Provider Network/ Provider Portal
Provider Self-Service

Provider Portal

Welcome, Dr. Amelia Chen · NPI: 1234567890 · Effective: Jan 1, 2025

12
Open Auth Requests
34
Pending Claims
3
Unread Messages
7
Roster Updates
Claim Status Lookup
Claim Details
Claim IDCLM-2025-08812
PatientMaria Gonzalez
Date of ServiceMar 14, 2025
StatusIn Adjudication
Billed Amount$342.00
Allowed Amount$287.50
Paid Amount—
Expected Payment~5–7 business days
Try: CLM-2025-08812, CLM-2025-07441, CLM-2025-09003
Submit Auth Request
Secure Messages
UR
UM Department
Auth decision: PA-2025-03391 — Approved
10:22 AM
CM
Care Manager — Rosa Diaz
Follow-up: Maria Gonzalez discharge plan
Yesterday
CR
Credentialing Team
Recredentialing documents due April 30
Mar 28
My Patient Roster
Patient Name Plan Member ID Last Visit CCM Status Next Appt
Gonzalez, MariaMedicare AdvantageMBR-4412Mar 14, 2025EnrolledApr 10, 2025
Thompson, JamesCommercial HMOMBR-3801Mar 8, 2025Not EnrolledMay 2, 2025
Patel, SunitaMedicaid ManagedMBR-5227Feb 28, 2025EnrolledApr 28, 2025
Williams, RobertMedicare AdvantageMBR-2998Mar 19, 2025PendingApr 18, 2025
Kim, JanetCommercial PPOMBR-6614Mar 22, 2025Not EnrolledMay 15, 2025
Okonkwo, EmekaMedicare AdvantageMBR-7734Mar 5, 2025EnrolledApr 4, 2025
Chen, LisaCommercial HMOMBR-8841Feb 18, 2025Not EnrolledMay 8, 2025
Rodriguez, CarlosMedicaid ManagedMBR-3312Mar 27, 2025EnrolledApr 25, 2025
Foster, HelenMedicare AdvantageMBR-5589Mar 12, 2025EnrolledApr 12, 2025
Nguyen, DavidCommercial PPOMBR-9903Feb 22, 2025PendingApr 22, 2025
Page Guide — Provider Portal
Getting Started
The Provider Portal is your self-service hub for managing claims, authorizations, patient rosters, and secure communication with the health plan. All actions are HIPAA-compliant and audit-logged.
  • Quick stat strip shows items requiring attention
  • All data is real-time from the core platform
  • For urgent clinical questions call 1-800-EKL-CARE
Claim Status Lookup
Enter a claim ID to see real-time adjudication status, allowed amounts, and expected payment dates. Claim IDs can be found on the ERA 835 remittance or claim submission confirmation.
Auth Requests
Submit prior authorization requests directly. SLA timelines:
  • Routine: 7 calendar days
  • Urgent: 72 hours
  • Emergent: 24 hours (contact UM directly for stat cases)
Attach clinical documentation to support the request.
My Patients & CCM
Your patient roster shows all members who have you listed as their PCP. CCM (Chronic Care Management) status indicates enrollment in the care management program. Click "View" to see the full care plan and communicate with the care team.