Determine status of claims. P.O. View member benefit and coverage information. UHSM medical sharing eligibility extends to qualifying costs at the more than 1.2 million doctors, hospitals, and specialists in this network. We are equally committed to you, our PHCS PPO Network, and your overall satisfaction. 0000010680 00000 n On a customer service rating I would give her 5 golden stars for the assistance I received. 042-35949260. e-mail [email protected] Address. Patient Date of Birth*. Wondering how member-to-member health sharing works in a Christian medical health share program? Escalated issues are resolved in less than five business days on average. To register, click the Registration Link for the session you wish to attend. Continued Medical Education is delivered at three levels to the community. How long should it take before I get paid for my services? MultiPlan periodically uses our internal call center to verify provider data via outbound telephone calls. 1.800.624.6961, ext. UHSM is not insurance. Neither CCM nor any Medi-Share member assume any legal obligation to share in the payment of any medical expense incurred by another Medi-Share member. Google Maps, and external Video providers. Our Christian health share programs are administered by FirstHealth PPO Preferred Provider Organization Network. 7914. 7GTf*2Le"STf*2}}:n0+++nF7ft3nbx/FOiL'm0q?^_bLc>}Z|c.|}C?[ 3 endstream endobj 12 0 obj <> endobj 13 0 obj <> endobj 14 0 obj <> endobj 15 0 obj <> endobj 16 0 obj <>stream Simply call 800-455-9528 or 740-522-1593 and provide: PHC's Member Services Department is available Monday - Friday, 8 a.m. - 5 p.m. You can call us at 800 863-4155. All claims from providers must be submitted to our clearing house Change Healthcare, submitting ID 95422. Claim Address: Planstin Administration . Oscar's Provider portal is a useful tool that I refer to often. Provider Application / Participation Requests Our goal is to be the best healthcare sharing program on the planet and to providean AWESOME*experience, every time! For Providers; Vision Claim Form; Help Center; Blog; ABOUT. For all provider contracting matters, grievances, request for plan information or education, etc. RESOURCES. Certain states expressly exempt from insurance regulation healthcare sharing ministries that, among other things, post a specific notice. About Us. Subscriber SSN or Card ID*. Clients whose plan members have access to our networks are required to utilize a MultiPlan and/or PHCS logo on member ID cards and the MultiPlan and/or PHCS name and/or logo on the Explanation of Benefits (EOB) statement. As a provider, how can I check patient benefits information? If the issue cant be resolved immediately, it will be escalated to a provider service representative. You have the right to correct any erroneous information submitted by you or other sources to support your credentialing network application. 1-800-869-7093. 0000015295 00000 n 0000006540 00000 n 0000003023 00000 n Mail Paper HCFAs or UBs:Medi-SharePO Box 981652El Paso, TX 79998-1652. And our payment, financial and procedural accuracy is above 99 percent. The provider's office can enter claims and verify if they have been accepted and are ready for adjudication. U30\se pQr/Wg>00F{KMC'Z810vl@ t] endstream endobj 8 0 obj <>>> endobj 9 0 obj <>/Font<>/ProcSet[/PDF/Text]/XObject<>>>/Rotate 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 10 0 obj <> endobj 11 0 obj <>stream All providers are required to submit claims and encounters using current HIPAA compliant codes, which include the standard CMS codes for ICD10, CPT, HCPCS, NDC and CDT, as appropriate. 0000067362 00000 n 0000075951 00000 n Contact Change Healthcare (formerly EMDEON): 800.845.6592 How do I handle pre-certification and/or authorization and inquire about UR and case management procedures for PHCS and/or MultiPlan patients? . Provider Services: 800.352.6465 Claim Submissions: Mail: MagnaCare P.O. Was the call legitimate? Contact Us. We accept the revised CMS-1500 and UB-04 forms printed in Flint OCR Red, J6983, (or exact match) ink. We're shifting the power back into the employer's hands through pricing transparency and claims auditing technology. * For practitioner and ancillary services only-for facilities, the member's plan is using a Medicare reimbursement-based model . P.O. The following information must be included on every claim: Claims that do not meet the criteria described above will be returned to the provider indicating the necessary information that is missing. 1-855-774-4392 or by email at 0000081130 00000 n If you are a rural hospital participating in the MultiPlan or PHCS Network, you may submit an application for a grant. The self-funded program has a different Customer Service phone number: 1-877-740-4117. Eligibility and claim status information is easily accessible and integrated well. 0000015033 00000 n We have the forms posted here for your convenience. Refer to the patient's ID card for details. Claim Watcher is a leading disruptor of the healthcare industry. Simply call (888) 371-7427 Monday through Friday from 8 a.m. to 8 p.m. (Eastern Standard Time) and identify yourself as a health plan participant accessing PHCS Network for Limited Benefit plans. 0000081511 00000 n How can my facility receive a Toy Car for pediatric patients? The network PHCS PPO Network. PHC Californias Claims department date stamp, For clean claims, expect reimbursement within 45 days of PHC Californias receipt of the claim if submitted on paper, You will receive an Explanation of Benefits (EOB) that details how each service is paid, You will receive an Explanation of Payment and Recovery Detail (EOPRD) when PHC California identifies a previous claim overpayment. Box 8504, Mason, OH 45040-7111. If you are calling to verify your patient's benefits*, please have a copy of the member's ID card easily accessible. . Please do not send your completed claim form to MultiPlan. 0000012196 00000 n To pre-notify or to check member or service eligibility, use our provider portal. 0000007073 00000 n Benefits Administration and Member Support for The Health Depot Association is provided byPremier Health Solutions. At Amwins Connect, we're proud to partner with some of the nation's premier health insurance service providers and companies. 0000011487 00000 n Westlake, OH 44145. Benchmarks and our medical trend are not . UHSM serves as a connector, we administer the cost-sharing program and help health share members support each otherits AWESOME! 1. within ninety (90) calendar days, or as stated in the written service agreement with PHC California. Call: (800) 474-1434, Monday through Friday, 8:30 a.m. to 5:30 p.m. All Other Providers* . Our website uses cookies. Save Clearinghouse charges 99$ per provider/month For corrected claim submission(s) please review our Corrected Claim Guidelines. Electronic Options: EDI # 59355. You and your administrative staff can quickly and easily access member eligibility and claims status information anytime, on demand. Health Equity | Customer Service 866-212-4721 | memberservices@healthequity.com. If so, they will follow up to recruit the provider. To set up electronic claims submission for your office. By continuing to browse, you are agreeing to our use of cookies. Blue Cross and Blue Shield of Illinois (BCBS IL) (Mercy Chicago) | PPO Customer Service Inquiry Unit (800) 327-8497 | HMO/BlueAdvantage Service Inquiry Unit (800) 892-2803 | www.bcbsil.com. By continuing to browse, you are agreeing to our use of cookies. Call 1-800-716-2852 or the number on the back of your member ID card for immediate assistance regarding your care or a bill. PHC California will process only legible claims received on the proper claim form that contains the essential data elements described above. You can be assured that we do all we can to keep the relationship between our two most important constituencies MultiPlan payors and providers healthy and effective. We know that the relationship between you and your doctor is vital. Notification of this change was provided to all contracted providers in December 2020, Doctors orders, nursing or therapy notes, Full medical record with discharge summary, All ICD10 diagnosis code(s) present upon visit, Revenue, CPT, HCPCS code for service or item provided, Name and state license number of rendering provider, Current Procedural Terminology (CPT) for physician procedural terminology, International Classification of Diseases (ICD10-CM) for diagnostic coding, Health Care Procedure Coding System (HCPC), Telephone: (800) 465-3203 or TTY: (800) 692-2326, Mail to NPI Enumerator P.O. 0000041180 00000 n How do you direct members to my practice/facility? We are a caring community dedicated to keeping our members healthy, happy, and in control of their well-being. Kaiser HMO Plan | Nurse Line 800-777-7904 | Customer Service 800-777-7902 . Should you experience difficulties with a particular payor during your participation in our Network, we will work closely with you and the payor to resolve any issue. 3 Contact Us - The Health Plan. For Allied Benefit Systems, use 37308. For best results, we recommend calling the customer service phone number shown on the back of your ID card. That goes for you, our providers, as much as it does for our members. That telephone number can usually be found on the back of the patients ID card. 866-842-3278, option 1. contact. Medi-Share members are exempt from the individual mandate in the Patient Protection and Affordable Care Act. Providers who use ClaimsBridge obtain the following benefits: . Scottsdale, AZ 85254. What are my responsibilities in accepting patients? This video explains it. Have you registered for a members portal account? 0000072643 00000 n UHSM is excellent, friendly, and very competent. To become a ValuePoint by MultiPlan provider, send an e-mail to valuepoint@multiplan.com. Welcome to Claim Watcher. . You should receive your payment within 30 business days after the patients claims payer has received a completed legible claim, as required of our clients by our participating provider agreements. PATIENT STATUS SINGLE MARRIED OTHER EMPLOYED FULL-TIME PART-TIME STUDENT STUDENT . Mail Paper HCFAs or UBs: We offer making and maintaining every individual's profile by our professional doctors on monthly basis. 800-527-0531. 0000081674 00000 n Customer Service fax number: 440-249-7276. Providers needing to check an insured's eligibility or claim status will need to refer to the information on the insured ID card. Contact the pre-notification line at 866-317-5273. Documentation required with a CMS1500 or UB04 claim form: Standard Code Sets as required by HIPAA are the codes used to identify specific diagnosis and clinical procedures on claims and encounter forms. If you're a PHCS provider please send all claims to . Quality - MultiPlan applies rigorous criteria when credentialing providers for participation in the PHCSNetwork, so you can be assured you are choosing your healthcare provider from a high-quality network. Contents [ hide] 1 Home - MultiPlan. I called in with several medical bills to go over and their staff was extremely helpful. P.O. 0000067249 00000 n Claim Processing Information Request for Claim Reconsideration (Fillable PDF) HIPAA Connect / EDI Claims Non-participating Provider Waiver of Liability form Apr 25, 2022 1-800-924-7141 The corporate Provider Service phone lines are open Monday - Friday, 8 a.m. to 5:15 p.m. (ET). ABOUT PLANSTIN. 0000072566 00000 n Three simple steps and a couple minutes of your time is all it takes to obtain preauthorization from UHSM. Providers can access myPRES 24 hours a day, seven days a week. As Health First Health Plans continues in partnership with Oscar to support key operational tasks to improve our members' and providers' experience, we have become aware of some claims configuration issues that have resulted in incorrect and/or delayed payment. If emailing an inquiry please do not . Login to myPRES. Really good service. Send your completed HCFA or UB claim form with your regular billed charges to the claims remittance address indicated on the patients ID card. Can I have access to and review the credentialing/recredentialing information your network obtained to evaluate my application? 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