1. Log onto the Physicians Plus homepage at www.HealthyChoicesBigRewards.com
2. Click on the orange GO-TO link located on the left side of the page, and you will be directed to the GO-TO Home page.
3. Click on the Sign Up for a Provider Account link under the Provider Service header.
4. You will be directed to the Request Web Account page. Click on I Agree if you have read and agreed to the terms of usage outlined on the page. Otherwise, click Cancel and you will be directed back to the GO-TO Home page.
5. After agreeing to the terms of usage, you will go to the Account Information Entry page where you will sign up for an account.
6. Fill out the required fields on the screen. You may register using either your Physicians Plus provider ID number or your tax ID number (do not fill out both fields). You may enter multiple provider IDs using commas to separate each ID in the Provider ID(s) field. If you sign up using a Tax ID Number (TIN), you can only enter one TIN per account.
7. Click Submit once you have filled out all of the required fields on the Account Information Entry screen, and the User ID and Name that you have requested will be displayed.
8. Click OK and you will be returned to the GO-TO Home page. You will be notified by e-mail when your request for an account has been processed. Processing your request could take up to two business days.

Once your request for an account is approved, you can log onto the GO-TO Provider site from the GO-TO Home page. You may login one of three ways:

• The User ID and Password fields on the left side of the home page
• The GO-TO for Providers link under the Provider Service header and then login as prompted
• Clicking any link under Providers, then clicking GO-TO for Providers on the left side of the page

If you signed up for your account with provider ID numbers:

The Provider Home page will display two tables:

1. Provider Statistics - This table displays a list of all of the providers to which you have access. You will see statistics for each provider, including the number of members assigned to the PCPs. Clicking on the number in the Members column will bring up a list of members who selected that provider as PCP.



2. In-Process Claims Aging - This table displays statistics for each provider on the number of claims that are in process and for how long they have been processing.

If you signed up for your account with a Tax ID Number:

The Provider Home page will display the Provider Statistics and In-Process Claims Aging tables, which contain aggregate statistics for all of the providers under your TIN and do not list each provider separately.

Authorization Status

The Authorization Status link will take you to the Authorization Search page. Enter your search criteria and click the Search button at the bottom of the form. GO-TO will return a list of all authorizations that meet your search criteria and that are accessible under your login.

The Search buttons next to the Referring Provider ID and Referred To Provider ID fields will take you to the Physicians Plus Provider Search engine where you can look up Provider ID numbers.

The results of your search will be displayed on the Authorization List page. Note: You will only be able to access authorization data for the providers included under your GO-TO account ID. Clicking on the number in the Auth Number column will take you to the Authorization Detail screen that displays more detailed information about the authorization.

Member Eligibility Status

Clicking on Member Eligibility will direct you to the Member Search screen where you can search for eligibility information on any current Physicians Plus member.

• If you signed up for your account with Provider ID numbers, there will be a drop-down menu at the Provider field that will allow you to select either "All Providers" or one of the doctors included in your login.



• If you signed up for your account with a Tax ID number, there is a Provider Number field available for limiting your search, and the adjacent Find button will open the Physicians Plus provider search engine in order to look up provider numbers.

Enter your search criteria, and click on Search at the bottom of the screen. Note: If you use Member ID to search for a member, you can either enter the first 9 digits of the ID to search for the family or all 11 digits for an individual. The results of the search will be displayed on the Member List page, and you can click on a number in the Member ID column in order to access the Member Eligibility screen for that member.

Note: Member eligibility information is only available for members active on 1/1/2004 or later.

The Member Eligibility screen displays detailed information on the member and includes six links to other sources of member data:

• All Eligibility Dates - This link, located to the right of the Eligibility Information field, will pull up the member eligibility history since January 1, 2001.



• Other Coverage - This link, located to the right of the Eligibility Information field and below All Eligibility Dates link, will pull up a list of any other coverage the member may have.



• Member Benefits - This link, located at the bottom left of the screen, will generate a list of the member's riders. You can click on any of the rider codes and view detailed benefit information for that rider.



• View Claims - This link, located at the bottom center of the screen, will direct you to the Claim Search screen with the member's ID number automatically populated in the search criteria. Clicking on Search will generate a claim list for the member. Note: You will only be able to access claims data for the providers included under your GO-TO account ID.



• View Referrals - This link, located at the bottom center of the screen, will take you to the Authorization Search screen with the member's ID number automatically populated in the search criteria. Click the Search button at the bottom of the form, and you will be taken to an authorization list for the member. Note: You will only be able to access authorization data for the providers included under your GO-TO account ID.



• Benefit Accumulators - This link, located at the bottom right will generate a Deductible and Maximum Out of Pocket (MOOP) Expense Summary for the member.

View Claim Status

The View Claim Status link directs you to the Claim Search screen where you can search for claims data for providers included under your GO-TO account ID.

If you signed up for your account with Provider ID numbers, you can limit your search to a specific provider by using the drop-down menu of providers to whom you have access.

If you signed up for your account with a Tax ID number, there is a Provider Number field available for limiting your search, and the adjacent Find button will open Physicians Plus' provider search engine in order to look up provider numbers.

In any account, you may search for claims using either the full claim number or a portion of it.

Note: Claims are only available for members active on 1/1/2004 or later.

Click Search at the bottom of the form after you enter your search criteria, and you will see a Claim List of results. The results of the search can be sorted by clicking any of the column headers on the Claim List page. For example, clicking Date of Service arranges the claims in ascending order according to the claim date of service. Clicking the numbers in the Claim Number column will direct you to the Claim Detail screen for that claim.

Note to Dentists: The GO-TO system will only display services covered under the medical certificate (examples: TMJ, accidental dental, services that apply to the non-covered dental benefit, and oral surgery). Services covered under the dental certificate will not display on GO-TO. For questions about dental claims, please contact SVA Healthcare Services at 608-831-8181.

On the Claim Detail screen, next to the claim number is a link to the Claim Adjustment Review Request (CARR) form. This link directs you to an electronic version of the CARR form. Provider contact information and member information will auto fill into the form. Check the proper box for the adjustment request and fill in any additional information in the space next to the reason. If applicable, attach a link and click Submit. You will also have the option to print the form.

On the upper right of the Claim Detail screen is the View/Print Explanation of Benefits link. When you click on this a separate window will open with the Explanation of Benefits. Note: Some Explanations of Benefits will take several minutes to download. Others may not open at all due to the size of the file and the configurations of individual computers.

Whenever you see the information icon (the letter i in a yellow circle), you can hover your cursor over the icon in order to bring up more information about the field. For example, the information icon next to the Place of Service (POS) code will display the place of service indicated by the code.

Provider Forms

Clicking Provider Forms will take you to a list of downloadable provider forms.

Change Password

The Change Password link directs you to a form where you can change the password for your account.

For technical questions about the GO-TO Provider Service site, please contact Erin Olson at 608-260-7104 or 800-545-5015 x7104. For all other inquiries, please select from the following:

Provider Service Department: 608-282-8900; 800-545-5015

Mark Bennehoff: 608-260-7179
Service Area: Meriter Hospital; Meriter-affiliated physicians; Dodge, Fond du Lac, Green Lake, Jefferson, Marquette (Montello), Rock, Walworth, Waupaca, Waushara, and Winnebago counties.

Traci Schaefer: 608-260-7077
Service Area: UW Hospital and Clinics; UW Medical Foundation; and Dane County.

Jean Hooverson: 608-260-7027
Service Area: Adams, Columbia, Grant, Green, Iowa, Juneau, Lafayette, Marquette, Richland, Sauk, Vernon, and Wood counties; chiropractic providers; and dental providers.