Overview of Horizon Docs

Hello and welcome, thank you for joining, the Horizon Docs training.

Horizon Docs is a web based centralized document repository that allows Horizon to securely exchange documents with providers.

Today's agenda, understanding Horizon Docs, the importance of using Horizon Docs, how to use Horizon Docs, as well as learning best practices within Horizon Docs.

This slide deck will also serve as a quick reference guide for you.

Over the course of this presentation Horizon refers to both lines of business Horizon Blue Cross Blue Shield of New Jersey, and Horizon New Jersey Health.

Horizon Docs is a web based centralized document repository that allows Horizon to securely exchange documents with providers.

Some of the key features is that it's a web based tool accessible via NaviNet provider portal for both Horizon Blue Cross Blue Shield of New Jersey, and Horizon New Jersey Health.

The documents are organized by category and subcategory. Email notification is sent to the designated users when we, Horizon, send a document. Documents are sent to providers based on their tax ID number.

Users are assigned permissions to view documents based on sensitivity level of the document. We will be going over the different sensitivity levels of the documents.

The providers assign their user permissions based on the type of document they should be able to view and what best fits their role and responsibilities within the practice.

There are many benefits of using Horizon Docs, such as to establish a portal for Horizon and providers to exchange documents in an easy and fast way that ensures proof of submission.

We will be reviewing these 4 steps on how to exchange documents with Horizon.

If you already have access to the NaviNet portal, skip to step one. Step 1, 2 and 3, are for security officers only so, if you were not a security officer, please skip to step 4.

If you are new to Navinet provider portal, you will have to register for access to NaviNet. First, register a security officer then set up the permissions for the users to view documents based on sensitivity level of the document on the NaviNet provider portal.

The security officer will be established during the registration process.

The provider security officer registers user emails to be notified when Horizon sends documents.

Horizon users, access Horizon Docs to exchange documents with Horizon by viewing and downloading documents sent by Horizon and you can send an upload documents to Horizon. If you already have access to the NaviNet portal this should be familiar to you.

Just to reiterate if you are not the security officer, please skip step 1, 2 and 3 and begin with step 4. We will be reviewing all the steps.

This slide is very important.

Horizon Docs can only be accessed using NaviNet. All providers must have access to NaviNet to access Horizon Docs if you do not have access to NaviNet there's a link to register, you will provide the requested contact in office information and follow the registration process.

The users who register the provider on NaviNet will automatically be assigned to the security officer for the provider as default, the security officer is a special role that will be responsible for setting up and managing permissions for the users to view documents based on the sensitivity level.

You also will register email addresses of users in your office who should be notified when Horizon sends a new document belonging to a specified category. And just to note the clinical sensitivity level will be the level the user must have to view the document.

The security officer must register everyone in the office that works with our programs. Just to reiterate if you are currently not registered for NaviNet, the 1st person that goes on to register becomes a security officer by default.

Step 2 security officer will now set up user permissions based on document sensitivity.

If a user accesses Horizon Docs, using the same TIN from both the commercial and GP portals, the security officers just set up the same permissions on both commercial and GP portal, so the user has the same experience on Horizon Docs, irrespective of which portal, the user logs into.

There are 3 sensitivity levels that the security officer can enable or disable for each user and this can be modified at any time by the security officer.

The 3 levels are clinical sensitive, which may contain PHI and PII but no financials, only clinical data.

Nonclinical sensitive, which may contain PHI and PII and financials, but no clinical data.

General contains only non PHI, non PII, non-financial data, for example, general Horizon company updates.

Horizon will ensure documents are mapped to the categories and sub categories that in turn map to a particular sensitivity level. For example, the quality improvement liaison may request records for supplemental data. The category is quality, the level of sensitivity for the category is quality. It is mapped to sensitive clinical.

There are two versions of the NaviNet provider portal. One is for Horizon BCBSNJ and the other one is for Horizon New Jersey Health. Please take notice we have 2 sites here for you, and you have to set up users for both Horizon commercial and then for Horizon New Jersey Health.

So, we're going to set up the user permissions now. On the NaviNet toolbar you're going to select my health plan, and then select Horizon New Jersey Health, or Horizon BCBSNJ.

Next step, you're going to go to the Navinet toolbar and select administration and click manage user permission.

On this screen, you're going to select the users whose permission you would like to change and click edit access. This will be repeated for all users who would need access to Horizon Docs. As previously stated the security officer can change the user permissions at any time.

On the user transaction management screen, click, enable. This enables the sensitivity level for the user. Security officers must assign users to 1 or more sensitivity levels based on the types of documents users need to view.

This is a critical step since users will not be able to view documents that map to sensitivity level that they have not been assigned to, by their security officer.

If a user is not assigned to a sensitivity level, they will not be able to see any documents within Horizon Docs. Security officers must assign him or herself permissions in order to view documents on Horizon Docs. We recommend that the security officer assigns at least 1 person to all 3 sensitivity levels. So this way it ensures that, at least 1 person in the office will have access to receive all documents that were sent by Horizon.

Once this step is completed sign out, or the enabling process will not be saved appropriately then sign back into NaviNet.

In the Navinet toolbar select health plans, then select Horizon New Jersey Health, or Horizon BCBSNJ. Under workflows for this plan, select Horizon Docs.

This is a page that shows in the Navinet toolbar. If you select the help icon, a tab open and showcases video tutorials to help you navigate and setup user permissions.

Registering email addresses step 3, the provider security officer registers email addresses to receive email notification of when Horizon sends documents. This serves as an alert for users to enter the portal when documents are available to view and download in Horizon Docs. NaviNet does not have email addresses captured so to ensure that users receive this email notification it is essential to input email addresses attached to each perspective user.

Click yes, on the dialogue box to enter email address information. Note, this dialog box will continue to display until the security officer registers at least one email address for each TIN sensitivity level, combination.

Now to begin registering Email addresses. Multiple email addresses can be registered at one time.

Select a TIN, otherwise known as a tax identification number and sensitivity level from the drop down enter one or more email addresses and click save repeat for each set level and sensitivity needed.

This way an email notification will be sent to providers when Horizon sends a document to that TIN and sensitivity level, we recommend entering at least 1 email address for each TIN sensitivity combination, this is important so you receive a notification, anytime Horizon sends you a document. A security officer can change an email address or sensitivity level access at any time.

Click the security officer to return to this page at any time to change or delete email addresses. Only a security officer has access to this page and information.

The security officer identifier will only be visible to the security officer.

Step 4, we will review receiving and sending documents within Horizon Docs.

After you have selected Horizon Docs, the tab on the top of the screen are Horizon to provider, which is your inbox, or received documents provider to Horizon, which is your outgoing or sent documents, upload documents, which is your composed or sending documents.

Security Officer where you would change user permissions.

The screen displays the login, welcoming the user accessing Horizon Docs. The bell like icon displays the status of document uploads.

Searching and filtering on Horizon to provider page. The search bar at the top of the page can be used to search for or filter documents by TIN, category, subcategory, or date range.

Once you have entered the search criteria for 1 or more of the categories, click the search button, which is the magnifying glass. Documents matching the filters you selected will be displayed. To clear out the search filters, select the round arrow icon.

Provider to Horizon and Horizon to provider are similarly laid out.

Exploration status and actions will be reviewed in detail in the next slide.

We will now further review the icons and additional details about documents sent by Horizon with the Horizon to provider page.

Dark gray icon indicates the document has not expired and can be downloaded. The yellow icon indicates that the document is close to expiring in less than 10 days. The red icon indicates the document has already expired and cannot be downloaded.

The light gray icon indicates the document has expired, but has been viewed and also downloaded. The black eye icon indicates the document has not been viewed. The green eye icon indicates the document has been viewed. The blue arrow icon pointing down, allows you to download the document to your desktop.

Select the resend icon to request the document be resent.

When you click resend a message box will display requesting information of the resend request. Click, Yes.

This page will show you how to upload documents, enter your email address, enter your name, select the category from the drop down list. You will only be able to select categories that your security officer assigned you access to.

To adjust what categories you have access to, you must reach out to your security officer.

Select the subcategory from the drop down list. Only subcategories belonging to the selected category will be visible, select the TIN from the drop down list optional but strongly recommended is to enter the Horizon recipients email and any comments you would like to add. This way, the CQIL will receive an email that you have uploaded a document for them to view in Horizon Docs.

Browse to select the documents you want to upload you can upload up to 10 documents in 1 transaction.

Click next, after entering all the required information on the upload documents page, the next button will only be enabled when all required fields are completed.

Once you click on next a confirmation page is displayed. This allows you to review what has been uploaded if you need to modify anything, click on the back button located on the bottom right corner. If there are no changes click confirm.

Once you click on Next, a confirmation page is displayed. This allows you to review what has been uploaded. If you need to modify anything, click on the back button located on the bottom right. If there are no changes, click confirm.

This now brings us the validation page. This allows the individual sending the document to be able to see the document was successfully uploaded. While the document is being uploaded, the progress of the upload will be displayed in an alert bell icon.

Click on the bell icon to minimize. A green checkmark will signal that the document was successfully uploaded. A red X will be displayed at the pop up window if the document was not successfully uploaded.

If the document was successfully uploaded, it will appear at the top of the provider to Horizon page. If not, it will not appear.

Please do not send documentation through Horizon Docs that we have not specifically requested through Horizon Docs.

It is critical that you continue to use existing channels processes to submit time sensitive documentation, such as authorizations, inquiries, complaints and appeals, claims related documentation.

Now, we will review Horizon Docs categories and sub categories.

Before sending a document to Horizon, please review the attached spreadsheet for categories for documents, sent by providers, sub categories associated with categories, descriptions of the types of documents that should be assigned to each category subcategory and sensitivity level associated with the category.

When reviewing received documents from Horizon New Jersey Health on the Horizon to provider page, please review the attached spreadsheet for categories documents sent by Horizon New Jersey Health subcategories associated with categories, descriptions of types of documents that should be assigned to each category subcategory, and the sensitivity level associated with those categories.

Frequent documents that Horizon quality results and recognition clinical quality improvement liaison send to the providers are the provider gap report is the document name.

The category is patient data and the subcategory is Medicare gap list and sensitivity level is clinical. The R&R payment summary does not contain PHI, but financials, so sensitivity level is nonclinical.

This sheet should be referenced when a security officer is assigning sensitivity levels and category subcategory access to future users.

Thank you for listening. If you have any questions, please email them to Quality_RR@horizonblue.com. In addition please take a few minutes to complete a brief survey monkey questionnaire as we value your feedback.

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