Empowering Health-Care Professionals with Information at the Point of Service
Several years ago, representatives from a number of Arkansas health-care systems and Arkansas Blue Cross and Blue Shield envisioned a statewide, seamlessly integrated health-care delivery and claims processing and communication transaction system; wherein, the hospitals of the state would be connected to physicians practicing in their facilities, and the various facilities and individual physicians would be connected to each other, to major employers in their regions and to payers by way of a health-data network. AHIN is the communications tool created to implement this vision.
What Is AHIN?
AHIN is an online Internet portal that provides advanced functionality, which allows physicians and hospitals to manage their business functions more efficiently. It was one of the first health-information networks in the United States to offer advanced real-time functionality and continues to offer capabilities that are unique within the industry. This functionality is the primary reason that Hospitals and Health Networks magazine identified Arkansas Blue Cross as one of the "10 Most Wired Health Plans" in the country.
How AHIN Works
Links to Arkansas Blue Cross information systems provide access to eligibility, claims, claim-status, remittance advices, fee schedules and pharmacy pre-authorization information. Links to other Blue Cross and Blue Shield plans provide similar access to this information nationwide. A unique feature allows claim submission and online, real-time correction of erred claims regardless of how they were submitted. An interface with the Arkansas Medicaid system allows access to eligibility for this program.
Users access AHIN through a secure website using all popular Internet browsers simplifying installation and maintenance. Since AHIN operates in this manner, everything necessary to access the system is already present on most personal computers.
Security of data is always a major concern, and AHIN's developers went to great lengths to limit access to patient or other data to a need-to-know basis. The system operates as an extranet and uses both hardware and software controls to limit data access to users with the proper authorization. Access to data stored on the network is through a security system, which is addressable down to the object level, and individuals who have security clearance to view patient or other data are limited to viewing information specific to their organization.
AHIN functions as a repository for demographic, insurance eligibility, claims and related information. In addition, AHIN serves as a conduit through which information — such as referral/precertification processing, claims submission, claim status, remittance advice and claims error notification/correction/resubmission &mdash may be sent from one point to another.
The primary functions provided by AHIN include:
- Demographics: Available for more than a million Arkansas Blue Cross, Health Advantage, Medipak, Medipak Advantage, BlueAdvantage and USAble Mutual Insurance Company members and former members; updated nightly.
- Eligibility: Available for Arkansas Blue Cross and Blue Shield and out-of-state Blue Cross and Blue Shield (Blue Card) plans, Health Advantage, BlueAdvantage Administrators, USAble Mutual Insurance Company and Arkansas Medicaid. Eligibility information for the Arkansas Blue Cross and Blue Shield family of companies is updated nightly. All other eligibility uses real-time interfaces to the host system.
- Fee Schedules: The Arkansas Blue Cross and Blue Shield Fee Schedule is available in AHIN with two ways to access: 1) A Search and Display method from the” Home Page” and 2) a full listing of all codes.
- Claims: Received and processed for all payers, including those who do not accept electronic claims. Claims processing includes electronic error notification to submitters with the ability to perform online error correction and claims re-submission. Information related to claims processed through AHIN is on a real-time basis.
- Claims Status: Available for all Arkansas Blue Cross and Blue Shield and out-of-state Blue Cross and Blue Shield plans, Health Advantage and USAble Mutual Insurance Company. Arkansas Blue Cross and Blue Shield claim status is updated nightly. Information from out-of-state Blue Cross and Blue Shield plans is via real-time interfaces to the host system.
- Remittance Advice: Doctors and hospitals are able to search for and retrieve individual or entire remittance advices. This online availability allows them to be printed, saved to a local machine and be replicated for multiple uses. The remittance advice is provided for finalized Arkansas Blue Cross and Blue Shield, Health Advantage, BlueAdvantage Administrators, USAble Mutual Insurance Company, Medipak, Mediapk Advantage and out-of-state Blue Cross and Blue Shield claims.
- Pharmacy Prior Authorization: Users have the capability to review and track submitted pharmacy authorization requests for patients with Health Advantage, BlueAdvantage or Arkansas Blue Cross and Blue Shield insurance.
- Medical Edit Research: The Edit/Coverage function provides users with procedure-code-specific member coverage and licensed prepayment edit information.
- Tutorial: The Computer Based Training (CBT) module has an easy-to-use main menu that allows the user to choose to complete each section or only those sections that pertain to their specific job duties. The lessons will allow the user to practice what is learned in each section in a realistic simulation of AHIN.
How Do I Get AHIN?
The best news of all is that AHIN access is free of charge. To gain access to
the system, please complete the following:
Download the AHIN Setup Document and Agreements [pdf, 96 KB]
— Complete, sign and mail the documents to:
Advanced Health Information Network
601 S. Gaines Street
P.O. Box 1489
Little Rock, Arkansas 72203-1489
An AHIN Customer Support Representative will notify the contact person listed
on the AHIN setup document when all testing is complete and provide the
assigned user names and password.
If you have any questions regarding AHIN, you may contact AHIN Customer Support at 501-378-2336 or email: firstname.lastname@example.org.