Please find resources for our Ohio provider network below. r ; To report compliance, ethics or fraud waste and abuse concerns please call . Providers should submit all claims within ninety (90) days of the date of service for prompt adjudication and payment. Submit claims through the EDI on the back of the member's insurance card. endstream endobj 145 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Box 211595 Eagan, MN 55121 What is the Payer ID? Report Fraud, Waste and Abuse. For the Sonder Health Plans Claims Department: 1 (888) 525-1730 or email us at claims@sonderhealthplans.com. ATTN: Prior Authorizations. /Tx BMC For customer service inquiries, please call (877) 804-4629 or email us at hnascustomerservice@hnas.com. Providers can also call Sutter Health Plus Member Services at (855) 315-5800 for the member's PPG and claims submission address. endstream endobj 127 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 132 0 obj <>/Subtype/Form/Type/XObject>>stream EMC P.O. Last updated on April 14, 2020, We welcome your inquiries. Suite 200 For Care: 888-407-7928 (Edmeon, Gateway, Relay Health, and other EDI Clearinghouses). Vivida Health PO Box 211290 Eagan, MN 55121 . %PDF-1.6 % E\i\z SmartHealth network contracts. If CHA is doing the Utilization Management, then CHA's telephone numbers are printed on the reverse side of the identification card: (800) 301-1824 and (574) 647-1824. 13430 N. Scottsdale Road If you have an HMO D-SNP plan: Fax: 1-833-434-0540 Mail: Devoted Health P.O. At Group Benefit Services (GBS), we help employers do just that. Beacon Health PO Box 202316 Austin, TX 78720 Claim Submission Address: Beacon Health P.O. Members may be fully and personally liable for the cost of unauthorized or out-of-PACE program agreement services. EMC We work with all major clearinghouses that submit through the Utah Health Information Network (UHIN). endstream endobj 143 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Following are helpful resources for health care providers serving participants of the Alliance Coal Health Plan. Beacon Health Options' Online Client Service. available. Box 211468 Eagan, MN 55121. H2TH2P0P0434Pf endstream endobj 129 0 obj <>/Subtype/Form/Type/XObject>>stream 2. J$+>{~Cz^&lg| \ Contact our team 24/7/365, and they'll begin navigating every aspect of your care, from lab results to virtual and in-office scheduling, and follow-up, our team is always there to guide you. H41@UAY!$|@4XR3T"2W^0 3S002 IL Route 53 Corner of Route 53 and Butterfield RdGlen Ellyn, IL 60137 US, 14447 West 159th Street Homer Glen, IL 60491 US. *New vendors must submit a W-9 to Peak TPA for payment. Box 21552 Eagan, MN 55121-9159 Express Scripts Phone: 800-391-9701 Office locations 7001 220th St. SW. Mountlake Terrace, WA 98043 3900 East Sprague Ave. Spokane, WA 99220 Pharmacy Service Phone: 888-261-1756 Fax: 888-260-9836 Get in-person assistance H2TH2P0P0434QE\i\z About. Mailing Address: PO Box 14998, Oklahoma City, OK 73113. H23754VH2P0P0434Pf WELCOME TO BAY BRIDGE ADMINISTRATORS Bay Bridge Administrators is a full-service, nationally recognized, third party administrator of fully-insured employee benefit plans. Cobra Portal. Not all products are available in all states. View Our Profile Get In Touch With Us Anything On Your Mind. Medical Claim. I hereby authorize the following person to act on my behalf in the filing and processing of my appeal or grievance with CountyCare: Name of Authorized Representative . UC will arrive to a health care provider's office accompanied by their current custodian, and with a valid authorization code for services to be rendered. Prescriptions Claim. CountyCare Health Plan P.O. EMC H3329_2020_WEB_FBevents Approved 04172020 The service facility location information. When we researched Aither it described the clear BLUE hue surrounding the Earth - it so happens blue and white are the colors that represent transparency. Payments. PO Box 21531 Eagan, MN 55121 Claim Forms: How to Submit Your Claim A guide for submitting a claim when the service provider does not submit the claim directly. lh 2Is eM Plan Details. All submitted reviews are held for editor approval to ensure that the content is approriate for our website visitors and meets our comminuty content standards. 177 0 obj <>/Filter/FlateDecode/ID[<4F753DC0EE7F46FCB7413606DC16809C><53A043C77D285640AB45E209ABEE4B6F>]/Index[118 116]/Info 117 0 R/Length 190/Prev 518412/Root 119 0 R/Size 234/Type/XRef/W[1 3 1]>>stream /Tx BMC If you have patients whod benefit from our services and want information about our program, you can refer them to us. Box 21747. Box 21943 Eagen, MN 55121 EDI# 35193. Box 1868 Portland, ME 04104 Premium Billing . Box 21155 Eagan, MN 55121. Member or Provider. Grace periods and claims pending policies during the grace period Providers must bill professional claims on the CMS 1500 form and facility claims on the UB 04 form. Fill out the other insurance survey form and mail it to: FirstCare Health Plans, P.O. We have created a brief guide to what an SDR is, how to identify one, and how they can be communicated to CenterLight. Contact Sonder. Ask, review, pay. /Tx BMC EMI Health's payer ID is SX110. We'll Be Glad To Assist You! endstream endobj 134 0 obj <>/Subtype/Form/Type/XObject>>stream Mail Forms and . For submitting medical claims. We administer a wide range of healthcare benefits that cover preventive health to keep your employees well. Our sister company, Edison Healthcare, services hundreds of clients and hundreds of thousands of employees. The Bind personalized health plan will be offered on a fully insured basis to employers with more than 50 employees. Our customer support team is always available to answer questions your staff may have 833-733-8478. We look forward to continuing to work with you in helping enrich the lives of the individuals and communities we serve. Note: When submitting claims under this payer ID, use only the 10-digit member ID. Login to MyFlexOnline lh 2Is eM With a long list of preferential benefits available at no cost to the member, health care becomes more accessiblebecause everyone should be able . H3329_2021_WEBr2 Approved 01192022 YES. Box 21800 Eagan, MN 55121-0800 The provider redetermination time limit for receipt of redetermination request is calculated from the date of original denial or Explanation of Payment (EOP). We want to know about it right away so that we can help fast-track things. customerservice@aitherhealth.com Call Here It's best to call the number on your ID Card that goes to your dedicated team. EDISON HEALTH SERVICES. For details on submitting claims, updating rosters, and other tips, please check our additional provider resources. For any questions regarding claims status, please call Provider Services at 1-800-761-5602, Monday through Friday, from 9 AM to 5 PM. EMC EDI Payor ID: 42011 Mail claims to: American Republic Insurance Company P.O. CONTACT US. EMC Learn more today! Address: 3145 Lexington Ave S, Eagan MN 55121 Large Map & Directions ; Phone: 651-405-3068; Fax: 651-454-9478; TTY: 877-889-2457; . Enrollment in CenterLight Healthcare PACE depends on renewal of its contract with CMS and NYS. 3145 Lexington Ave S, Eagan MN 55121. PROVIDER PORTAL + How do I log in to the provider portal? Peak TPA. Then we toyed with Aither Administrators vs. Aither Health, well you know which won. >pRi&s#T2W^0}s\uDXX,zGr*Y8T` z /Tx BMC Community Health Alliance P. O. Verify Benefits Verify Patient Benefits Get Started. H2TH2P0P0434Pf Alliance Direct Opt-In. H2TH2P0P0434QE\i\z For best results, we recommend calling the customer service phone number shown on the back of your ID card. Box 211681 Eagan, MN 55121 For pharmacy support: Contact MedImpact Provider phone line: 8444012055 Fax: 8587907100 If you require additional communication or to send form and documents, you may: Fax to Centivo Support: 7162191946 Health professionals provide excellent health care to American Republic policyholders. endstream endobj 144 0 obj <>/Subtype/Form/Type/XObject>>stream To join our Ohio provider network, just complete this form. P.O. P.O. hbbd```b``~"d&H`nIdJ$60&M?p0 I X S9W Hy #di`Y}0LH)EA| 6N]`vY6d~ - "@3LpV8JRDg`>` 7( H23754VH2P0P0434QE\i\z Login to eHealthChoices Flexible Spending MyFlex Online allows you to view your FSA, HSA or HRA account balance, submit eligible claims on qualified expenses and access forms. Member's name, date of birth, sex and ID number. lh 3s ~"q /Tx BMC lh 3s 5: Our programs are faith-based and inclusive, and are built Offering employee benefit services including third party administrators, TPAs, employee bridge plans and self funded plans. The Company Careers. P.O. Eagan, MN 55121-0051 Electronic pay ID: 12422 Medica Behavioral Health claims should be submitted to: Medica PO Box 30757 Salt Lake City, UT 84130 Electronic pay ID: 87726 Medica Chiropractic claims should be submitted to: Medica PO Box 212 Minneapolis, MN 55440-0212 Electronic pay ID: 41161 Empower by Medica PO Box Online; Lot Parking; Eagan Post Office Map. Medica Behavioral Health (MBH): 1-800-848-8327. endstream endobj 140 0 obj <>/Subtype/Form/Type/XObject>>stream Box 211533 Eagan, MN 55121 Facility/Hospital Mail* UB-04 / CMS-1450 claim form to: Redirect Administrators Are you sure you wish to report this review as abusive, offensive or otherwise not appropriate for this website? Best of the Web is an online platform connecting businesses and consumers backed by our team of editors. EMI HEALTH PO Box 21482 Eagan, MN 55121 If the claim form is not properly completed, it cannot be processed, and it will be returned. At 90 Degree Benefits we know your patients are your priority and we know the importance of providing comprehensive health plan information 24/7 so you can find what you need quickly and get back to what you do best care for our patients. Box 211256 Eagan, MN 55121 . If you have questions just give us a call at 1-877-762-3515, 8am to 5pm. Prescription Drug Coverage Determination Form (PDF, 25KB), Prescription Drug Coverage Determination Form (Online). Enrollment in CenterLight Healthcare PACE depends on renewal of its contract with CMS and NYS. Box 21524 Eagan, MN 55121 Electronic Payer ID: 65-456. endstream endobj 125 0 obj <>/Subtype/Form/Type/XObject>>stream Eagan, MN 55121. Emails will be answered in the order they were received. /Tx BMC Consumer Health Portal. 888-920-7526 member@planstin.com. Employment Verification: HR@redirecthealth.com, 13430 N. Scottsdale Road Please call our Participant Services Department at, CenterLight Healthcare, 1733 Eastchester Road, 2nd Floor, The Bronx, NY, 10461, United States. Univera Healthcare Attn: Prospective Member Processing P.O. Eligibility. /Tx BMC %%EOF Box 24992 Seattle, WA 98124-0992 Electronic Payer ID: 84-135 . Institutional/UB Claims. For any questions regarding claims status, please call Provider Services at 1-800-761-5602, Monday through Friday, from 9 AM to 5 PM. PO Box 30757 Salt Lake City, UT 84130. Box 21670 Eagan, MN 55121-0670 InterWest. By submitting this review you agree to our Privacy Policy and Terms of Service. Please note that authorized services for PACE participants have no deductibles or copays. How do I become a WPS provider? H3329_2018_WEB_LANDING PAGE_004r1_M Approved 01072019 Mailing Address: Medicare Supplement Claims PO Box 211635 Eagan, MN 55121 Quick Reference Guide Our extensive expertise in TPA means your organization can focus on providing care, instead of the technicalities of a health plan. H23754VH2P0P0434Pf Reviews & Feedback. Box 211592 Eagan, MN 55121-2892 Payer ID 06541 CountyCare Provider Quick Reference Guide January 2021 Page 1 of 2 Provider Services CountyCare Website Visit for documents, forms, important health plan information, and provider and member resources. Complete a claim review form within 60 days of EOP receipt. 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