Fill out the form below and we will connect you with the right resource(s) to have all your questions answered. Please do not send us paper claims. Enrollment Inquiry & Support Tool Let us know how we can help you. ISA-08 GS-03 Keystone Health Plan East Independence QCG ; Keystone Health Plan East POS . describe a time when you were treated unfairly. Provider Tax Identification Numbers will 2023 MultiPlan Corporation. 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 P.O. PHCS: If your patient has ONLY a PHCS logo on their ID card, please submit claims to: Payer ID: 36326 54704 : 95056 . %PDF-1.6 % They are the best source to assist you with claims status including payment and denial information. continue to be required by FCE for claims processing and reimbursement. If you're a provider or provider's office interested in partnering with Nova to deliver a direct primary care solution, please contactAskNova@novahealthcare.com. PO Box 21702 Eagan, MN 55121 Utilization management Call 844-966-0329 or fax 888-302-9325 to contact our utilization management team. Main Building. Claims may be submitted to the following address: WPS Health Insurance. gg*HAvr~-qxG1qb[-~xxp(K3%Qlexubmdt6G=vxpvvqI7I:Sb I$3I$; ]\N1M*JCIQ. j=d.createElement(s),dl=l!='dataLayer'? Providers - Vitori Health PO Box 21342 Eagan, MN 55121-0342. . FCE is Corporate Address Mail correspondence to: Claims submission | Providers | Independence Blue Cross (IBX) 0 Contact | WPS - WPS Health Box 211422, Eagan, MN 55121 PPO Network Your patient's health plan accesses no network. Box 211184. For electronic claims submission please use electronic payer ID: 27034 . The Provider Claim Redetermination Request Form is processed within 30 days of receipt. <> PO Box 211428 How long does the provider credentialing process take? Medica | Claim Submission and Product Guidelines Claims should be itemized and state the provider of the service, diagnosis, date of service, services provided, and amount charged for the services. P.O. You may request that the provider of services file the claim on your behalf. Dental pre-estimates can be faxed to TLC Benefit Solutions, 229-249-9840, or mailed to P.O. PO Box 211286 Eagan; MN 55121 (847) 298-6000 (847) 298-5802; AHPO-ResolutionCtr@Aah.org 374 1780741488; . Attachment/Appeal Fax# 952-992-3024 . P.O. Valid and registered : NPI is . x}[s6{&.JIOwZd o/v//lwzv}|y_&TBn}?l.}oQdMy{~HbSMP7 s~o[}tUG0/Nyo{,J:T$aI|H@O_jVLyjV@>G77 Aug@GQO_>d+l6T5>A.1z{;|})eE&)35~5om[|{w-re^P=Jw"4Y]GW>+>4 *lBC3zcmW~\U0e.t^j2PtTU/%xz.w`]7OBu'!EW>K(>QEJ@&lh5. All Rights Reserved. Fax: 1-800-953-8856 Phone: 1-800-953-8854 Pre-Service appeals, services have not yet been rendered or appeals where the member is in a hospital/facility are considered MEMBER APPEALS. PO Box 21631 Eagan, MN 55121 . Mental Health, Behavioral Health, and Substance Use Disorder Claims rendered by in and/or out-of-network providers: EDI Payor #39026. 12X25 : Claims Receipt Center . stream.support@sdata.us endobj 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). 1 0 obj Resources. Easy Access to HIPAA Compliant Patient Information and Much More!
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