Report Inquiry

Health Plans: 

  • AmeriHealth Caritas Louisiana,
  • AmeriHealth Caritas New Hampshire,
  • AmeriHealth Caritas PA Community HealthChoices,
  • AmeriHealth Caritas Pennsylvania,
  • Horizon NJ Health,
  • Keystone First,
  • Keystone First Community Health Choices,
  • Select Health of South Carolina

Workflow: 

  • Report Inquiry

This transaction lets you view Administrative, Clinical, and Financial, and Member Clinical Summary reports.

To search for a report:

  1. On the Health Plans menu, choose your health plan.
  2. Under Workflows For This Plan, select Report Inquiry, and then click one of the following report types (the report types that are available may vary by health plan):
    • Administrative Reports
    • Clinical Reports
    • Financial Reports
    • Member Clinical Summary Reports
  3. On the Report Select screen, the Select Report list contains all the reports that are available for the category that you chose. Select a report type.
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    In the Report Criteria section:
    • Enter all the required fields.
    • Depending on the type of report you are searching for, the Report Search screen might include a Report Type section, in which you can select one of the following formats:
      • PDF: To view the report as a PDF document in a new window. You may print the report or save it for later reference. When you are done viewing the report, click the X in the upper right corner of the screen to close the pop-up window. If you do not have Acrobat Reader, you can download it from the Adobe website. If the Report Search screen does not include a Report Type section, the report will display as a PDF document.
      • Excel or CSV: To download the report in Excel or CSV (comma-separated value) format. A Save As dialog box appears. Navigate to the location where you want to save the report and click OK. If you have Excel installed on your machine, you can view the report as an Excel spreadsheet. If you do not have Excel, you can view the report in CSV format in a text editor such as Windows Notepad.
    • Click Search.

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  4. If you selected a clinical report and this is the first time you have requested clinical information, the User Clinical Access Confirmation screen appears, asking whether you are authorized to view reports with sensitive clinical data. 
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    • Click Yes if you are authorized to view reports with clinical data. The system records your response, and you will not be asked this question again.
    • Click No if you are not authorized to view reports with clinical data. The system records your response. If you need to access clinical information in the future, the User Clinical Access Confirmation screen will appear again.
    • Click Exit to return to Plan Central. The system does not record your response. If you need to access clinical information in the future, the User Clinical Access Confirmation screen will appear again.

Tips

  • If you request access to a clinical report and you are not sure whether you are authorized to view reports with clinical data, click No on the User Clinical Access Confirmation Screen.
  • Please note that once you have access to clinical information, you will need to attest your authorization every 60 days.

 

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