Monday to Friday, October 1st March 31st Peak Healthcare is a leading provider of post-acute care services, offering skilled nursing, rehabilitation and long-term care in Maryland. 11010 Prairie Lakes Drive, STE 175 Eden Prairie, MN 55344 Claims Status Phone Number: (952) 400-7600 Claim status email - Intake@eclusive.com For additional claims questions, please contact Jovonne Tate at 248-556-9303 For Medical Record Requests or Inquires, please contact the PACE Medical Records Department: Email: PACEMedRec@pacesemi.org One fax represents one claim payments. Answer 3. Ask if we submit to your state already! At CareVention HealthCareTM (CVHC), our client-tailored third party administration (TPA) service, PeakTPATM, offers expertise in health plan management to help healthcare organizations stay focused on care delivery. For more information on how PeakTPA can serve your organization, call us at (833)-609-4609, or click the button below. Provider Forms - Automated Benefit Services Streamline Your Complete Healthcare Data Workflow. If you already paid the bill, include a paid receipt or copy of your cancelled check. Heres how the Sonder Team and our network of providers are working to support our members and continue to keep them save during these trying times. Programs of All-Inclusive Care for the Elderly (PACE). Colorado Springs Office. Zelis simplifies administrative work so employees can focus their efforts more effectively. This field is for validation purposes and should be left unchanged. Forgot your password? CareFirst BlueCross BlueShield website for Providers & Physicians. Peak Healthcare - Home PeakTPA provides complete claims adjudication, processing and payment for your PACE program. Please note that authorized services for PACE participants have no deductibles or copays. Phone 800.207.1018. Rachel Peterson - Director of Claims, PEAK TPA/eClusive - LinkedIn Broker benefits Get in touch. PeakTPA submits your monthly enrollment file to CMS in a timely manner. Our team has extensive knowledge in the self-funded health benefits marketplace and understands how needs vary by company size and industry. To verify benefits, pre-authorizations or questions, contact: 336-550-4040 Phone 336-550-4044 Fax Mail claims to: PACE of the Triad c/o Peak PACE Solutions P.O. I'm a Provider. Please use MM/DD/YYYY format. PeakTPA submits risk adjustment data to CMS based on claims and encounters received, follow-up and correction of errors, and submission of return files to PDAC. We also share information about your use of our site with our social media, advertising and analytics partners who may combine it with other information that youve provided to them or that theyve collected from your use of their services for managing their user experience. Our system allows you to track your RAPS data submission status real time. Our integrated validation, matching, and normalization tools ensure the highest quality data possible, increasing auto-adjudication and reducing manual processing. Box 30760 Tampa, FL 33630-3760. Specialty Providers are responsible for providing quality care for contracted and covered health care services to eligible Members, and for ensuring that any required referrals and/or authorizations have been obtained. Whether you are an employee needing benefits support and information, or an employer wanting employee benefits management . Contact PACE Organization of Rhode Island by filling the form and we will get back to you as soon as possible. Claims Processing | National PACE Association Name Specialty Address City State Zip Phone Distance Map Sort; Map Providers may use the following link to access USPSTF published recommendations. Box 30760 Tampa, FL 33630-3760 For claims status, please call: 866-386-4447 Electronic claims payer ID: 27034 We Want to Hear from You! Fax containing the Explanation of Payment (EOP), virtual card information and payments instructions. Enrollment in Sonder Health Plans depends on contract renewal. Find a Portal. Provider Servicess fax center is open from 8 am to 7 pm. *New vendors must submit a W-9 to Peak TPA for payment. OPIS is offered to providers free of charge and is available 24 hours a day, seven days a week through our interactive intelligence phone system (IVR). Division Director, Member and Provider Services. Peak Health Insurance Corporation is in the process of applying for licensure as a West Virginia health insurance company. Atlanta, GA 30339, April 1st September 30th At Peak One Administration, our mission is to deliver user-friendly employee benefits administration solutions and the highest levels of productivity-enhancing features while out-performing in customer service and attention. Other website users will need to contact Allied directly at 800-288-2078 for forgotten account numbers. Just email providerportal@careventionhc.com or call customer support for the health plan for which you provide services: ArchCare : 866-386-4447 Innovative Integrated Health Community Plans:: 888-374-9900 Troy Medicare : 888-494-8769 Greater Minneapolis-St. Paul Area. ICD-10 Provider Resources - eMedNY ICD-10 Provider Resources - Small Physician Practice ICD-10 Provider Resources - CMS ADDITIONAL RESOURCES Provider Addition/Change Form Request for Claims Review Form WE'RE HERE TO HELP. For Commercial/HMO inquiries, please call 517.364.8500 or (toll free) 800.832.9186. PeakTPA offers a full suite of health plan management and back office services that optimize financial management and fulfill financial management and regulatory requirements. National Provider Identifier (NPI) Only numbers are allowed. Question 5. Simply enter the virtual card number into your card terminal and youre done. CareFirst Provider 233(g)-(n). EZ-NET Login - Cognify Please make sure to confirm Member eligibility and to submit your claims/encounter data into SHP as required to comply with prevailing Medicare and documentation standards. (413) 241-6321 IMPORTANT NUMBERS/ADDRESSES: Authorization Phone Number: Authorization Fax Number: Eligibility TTY Claims Inquiry Serenity Care PACE Center: Claim Address: Peak PACE Solutions PO Box 30760 Tampa, FL 33630 Fax: (314) 961-3456 EDI Payer ID 27034 (413) 241-6321 (413) 747-3979 (413) 241-6321 (413) 734-5440 (413) 241-8967 (413) 241-6321 Contact Us - PACE What you need to know about the coronavirus, COVID-19. Information for Providers | ArchCare We are continuing to operate under normal business hours and are here to assist. What is a TPA In Health Insurance? - HealthCare Recruiters International We are proud to have a network of providers and professionals who are passionate about quality care. a) HCFA-1500 (standard form used by Providers) b) UB-04 or UB-92 (standard form used by Hospitals) 8. Contact us by calling the number on the back of your patient's ID Card or contact us via the 24/7 faxback number (888) 494-4600, and we'll get you the information you need. Zelis Payments delivers payments with enhanced data quality and total access to payments information in one consolidated multi-payer account. 254b, and a deemed Public Health Service employee, under 42 U.S.C. Peak Health, LLC is currently licensed as a Third-Party Administrator in the State of West Virginia. Eagan, MN 55121. We verify the PACE program is receiving proper payment from CMS related to state and county code, Institutional Indicator, ESRD Status and Part D components. Enter a valid 10-digit number. Name *. Question 1. CHA PACE Claims Information | challiance.org The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes. PeakTPA submits encounter data to CMS based on claims received electronically or on paper. The timing of training is based on the clients need. Hours: 8.00 am 8.00 pm 6190 Powers Ferry Road 1866-263-9083 (TTY/TDD: 18006621220) H4393_2016website_CMS Approved For a downloadable version instead of the interactive webpage, click here. LEARN MORE PeakTPA also submits encounter data to many states. Thats where every provider comes in. PeakTPA includes a full suite of management services. Sonder Health Plans, Inc. (SHP) Members have access to Medicare-Covered preventive services at no cost. Enter the following information in order to retrieve your username and password. The best days to call are Wednesday through Friday, if possible, due to lower call volume. Contact - UCHealth Plan Administrators Home - Pinnacle Claims Management Employee Search Employee ID: Last Name: Employee Only Employee & Dependents Business Name. LIFE Beaver County. Peak provides encounter data submission and error correction for PACE organizations based on claims, which is crucial for achieving accurate reimbursement. Box 21631 St. Louis, MO 63119. Provider Portal: October 11 th, 2022: 1:00 pm - 3:00 pm CT: Registration Link > Provider Portal: November 15 th, 2022: 9:00 am - 11:00 am CT: Registration Link > Provider Portal: December 13 th, 2022: 1:00 pm - 3:00 pm CT: Registration Link > Providers may use the following link to access the AHRQ CPGs: Filing a claim shouldnt be stressful. Solutions. . For more information on how PeakTPA can serve your organization, call us at (833)-609-4609, or click the button below. All of our services are now on one site! PeakTPA Providers - acs-benefit-services.zelisenroll.com We also submit the MMR to the PACE Data Analysis Center (PDAC) and provide all related journal entries. 3284 to get started. Providers | PACE of the Triad PACE of the Triad c/o Peak PACE Solutions P.O. WebTPA TTY: 800.745.5555. 401.434.1400. Only numbers are allowed. Care Team - Peak Vista Community Health Centers, Colorado Springs, CO Forget about wasted time from fixing errors. Peak performs back-office functions for PACE organizations, including acting as a Third Party Administrator (TPA) to manage claims from healthcare providers. Please refer to the CDC for the most current updates on the coronavirus status, and we will continue to share updates as situations evolve and change. 7 days a week, H1748_WEBSITE21_V2 About. Phone Number *. For Sparrow Health System inquiries, please . . providers - IBA TPA sales@abs-tpa.com. Our extensive expertise in TPA means your organization can focus on providing care, instead of the technicalities of a health plan. Discover what works best for your business: Choose how your data & payments are delivered. Feel confident with our National PACE Association (NPA) membership, which ensures PACE-tailored services for increased quality and efficiency at a fair price. Contact Us For Information on Benefit Plan Administration | EBMS (888) 216-5210 Role of Primary Care Providers Providers | PACE of the Triad Members Employers Benefits Consultants Providers. Peaktpa.com Site Provider Servicess call center is open from 8 am to 7 pm. Contact Us Drop Us a Line Office 345 Marshall Avenue, Suite 101 St. Louis, MO 63119 Call Us (833)-609-4609 For Provider Services (866) 386-4447 Email Us info@PeakTPA.com Sonder Health Plans, Inc. is an HMO with a Medicare contract. Tax ID Number* First Name* Last Name*. Its where you make a difference. Fax 719.365.5004 Answer 5. Providers - Automated Benefit Services For the Sonder Health Plans Claims Department: 1 (888) 525-1730 or email us at claims@sonderhealthplans.com. A TPA for employee health benefits is "a person or organization that performs administrative services, such as claims processing, adjudication or record-keeping, typically on behalf of an employer that self-insured health benefits," according to an article recently published by Zane Benefits. The six- to eight-week implementation plan includes weekly calls with your staff to ensure a smooth transition to PeakTPA services. Our extensive experience with TPA allows organizations to focus on providing care instead of the technicalities of a health plan. For Provider Services (866) 386-4447 Email Us [email protected] About PeakTPA PeakTPA offers a full suite of health plan management and back office services that optimize financial management and fulfill financial management and regulatory requirements. English. We are always here to help answer any questions. We encourage feedback from all our stake-holders. Last Updated 11/09/2022. BAS Health | Benefit Administrative Systems | Health Care Plans - BAS Site is running on IP address 104.198.3.190, host name 190.3.198.104.bc.googleusercontent.com (Mountain View United States) ping response time 1ms Excellent ping.. Last updated on 2022/08/16 Hours: 8.00 am 8.00 pm You can accept or reject most of these cookies. PO Box 21631. PeakTPA offers a full suite of health plan management and back office services that optimize financial management and fulfill financial management and regulatory requirements. By clicking Accept, you agree to the use of cookies when using this site. Peak TPA. Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network. Experts Since 1996 Administer Custom Plans Client-Focused One-Stop Solution Experts Since 1996 Pinnacle Claims Management has more than 20+ years of experience in managing employee health benefits. Zelis ACH allows the choice of what works best for your business: 835 or Explanation of Payments (EOP) are available in CSV, XLS, or PDF formats, Receive remittances by secure download, secure FTP or secure email. Contact Us - Physicians Health Plan If you are a provider contracted with ArchCare Advantage HMO Special Needs Plan, please call: 1-800-373-3177 If you are a provider contracted with ArchCare Community Life (MLTCP), please call: 1-855-467-9351 If you are a provider contracted with ArchCare Senior Life (PACE), please call: 1-866-263-9083 Learn More CenterPlace , 131 Pleasant Drive, Suite 1 Aliquippa, PA 15001 PeakTPA sends TrOOP notifications to disenrollees as required. You can manage all your payment information in our easy-to-use provider portal. For a downloadable Preventative Services Check List, click here. Dennis MacGillis Call: 1 (248) 341-3025 dmacgillis@abs-tpa.com. Because PACE-RI is both the insurer and provider of care for participants, our providers enjoy great flexibility with care . PeakTPA is a service of CareVention HealthCare. Popular Questions. If you'd like to better understand how HMA can add value to your business, our team would be happy to consult with you. Payment will be made to the Provider of Service unless a paid receipt statement accompanies the bill when claim form is submitted. Eligibility Search Contact Us. C/O Peak TPA P.O. Sonder Health Plans (SHP) believes that Members should have access to the care they need. Suite 320 Answer 1. Need help registering for the PeakTPA Provider Portal, tips for navigating the site, or need to reset your password? Administrative Services; Care Solutions; Analytics; Provider Networks; Resources; Careers; Contact . Provider Portal Info > MultiPlan Peaktpa.com.This domain provided by godaddy.com at 2019-06-07T17:56:42Z (3 Years, 70 Days ago), expired at 2025-06-07T17:56:42Z (2 Years, 295 Days left). PCPs may use any referral documentation type, such as their own internal referral forms, or script for initial referrals to a Specialty Provider; however, if PCP is referring to a Specialist for services that are NOT listed under our Service Specific Referral Not Required List, a PCP Referral Form must be completed and faxed to 1(888) 217-4320 to notify SHP of the referral. For general inquiries & questions, contact us via email. Copyright 2022 - Sonder Health Plans, Inc. |, Service Specific Referral Not Required List. The technical storage or access that is used exclusively for statistical purposes. Contact Us - PeakTPA Faxing this PCP Referral Form indicates to SHP that the Specialist has conducted the required follow-up with the PCP and that the PCP has reviewed the required information and has agreed with the Specialists proposed plan of care. Most services under our Plans do not require Prior Authorization by the plan when services are rendered in an office or similar place of service. To provide the best experiences, we use technologies like cookies to store and/or access device information. Responsible for operational oversight and management of numerous . Peak Provider - Peak Health Third Party Administration - CareVention HealthCare 2420 E. Pikes Peak Ave. Suite #1044 Colorado Springs, CO 80909. Take a look around to learn more. Just fill out our request form below or give us a call at (888) 811-8944, ext. These reports provide helpful insights regarding the performance of your PACE program. PCPs are responsible for initiating specialist referrals and for obtaining or facilitating any required pre-authorizations. Skip to content. Peak is the leading health plan management solutions and services provider in the PACE (Program of All-inclusive Care for the Elderly) market. Login. Print or download data in whichever format you prefer (835, CSV, XLS, or PDF). you may have. With customer-focused and PACE-specific approaches to TPA services, PeakTPA helps your organization remain compliant, obtain accurate reimbursement, and measure performance. Answer 2. We submit data both to the Centers for Medicare and Medicaid services (CMS) and many State Administering Agencies (SAAs) for accurate reimbursement. Customer Service; Flexible Spending Account; Forms & Resource Center; Employers; Producers; Providers; . 100 Garden City Plaza, Suite 110 Garden City, NY 11530. sales@ibatpa.com. We are always here to help answer any questions. Company; Services. Discrimination is against the law: Sonder Health Plans, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex or religion. Weve partnered with Mastercard to provide secure, card-based payments. Jan 2011 - Mar 20165 years 3 months. Consenting to these technologies will allow us to process data such as browsing behavior or unique IDs on this site. Answer 4. Discover what works best for your business: Zelis ACH With ACH, you get paid weeks faster than by mailed check. Peak Pace Solutions Provider Login - Peak Pace Solutions Provider Login English Khmer Portuguese Spanish. (888) 525-1730 Email Provider Services For general inquiries & questions, contact us via email Providerservices@sonderhealthplans.com Fax Provider Services Provider Services's fax center is open from 8 am to 7 pm. Eagan, MN 55121. Contact Information - Serenity Care Legal | Privacy. At CareVention HealthCare TM (CVHC), our client-tailored third party administration (TPA) service, PeakTPA TM, offers expertise in health plan management to help healthcare organizations stay focused on care delivery.We submit data both to the Centers for Medicare and Medicaid services (CMS) and many State Administering Agencies (SAAs) for accurate reimbursement. . Question 4. Provider TIN or SSN is required. Zip Code *. If Unable to Submit Electronically. Contact Us PACE Southeast Michigan For those services that do require prior authorization, such as elective inpatient procedures, please see our Prior Authorization Request Form for completion and submission per instructions on the form. Call 1-855-774-4395 and mention Code MICRO for more information. Healthcare Providers | InsuranceTPA.com We provide monthly claims expense reports organized by service and specialty type.

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