Medical claims rendered by in and/or out-of-network providers: Aetna Signature Administrators (If the subscriber lives in any of the following states: Alaska, Arizona, Colorado, Connecticut, Georgia, Kentucky, Maine, Massachusetts, Michigan, Nevada, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, Washington) MultiPlan (or PHCS) network providers are prevented, by contract, from differentiating, or discriminating, against members due to certain member characteristics, and are required to render such services to all members in the same manner, in accordance with the same standards and same availability as offered to the network providers other patients. Be sure to include all itemized bills and an EOB from your insurance carrier. Claims Submissions Go Paperless Madison Wisconsin | Quartz Great benefits pay off. WebAs a HCSM, members of Jericho Share voluntarily share in one anothers eligible medical needs based on the acceptance of the Member Information Guide. Farmington Hills, MI 48333, BIN/PCN/Group # vary by product see member's ID card, Any available provider within the Zelis network, Medica Government Programs Claims trademark of Sutter Health , Reg. WebPHCS/Multiplan National PPO Network | Planstin Administration PHCS Your Planstin plan provides access to the PHCS/Multiplan national PPO network of doctors. We also accept 50+ rural and rental networks. To help expedite your claim, it is always best to file based on the information provided on the back of your patients ID card. Health Plan Search PHCS (Private Healthcare Systems, Inc.) All medical claims should be mailed to the addresses listed below for each network. If you have other medical insurance, all medical bills must be first submitted to that carrier for their determination of eligibility. For customer service inquiries, please call (877) 804-4629 or email us at hnascustomerservice@hnas.com. If you are unable to locate a particular specialty, please contact the 1-800 number listed on the back of your ID card. Cookie Preferences. PO Box 2839 Closed Mondays 8 9 a.m. for training. Authorizations: Optum 1-800-873-4575, Eligible Chiropractic Codes for Commercial and Individual Plans Only, Medica Behavioral Health (MBH): 1-800-848-8327, Medica Behavioral Health WebClaims Information Medicare Claims Providers submit claims to Medicare, and Medicare forwards all claims to us for processing. You can search for a provider at PHCS or call 800-922-4362. WebClaims Information Medicare Claims Providers submit claims to Medicare, and Medicare forwards all claims to us for processing. Below is our statement recognizing member rights and protections. Your browser doesn't support JavaScript code, or you have disabled JavaScript. As MultiPlan is not your health plan and we do not maintain information regarding your insurance or health plan, we arent able to assist. 5 digit groups: Claim numbers are 10 digits (CMS-1500) and 11 digits (UB-04); 6 digit groups: Claim numbers are 12 digits, Prior Authorization submitted via email and/or fax number provided on the corresponding form, Medica Our complaint resolution process is a formal mechanism we use to address members concerns about their healthcare from our network providers. Through your health plan you have access to providers in our networks, but we do not administer your plan or maintain information regarding your insurance. Medica with CHI Health Fact Sheet (Accountable Care System Product) Billing provider . Please check with your health plan if you have questions about coverage and network providers for specific products. Harmony by Medica Check-ups, screenings and sick visits for adults and children. If you have claims for GEHA FEHB members and Medicare is the primary plan, GEHA participates in CMS Coordination of Benefits Agreement (COBA) Program and will receive claims and the Medicare primary benefit information electronically from the Coordination of Benefits Contractor (COBC). Medica Health Plan Solutions, BCBS AZ providers submit to payer ID 53589, Prior Authorization submitted via email and/or fax number provided on thecorresponding form, BIN/PCN/Group # vary by product seesee member's ID card, Claim Address (paper submission and correspondence), Zelis/Medica For the PHCS Network, 1-800-922-4362 For PHCS Healthy Directions, 1-800-678-7427 For the MultiPlan Network, 1-888-342-7427 For the HealthEOS Network, 1-800-279-9776 Why is a MultiPlan logo on my insurance ID Card? Effective April 1, 2021, all Quartz claims (except PPO) can be sent to Quartz P.O. For serious accidents, injuries and conditions that require immediate medical care. Medica AccessAbility Solution / Special Needs Basic Care (SNBC) Eagan, MN 55121-0051, Note: When submitting claims under this payer ID, use only the 10-digit member ID. While we strive to keep this list up to date, it's always best to check with your health plan to determine the specific details of your coverage, including benefit designs and Sutter provider participation in your provider network. Note: documents in Portable Document Format (PDF) require Adobe Acrobat Reader 5.0 or higher to view, download Adobe Acrobat Reader. We also accept 50+ rural and rental networks. Providers | Gravie Payer ID: 94265, Benefits/Claims: Medica 1-800-458-5512 Where can I find information about my copay, deductible, benefits, eligibility, etc.. WebThis page is all about Full Form, Long Form, abbreviation, acronym and meaning of the given term PHCS. This includes the right to have complaints addressed in a timely manner through formal procedures, appropriate to the nature of the complaint. If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. Consult our FAQ section if you have further questions on these documents. Medica Symphony HSA WebEagan, MN 55121 For Indiana Residents Who Purchased an Accident and Sickness Product and those covered by a Blanket Accident and Sickness Policy issued in Indiana: You Essentia Choice Care with Medica (Commercial) Inspire by Medica Medica Direct HSA Box 21800 Eagan, MN 55121-0800. Be sure to verify that services are covered under your plan by contacting your insurance company, human resources representative or benefits administrator directly. by providers with Doctor.com accounts when editing their profile on Doctor.com. Rx PCN: MD WebTo file dental claims, use EDI#37086 or mail to GPS PO Box 21424 Eagan MN 55121. Healthcare Provider FAQs If you include the 2-digit suffix for the member, the claim will reject as invalid eligibility for member, InstaMed: 1-866-945-7990 For best results, we recommend calling the customer service phone number shown on the back of your ID card. Medica Choice CareSM PMAP & Medica MinnesotaCare Fact Sheet, Monday Friday, 7 a.m. to 5 p.m., Central Time If you include the 2-digit suffix for the member, the claim will reject as member not on file, Note: When submitting claims under this payer ID, use only the 10-digit member ID. Find a Northern Californian Provider that meets your needs. PO Box 211435 Box 6090, De Pere, WI 54115-6090, All other claims (Badger Care Plus and non-PPO) Quartz, P.O. Essentia Choice Care with Medica (Individual and Family Business) This can be validated through the Change Healthcare payer ID list. Contact Balance by Medica WebUse this guide as a reference tool when submitting professional claims. If your patients group ID number is made up of 8 characters (e.g. Benefits are administered through Gravie with primary and regional leased networks through Aetna, Cigna, and PHCS/Multiplan. Version: 4.0.30319.42000 The PHCS and MultiPlan networks are networks of medical doctors and facilities that health plans use in order to provide a broader choice of healthcare providers offering discounted services to their members. How can I find it? If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. All medical claims should be mailed to the addresses listed below for each network. All dental claims should be mailed to GEHA at the appropriate address below: Medical claims rendered by in and/or out-of-network providers: Note: documents in Quicktime Movie format [MOV] require Apple Quicktime, download quicktime. We also accept 50+ rural and rental networks. WebChoose Click here if you do not have an account for self-registration options. How can my doctor participate in your networks? Or, mail to: Revolutionize Your Healthcare Administration with Planstin Phone: (800) 821-6136, UnitedHealthcare Choice Plus (If the subscriber lives in any of the following states: Alabama, Arkansas, Delaware, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Mexico, North Carolina, North Dakota, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington DC, West Virginia, Wisconsin and Wyoming) WebFor more than 30 years, Fringe Benefit Group has designed programs that simplify the benefits process for employers with hourly workers. Reach out to us directly at 866-545-2955 or questions@jerichoshare.com. WebHIGHLY TRAINED CLAIMS STAFF Our highly trained claims staff is prepared to meet the needs of national and regional clients throughout the claim lifecycle. Medica with CHI Health Eagan, MN 55121, Mental Health, Behavioral Health, and Substance Use Disorder Claims rendered by in and/or out-of-network providers: PHCS While we strive to keep this list up to date, it's always best to check with your health plan to determine the specific details of your coverage, including benefit designs and Sutter provider participation in your provider network. WebClaims Information Authorizations Patient Experience Surveys Forms Health Navigator Screening Request You can contact us by phone, or by mail. Professional Payer ID Provider Number Reference If the charges are not paid in full by the other medical insurance carrier, A-G Administrators will need to see that carriers EOB prior to considering eligibility for benefits. hb```M2 ea`0 The MultiPlan Network is a nationwide complementary PPO network. Box 30783, Payer ID: 94265 + For paper claims, please submit to Vivida at the following address: Vivida Health PO Box 211290 Eagan, MN 55121 The benefits of submitting EDI claims include: Improved cost effectiveness Improved claims tracking Electronic acknowledgment of claim receipt Faster payment of claims Better turnaround time for timely reimbursement Medica Pinnacle First. PROVIDER NAME / 2 required fields completed. WebClaim Submission To electronically submit or mail a claim on behalf of a Redirect Health member on the Multiplan PHCS Network, please follow the instructions below. ISA-08 GS-03 Keystone Health Plan East Independence QCG ; Keystone If you do have electronic claim submission capabilities, please submit claims electronically. GRV12345) then you will want to visit PreferredOnes provider portal for that patient. Note: documents in Excel format (XLS) require Microsoft Viewer, download excel. provider's profile, including items like having a photo, a biography,
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