The provider portal

The provider portal at /provider is for the hospitals, clinics, pharmacies and garages in your network: check a patient's cover, ask before treating, bill after treating, and see when the money comes - without a single phone call to your team.

Inviting a provider

On the provider (under Network > Providers), choose Invite to the provider portal. The front desk gets a set-your-password link by email.

For medical providers

• Eligibility - the front-desk question answered live: type a member number, card number, ID or name, and see covered-or-not, the plan, what the member pays per benefit, and the balances left this policy year. It is the same engine behind the QR code on the membership card, but with the benefit-by-benefit detail, always checked at this provider, so network tiers apply.
• Pre-authorisations - ask before admitting or treating: patient, procedure, diagnosis, estimated cost. The request runs the same checks your medical reviewers see and lands in their queue; the answer - approved amount, validity - appears back on the portal, usually within the day.
• Claims - after treating, submit the bill: patient, date, amount, what was done, and the pre-authorisation number if there is one. It is adjudicated against the member's plan like any provider claim; the portal shows billed, approved and paid amounts as they move.
• Payments - claims are gathered into batches, adjudicated and paid together; each batch appears with its totals and status.

For garages

A garage signed in to the portal sees the motor claims assigned to it and sends repair estimates straight from the claim: parts, labour, other, notes. Your claims team decides on the estimate in the usual screen; the decision and the approved total appear back on the portal. A second estimate on the same claim files as supplementary automatically.

What providers never see

Anything that is not theirs: other providers' claims, customers who were never their patients, your premiums or commissions. Every submission lands in your ordinary queues, with your permissions and approval chains unchanged.

Jobs

Jobs lists the work orders the insurer sends you, also announced by email. Accept or decline each one (say why when you decline), book the appointment, start it and complete it with a note of what was done. Finish by the date shown: the insurer measures how many jobs are done on time.

Invoices

Once a job is completed, Invoices > Send an invoice with your own invoice number, the amount and the tax. Each number can be sent once. You see when it is approved, and when it is paid into your verified bank account.