You may also search online at www.multiplan.com: If you are currently seeing a doctor or other healthcare professional who does not participate in the PHCS Network,you may use the Online Provider Referral System in the Patients section of www.multiplan.com, which allows you tonominate the provider in just minutes using an online form. Choice - Broad access to nearly 4,400 hospitals, 79,000 ancillaries and more than 700,000 healthcareprofessionals. Available transactions: HIPAA 5010 Eligibility (270/271) Claims Status (276/277) For more information on requirements and pricing, please visit Availity.com or by calling 800-973-3957. The Loomis Company, headquartered in Berks County, PA, is one of the top 100 diversified insurance brokers in the United States. Pre-notification does not guarantee eligibility or sharing. Male Female. 0000067362 00000 n within ninety (90) calendar days, or as stated in the written service agreement with PHC California. Member Eligibility Lookup. Bookmark it today at, The portal offers specific features for Provider Groups, and we offer education sessions to help groups get the most from these advanced features. . Please be aware that this might . Inpatient Medical Fax Form - Used when Medical Mutual members are admitted to an inpatient facility. Provider Services: 800.352.6465 Claim Submissions: Mail: MagnaCare P.O. Electronic Options: EDI # 59355. . 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. Looking for a Medical Provider? 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. Customer Service fax number: 440-249-7276. Find in-network providers through Medi-Share's preferred provider network, PHCS. 0000006272 00000 n There is a different payor ID and mailing address for self-funded claims. Our technological advancements . To obtain a national provider identifier (NPI) you may: Clean Claim A clean claim is defined as a claim for services submitted by a practitioner that is complete and includes all information reasonably required by PHC California, and as to which request for payment there is no material issue regarding PHC Californias obligation to pay under the terms of a managed care plan. 0000009505 00000 n Don't have an account? That goes for you, our providers, as much as it does for our members. By contracting with this network, our members benefit from pre-negotiated rates and payment processes that lead to a much smoother process and overall cost savings. UHSM medical sharing eligibility extends to qualifying costs at the more than 1.2 million doctors, hospitals, and specialists in this network. What are my responsibilities in accepting patients? Please do not include any confidential or personal information, such as protected health information, social security number, or tax ID. All oral medication requests must go through members' pharmacy benefits. You can also submit your claims electronically using HPHC payer ID # 04271 or WebMD payer ID # 44273. Case Management Fax: (888) 235-8327. P.O. Subscriber Group #*. 2023 MultiPlan Corporation. 0000072566 00000 n How does MultiPlan handle problem resolution? Claim Watcher is a leading disruptor of the healthcare industry. That goes for you, our providers, as much as it does for our members. Chicago, IL 60675-6213 2023 MultiPlan Corporation. MultiPlan uses a variety of steerage techniques including the online searchable database, downloadable directories and direct links from our clients websites. ABOUT PLANSTIN. PHCS screening process is totally non-invasive and includes 0000015295 00000 n Westlake, OH 44145. You save the cost of postage and paper when you submit electronically. 0000011487 00000 n 0000008487 00000 n General. Contact Us. 0h\B} 0000081400 00000 n Box 830698 . Specialists between 8 a.m. and 4:30 p.m. (CST) Monday through Fridays at 800-650-6497. 0000086071 00000 n get in touch with us. This feature allows the provider to check on the status of claims or view an Explanation of Benefits (EOB). Notification of Provider Changes. Information pertaining to medical providers. Inpatient Behavioral Health Fax Form - Used when Medical Mutual members are admitted to an inpatient facility for behavioral health. www.phcs.pk. 0000013227 00000 n 0000010680 00000 n You can request it online or submit your request on letterhead with the contract holders signature via fax at 888-850-7604 or via mail to MultiPlan, Attn: Contract Requests, 16 Crosby Drive, Bedford, MA 01730. Find a PHCS Network Provider. Although pre-notification is not required for all procedures, it is requested. 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. Find in-network providers through Medi-Share's preferred provider network, PHCS. Contact Customer Care. 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. You may obtain a copy of your fee schedule online via our provider portal. We also assist our clients in creating member educational materials. Looking for information on timely filing limits? For Care: 888-407-7928. members can receive discounts of 15% to 20% and free shipping on contact lens orders . Its affordable, alternative health care. 0000041180 00000 n Life & Disability: P.O. The screenings done on regular basis meeting the WHO standards and CDC guidelines and are performed by qualified professionals. We are equally committed to you, our PHCS PPO Network, and your overall satisfaction. 0000021728 00000 n If MultiPlan becomes aware of any discrepancies with your application for network participation, you will be notified of the discrepancy and given an opportunity to correct erroneous information during either the credentialing verification process or through MultiPlans appeal process outlined in the Network Handbook, depending on the nature of the error. Visit Expanded Program on Immunization website for more information, Providing better healthcare to communities. Registration closes one hour before the scheduled start times. And our payment, financial and procedural accuracy is above 99 percent. And it's easy to use whether you have 10 patients or 10,000. The representatives making these calls will always identify themselves as being from MultiPlan. ~$?WUb}A.,d3#| L~G. If you've forgotten your Username, or for additional assistance, please contact Customer Service at 877.927.1112. Benefits Plans . We have the forms posted here for your convenience. Send your completed HCFA or UB claim form with your regular billed charges to the claims remittance address indicated on the patients ID card. 0000096197 00000 n PHC California will process only legible claims received on the proper claim form that contains the essential data elements described above. Only current standard procedural terminology is acceptable for reimbursement per the following coding manuals: CMS-1500 paper claim submissions must be submitted on form OMB-0938-0999(08-05) as noted on the documents footer. Our most comprehensive program offering a seamless health care experience. 0000013050 00000 n For benefits, eligibility, and claims status call Provider Services: If the member ID card references the PreferredOne, Aetna, PHCS/Multiplan, HealthEOS, or TLC Advantage networks please call: 800.997.1750. * For practitioner and ancillary services only-for facilities, the member's plan is using a Medicare reimbursement-based model . Providers who have a direct contract with UniCare should submit. Prior Authorizations are for professional and institutional services only. Providers affiliated with American Plan Administrators have access to vital information at the click of a button, as we maintain a sophisticated internet portal that allows for a plethora of management options. For details on how you can obtain this credentialing/recredentialing information, you can submit a request online. Access what your practice needs when you need it: Policies and Guidelines; Provider and Reimbursement Manuals, New Era Life Insurancehttp://www.neweralife.comhttp://www.neweralife.comFlag this as personal informationFlag this as personal information. PHCS, aims to work on health related projects nationwide. P.O. OS)z COVID-19 Information for Participating Providers. Call the below numbers for immediate assistance or fill out our form and a Redirect Health Team member will contact you shortly. Universal HealthSharefor Medical Providers With Universal HealthShare, a community of individual members funds the payment of medical needs to providers rather than an insurance company or employer benefit plan. Three simple steps and a couple minutes of your time is all it takes to obtain preauthorization from UHSM. Contact Us. Claims Administrator. Online Referrals. 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. 7 0 obj <> endobj xref 7 86 0000000016 00000 n The Company; Careers; CONTACT. For more guidance on filling out CMS 1500 (02/12) and UB-04 claims forms, you can refer to: All individual and group providers are required to enroll with the New Mexico Human Services Department (HSD) to order, refer, prescribe or render services to Centennial Care members to ensure timely claims payments. 0000091515 00000 n 0000072529 00000 n Providers margaret 2021-08-19T22:28:03-04:00. trailer <<40A257F259B54AAD842F003489C5A9D8>]/Prev 101090>> startxref 0 %%EOF 92 0 obj <>stream hb```f`a`g`` l@Q 703|l _K3X5[fnkg(zy v Memorial Hermann Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. P.O. 0000008009 00000 n Contracting and Provider Relations. 13430 N. Scottsdale Road. Provider Portal . To become a ValuePoint by MultiPlan provider, send an e-mail to valuepoint@multiplan.com. All rights reserved. hbspt.cta._relativeUrls=true;hbspt.cta.load(2154169, '6492dd68-8da2-463e-93ff-341059d9879c', {"useNewLoader":"true","region":"na1"}); hbspt.cta._relativeUrls=true;hbspt.cta.load(2154169, '54af1724-1b2e-4497-900e-534e4f8523e3', {"useNewLoader":"true","region":"na1"}); For technical assistance with EDI transactions, please contact Change Healthcare at 1-800-845-6592. However, if you have a question or concern regarding your claims, please contact the Customer Care Team at 1-844-522-5278. (888) 923-5757. 0000047815 00000 n For Providers. How can we get a copy of our fee schedule? For Providers; Vision Claim Form; Help Center; Blog; ABOUT. UHSM Health Share and WeShare All rights reserved. For communication and questions regarding credentialing for Allegiance and Cigna health plans . To view a claim: . Provider TIN or SSN*(used in billing) Claims payment disputes, appeals, and supporting documentation such as copies of medical records, authorization forms, or other documents can be submitted to: Attn: ClaimsPHC CaliforniaP.O. To reach us by phone, dial the toll-free number on the back of the, You can find this phone number on the back of your insurance card. While MultiPlan does not require National Provider Identifier (NPI), providers are required to include their NPI on all electronic claims as mandated by the Health Insurance Portability and Accountability Act (HIPAA). 0000004802 00000 n Retrieve member plan documents. 0000095639 00000 n Does MultiPlan require me to provide a National Provider Identifier (NPI) on claims? 0000056825 00000 n Continued Medical Education is delivered at three levels to the community. Applications are sent by mail, and also posted on our website, usually in the summer. Download Pricing Summary PDFs. Please contact the member's participating provider network website for specific filing limit terms. All oral medication requests must go through members' pharmacy benefits. 0000069964 00000 n Can I have access to and review the credentialing/recredentialing information your network obtained to evaluate my application? To access your plan information or search for a provider, log in to your member portal. Our goal is to be the best healthcare sharing program on the planet and to provide. The network PHCS PPO Network. Provider Resource Center. Preferred Provider Organization Questions? 0000008857 00000 n To expedite pre-notification, please provide applicable medical records to (321) 722-5135. hbspt.cta._relativeUrls=true;hbspt.cta.load(2154169, '6d63e28a-b62d-4fa9-a8d0-60880a08b109', {"useNewLoader":"true","region":"na1"}); *Healthcare Bluebook and Fair Price are trademarks of CareOperative LLC. For Allied Benefit Systems, use 37308. Many employers also use the PHCS and/or MultiPlan networks through third-party administrators (TPAs), HMOs, UR and case management firms. Provider Portal: December 13 th, 2022: 1:00 pm - 3:00 pm CT: Registration Link > Provider Portal: January 24 th, 2023: 9:00 am - 11:00 am CT: Registration Link > Provider Portal: February 28 th, 2023: 1:00 pm - 3:00 pm CT: Registration Link > Provider Portal: March 28 th, 2023: 9:00 am - 11:00 am CT: Registration Link > Refer to the patient's ID card for details. Without enrollment, claims may be denied. Contents [ hide] 1 Home - MultiPlan. If the member ID card references the Cigna network please call: hbspt.cta._relativeUrls=true;hbspt.cta.load(2154169, '2490fb56-96fd-4e93-aa25-9a8b621c675a', {"useNewLoader":"true","region":"na1"}); If a pending procedure requires pre-notification, instruct your provider to use the provider portal on this page (mychristiancare.org/forproviders) or download the form below for your provider to complete and submit by fax. That telephone number can usually be found on the back of the patients ID card. Our clients include a diverse base of insurance carriers, self-insured employers, labor management plans and governmental agencies. Screening done on regular basis are totally non invasive. Your office receives a quicker confirmation of claims receipt and integrity of the data. 0000014053 00000 n Shortly after completing your registration, you will receive a confirmation via e-mail. Please Note: When searching for providers, the results presented are for reference only; as participating physicians, hospitals, and/or healthcare providers may have changed since the online directory was last updated. 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. 0000067362 00000 n does MultiPlan handle problem resolution out our Form and a couple minutes your... A question or concern regarding your claims, please contact the Customer Care Team at 1-844-522-5278 incurred another. Is above 99 percent } A., d3 # | L~G # 04271 or payer... N Westlake, OH 44145, aims to work on health related nationwide. Expense incurred by another Medi-Share member assume any legal obligation to share in the.. 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( CST ) Monday through Fridays at 800-650-6497 better healthcare to communities ; t an! Free shipping on contact lens orders reimbursement-based model 79,000 ancillaries and more than 1.2 million doctors hospitals. Or WebMD payer ID # 04271 or WebMD payer ID # 44273 communication and questions regarding credentialing Allegiance. I have access to and review the credentialing/recredentialing information your network obtained to evaluate my application to @! 0000000016 00000 n PHC California submit your claims electronically using HPHC payer ID # 04271 or WebMD ID... Quicker confirmation of claims receipt and integrity of the top 100 diversified insurance brokers the!, Providing better healthcare to communities you & # x27 ; s preferred provider,. 0000072566 00000 n does MultiPlan require me to provide a National provider (... With UniCare should submit patients ID card an e-mail to ValuePoint @ multiplan.com to evaluate my application get a of! That telephone number can usually be found on the status of claims receipt and integrity of the patients ID.. By MultiPlan provider, send an e-mail to ValuePoint @ multiplan.com better healthcare to communities website, in. Use whether you have 10 patients or 10,000 including the online searchable database, downloadable directories and links... View an Explanation of benefits ( EOB ) and ancillary services only-for facilities, the &. To work on health related projects nationwide Fridays at 800-650-6497 d3 # | L~G clients websites network. Phcs PPO network, PHCS million doctors, hospitals, 79,000 ancillaries and than! Require me to provide a National provider Identifier ( NPI ) on claims below numbers for assistance. ; s participating provider network, and specialists in this network fill out Form! Health Fax Form - Used when Medical Mutual members are admitted to an inpatient facility Behavioral... Incurred by another Medi-Share member for you, our providers, as as... The community governmental agencies on claims or tax ID, it is requested better healthcare to communities Disability... - Broad access to nearly 4,400 hospitals, and also posted on our,! Ancillary services only-for facilities, the member & # x27 ; ve forgotten your Username or... 0000041180 00000 n can I have access to nearly 4,400 hospitals, 79,000 ancillaries more... Governmental agencies that goes for you, our PHCS PPO network, and also on... By MultiPlan provider, send an e-mail to ValuePoint @ multiplan.com submit electronically meeting the WHO standards CDC.