by only one manufacturer. There is no therapeutically equivalent generic product available.

Software – A computerized program that is configured for the pharmacy provider to submit claims to Magellan in the appropriate format.

Software Vendor – A company that develops and sells pharmacy software packages to program users. The software vendors work hand-in-hand with the Magellan Health Services Provider Enrollment Department for program implementation.

Spend Down/QMB – Is to Medicaid what a deductible is to a commercial account. The amount the member must pay before they are eligible for program benefits.

Strength – The drug potency in units of grams, milligrams, percentages, etc.

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Switch – Company that connects the pharmacy to the processor by way of validity checks prior to routing the claim’s data to the processor.

TCC – The Technical Call Center is staffed with pharmacy technicians and customer service representatives. This call center is also known as the Pharmacy Support Center. They will assist providers with calls of a technical nature such as providing DUR codes for provider level overrides or explaining an NCPDP denial code on a claim. In some instances, they will also take participant calls and complete prior authorizations.

Tooltips – A common graphical user interface element. It is used in conjunction with a cursor, usually a mouse pointer. The user places the cursor over an item, without clicking it, and a small box appears with supplementary information regarding the item being hovered over.

Transaction Type – B1 = original, B2 = reversal, B3 = re-bill, E1 = captured claim.

Unit Dose – Indicates if a product is packaged by dose or bulk.

1–Not Unit Dose 2–Manufacturer Unit Dose 3–Pharmacy Unit Dose 4–Custom Packaging

Unit of Measure – A code that indicates how the drug should be measured per unit, when performing price calculations. Tablets and capsules should be measured by counting, liquids should be measured as milliliters, and solids should be measured as grams.

Universal Claim Form (UCF) – This is a standardized form created by NCPDP. Typically used by pharmacists for submitting paper claims.

Upgrade Access – The second option on the Who are you? window. This option is utilized when an existing user or Local Administrator needs to become a Delegated Administrator. This situation may occur when the existing Delegated Administrator is unavailable due to an extended leave or is no longer employed.

User – Refers to the person who will access any of the Magellan web applications on behalf of an organization. The user registers on behalf of the organization to access any of Magellan’s web applications and conducts business on behalf of Medicaid recipients.

Usual and Customary (U&C) – The dollar amount the pharmacy provider would charge a cash-paying customer to include any discounts for senior citizens, children, etc.

User Administration Console – UAC is the Magellan web-based enterprise solution to web registration and security.

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Version/Release – Identifies the format of the transaction sent or received.

Web PA – A web-based application developed by Magellan. It allows prescribers and their Delegated Administrators to enter prior authorizations for recipients and review the drug file to determine if a drug requires a prior authorization.

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8.1 Acronyms

AWP – Average Wholesale Price

BIN – Bank Information Number

CMS – Centers for Medicare & Medicaid Services

COB – Coordination of Benefits

CPhT – Certified Pharmacy Technician

CRN – Control Reference Number

CSR – Customer Service Representative

DAW – Dispense As Written

DD – Drug-to-Drug

DEA – Drug Enforcement Administration

DESI – Drug Efficacy Study Implementation

DME – Durable Medical Equipment

DMS – Disposable Medical Supplies

DOB – Date of Birth

DOD – Date of Death

DOJ – Department of Justice

DOS – Date of Service

DUR – Drug Utilization Review

EAC – Estimated Acquisition Cost

ED – Erectile Dysfunction

EFT – Electronic Funds Transfer

EOB – Explanation of Benefits

ER – Overuse Precaution

EVS – Eligibility Verification System

FDA – Food and Drug Administration

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FDB – First DataBank

FPL – Federal Poverty Level

FUL – Federal Upper Limit

GCN – Generic Code Number

GSN – GCN Sequence Number

GUI – Graphical User Interface

HCFA – Health Care Financing Administration (now CMS)

HD – High Dose

HIPAA – Health Insurance Portability & Accountability Act of 1996

HMO – Health Maintenance Organization

ICD-9 – International Classification of Diseases, 9th Edition

ID – Ingredient Duplication

KDP – Kidney Disease Program

LTC – Long-Term Care

MAC – Maximum Allowable Cost

MAP – Managed Access Program (Magellan Clinical Staff)

MC – Drug to Known Disease

MCO – Managed Care Organization

NABP – National Association for the Board of Pharmacy

NCPDP – National Council for Prescription Drug Programs

NDC – National Drug Code also National Data Corporation

NPI – National Provider Identifier

OBRA – Omnibus Budget Reconciliation Act

OTC – Over-the-Counter

PA – Prior Authorization

PAMC – Prior Authorization Medical Certification

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PBM – Pharmacy Benefit Manager

PCN – Processor Control Number

PDL – Preferred Drug List

PDMS – Prescription Drug Management System

PDP – Preferred Drug Program

PG – Pregnancy Contradiction

PHI – Protected Health Information

POS – Point-of-Sale

PP – Plan Protocol

PRN – Prescription Reimbursement Network

ProDUR – Prospective Drug Utilization Review

QMB – Qualified Medicare Beneficiary

RetroDUR – Retrospective Drug Utilization Review

SR – Prerequisite Drug Therapy

SSN – Social Security Number

TD – Therapeutic Duplication

TIN – Tax Identification Number

TPA – Third-Party Administrator

TPL – Third-Party Liability

UAC – User Administration Console

UCF – Universal Claim Form

WAC – Wholesale Actual Cost

WCS – Web Claims Submission