Updates to Select Health's Online Tools (PBT & Preauth Tool)

Select Health makes continual improvements to our online tools. Read below for the latest updates.

• Provider Benefit Tool (PBT) Updates
  • Viewing Provider Letters
  • Dental Providers: Adding Documentation to Pended Claims
• Preauth & Care Plan Tool Updates
  • Hysterectomy Authorization Update
  • Skilled Nursing Facilities (SNF) Now Eligible for Auto-Approval
  • New Inpatient/Outpatient Service Type & Code Type Guide

Provider Benefit Tool (PBT) Updates

VIEWING PROVIDER LETTERS

A new Provider Letters page is now available within the Provider Benefit Tool. This feature allows users to quickly search by Claim ID, Member ID, or Provider, making it easier to locate important communications and access correspondence when needed.

DENTAL PROVIDERS: ADDING DOCUMENTATION TO PENDED CLAIMS

Managing dental claims is now easier. Providers can now upload supporting documentation to pended dental claims before the claim is finalized and processed. This enhancement eliminates the need to wait for final claim adjudication, helping streamline claim resolution and reduce delays.

Is your clinic enrolled in PBT? Enroll today to enjoy all the conveniences that come with this useful online tool.

Questions?  Email us at providerwebservices@selecthealth.org.

Preauth & Care Plan Tool Updates

HYSTERECTOMY AUTHORIZATION UPDATE

Select Health has updated the hysterectomy authorization process to help ensure accurate claim processing and reduce the need for authorization updates after surgery. Please submit both applicable CPT codes on the authorization request:

• CPT code for uterine weight 250 grams or less
• CPT code for uterine weight greater than 250 grams

When submitting the claim, bill only the CPT code that matches the actual uterine weight documented at the time of surgery. Do not bill both codes.

SKILLED NURSING FACILITIES (SNF) NOW ELIGIBLE FOR AUTO-APPROVAL

In-network SNFs can now receive instant approval for initial care days at the time of submission. This enhancement:

• Reduces turnaround time for admissions.
• Provides immediate guidance on medical necessity.
• Improves access to timely SNF care for members.
• Simplifies the submission process with an easy-to-use tool.

To submit a request for auto-approval:

1. Ensure required care meets InterQual criteria.
2. Complete a simple, guided pre-admission survey within the Preauth Tool. (Need access? Follow these steps.)
3. Attach supporting clinical documentation to survey submission.
4. Receive real-time approval for initial days when criteria are met and documentation is sufficient.
5. If criteria are not fully met, documentation is incomplete, or benefit limits apply, the request is automatically routed to Utilization Review for review.

Note: Prior authorization is not a guarantee of benefit eligibility. Please call 800-222-6358 for up-to-date benefit information.

INPATIENT/OUTPATIENT SERVICE & CODE TYPES

The Service section of the Preauth Tool can be one of the more challenging areas for new users when submitting preauthorization requests online. The Service Type & Code Type Guide can provide helpful details on how to complete this section accurately and efficiently.

Pay attention to the following fields when completing this section:

• Code Type: Some services require the use of UM Service Groups as the Code Type rather than individual CPT codes. The Service Type & Code Type Guide includes the appropriate service codes that automatically bundle all required CPT/HCPCS codes, helping ensure requests are submitted correctly and reducing the need for manual code entry.
• Place of Service: Selecting the correct Place of Service (POS) is critical when submitting a request. Entering an incorrect POS can cause the authorization request to error out or process incorrectly. To help prevent these issues, use the Service Type & Code Type Guide to verify that the appropriate POS is selected before submitting the request.

Questions? Email web.preauth.support@selecthealth.org.