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po box 211342 eagan, mn 55121

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Box 4368 Lutherville, MD 21094. P.O. HealthEZ: PO Box 211186, Eagan, MN 55121 FACILITIES MEDICAL NETWORK: None -All claims paid at the Allowable Charge, generally 150% for facilities. 0000123789 00000 n We are excited about what our future holds and look forward to continuing to serve our policy holders with superior . Denver Health Medicaid Choice P.O. 0000081140 00000 n 0000133120 00000 n For details on how to file an appeal, click here. How do I become a WPS provider? 0000005135 00000 n <]/Prev 222131/XRefStm 2922>> 0000106646 00000 n 0000080492 00000 n September 2021 Box 699187, Quincy, MA 02169 Telephone is preferred method of contact. 0000081242 00000 n 0000125003 00000 n 0000211945 00000 n Acceptance of this card should indicate acceptance of the Plan's benefits as payment in full for services provided. PO Box 21702. This listing is NOT an active listing. Box 211422, Eagan, MN 55121* *Unless otherwise stated on Medical ID card. General Point of Contact. 0000061443 00000 n hbbd```b``"dd"l0[L^d`2LnS5glg$VQ5D:sn A^ 0000061195 00000 n Availity is an independent provider of health information network services that does not provide Blue Cross Blue Shield products or services. EDI Payer ID: PCU02 . Website: Claims.pointcomfort.com Espaol | 219 0 obj <>stream 0000132516 00000 n Box 211758, Eagan, MN 55121. 0000001471 00000 n ]B ef-kg@Lc 0000102510 00000 n 0000005066 00000 n 6 35 Status: Inactive Listing ID: 26928573 Interested in this property? 0000004497 00000 n Evolent Health (Evolent) will adjudicate all claims for 2020 Individual Plans. Customer Service: 1-800-884-4901 (TTY/TDD . 0000004845 00000 n 0000128684 00000 n 0000189592 00000 n Information for providers Learn more trailer Eligibility and benefits can still be verified Monday - Friday, 8AM - 5PM Central by calling: Member Services: (855) 979-5192 Provider Services: (855) 979-5194 Member ID remains the same: ACZ8300XXXXX-XX Group ID remains the same: 2008ALC Claims mailing address remains the same: Alliance Coal Health Plan PO Box 211577 Eagan, MN 55121 To avoid out-of-network costs and provider balance C D A B Clearinghouses may update submission rules. 0000008457 00000 n Mon - Thurs | 7am - 5pm. 0000025546 00000 n endstream endobj 218 0 obj <>/Filter/FlateDecode/Index[6 104]/Length 26/Size 110/Type/XRef/W[1 1 1]>>stream Box 21545 Eagan, MN 55121 *For use only by those who use Emdeon as their clearinghouse. Email Us Customer Service for Members Toll-free: 877.832.1823 Local: 608.395.6594 Customer Service for Providers 0000099450 00000 n 0000009297 00000 n . ZPn+.nuXAD?$[8Ni{do ~{2;^ {@ Eagan Post Office 3145 Lexington Ave S, Eagan MN 55121 About Address: 3145 Lexington Ave S, Eagan MN 55121 Large Map & Directions Phone: 651-405-3068 Fax: 651-454-9478 TTY: 877-889-2457 Toll-Free: 1-800-Ask-USPS (275-8777) Retail Hours: Monday: 9:00AM - 5:00PM Tuesday: 9:00AM - 5:00PM Wednesday: 9:00AM - 5:00PM Thursday: 9:00AM - 5:00PM Information about these test cases is available on the Insurance Council of Australia's website. Claims Department, PO Box 21082 Eagan, MN 55121-0082-0668 Tel: 888-446-3327 Fax: 201-460-3204 www.homesteadplans.com MEMBER REIMBURSEMENT CLAIM FORM PART A: MEMBER INFORMATION Name of Member Member ID # Female Address State Zip Code City | 0000002608 00000 n 2. We've used 2 TPAs over my 20 years here. Claims Submission Requirements. No provider contracts are needed, network contracting and 0000021063 00000 n Franais | or sexual orientation.Premera Blue Cross HMO complies with applicablefederal and Washington state civil rights lawsand does not discriminate on the basis of race, endstream endobj startxref Claims mailing addresses. P.O. 0000128657 00000 n P.O. Box 211342 Eagan, MN 55121 Do you need to file for reimbursement on a prescription pharmacy claim? Box 37200 Albuquerque, NM 87176-9907. | Visit Availity.com or call Provider Services. 5427 Everybody's Road Crandon, WI 54520 715-478-7448 For Part-timers to submit with EOB or visit summary. Send general mail to: Premium Payments Mailing Address: PO Box 14998, Oklahoma City, OK 73113 Agent Services Phone: (888) 524-3629 Mailing Address: PO Box 14498, Oklahoma City, OK 73113 Claims Phone: (888) 524-3629 Fax: (385) 207-7883 Mailing Address: Medicare Supplement Claims PO Box 211635 Eagan, MN 55121 0000104224 00000 n Create a Free Account 0000205654 00000 n 0000205283 00000 n Electronic Remittance (ERA) To file a claim by mail: P.O. 0000020931 00000 n 0000017499 00000 n )9}p;;c"HC2#Zdd%/1y*@/A"yPS Claims mailing address: Premera Blue Cross of Washington. Service: 877-874-6385 Sales: 212-300-0739 Fax: 212-214-0892 If you submit paper claims, continue to use the industry standard claims form and mail it to the. If authorization is approved, the prescription will be filed and the appropriate cost share will be applied. 0000199768 00000 n https://www.countycare.com Provider Portal Provides access to member eligibility, important 0000008762 00000 n Provider Reference Guide - Baylor Scott & White Health Plan Edvg%Y^Ghp B @(^:"At_`wG3;hjS1q~ wRyj>z|BI(E?s{H #aE;]5@( p! X(8L"R`(9@5esnqD[kt7lb. 0000124411 00000 n 35 0 obj <>/Filter/FlateDecode/ID[<9A8E96E6B26E3496CE9A56AE188A66E6><64B2F4EA76E099418B6AA5BD2B75F722>]/Index[10 40]/Info 9 0 R/Length 117/Prev 152506/Root 11 0 R/Size 50/Type/XRef/W[1 3 1]>>stream Submitting premiums. 0000098980 00000 n 110 110 hb``a``Jc *P#0p4 @1c 0000000016 00000 n (888) 888-4742 Ext. PO Box 1731 Portland, ME 04104 Mailing addresses. Non-PPO Dental Coverage %PDF-1.6 % Univera Healthcare P.O. 0000200414 00000 n xref Box 211597 Eagan, MN 55121 Wisconsin Family Care c/o WPS Health Insurance P.O. 0000006300 00000 n %%EOF Box 211184 Eagan, MN 55121 TO BE COMPLETED BY PATIENT PATIENT INFORMATION: 1. All claims must be . The following summaries about po box 211472 eagan mn 55121 will help you make more personal choices about more accurate and faster information. Prescriptions Claim. Claims & Membership Forms. 0000004540 00000 n Box 21013, Eagan, MN 55121 Ph: (610) 933-0800 | Fx: (610) 933-4122 claims@agadm.com PATIENTS NAME (LAST) (FIRST) 2. PPO - HealthEOS by MultiPlan, P.O. Our Premium Payment Address: Univera Healthcare - Group P.O. P.O. 0 | PO Box 21531 Eagan, MN 55121 TO FILE A GRIEVANCE, PLEASE MAIL OR FAX TO: Reserve National Insurance Company ("Kemper Health") PO Box 26620 Oklahoma City, Oklahoma 73126-9958 Fax: 405.254.2111 or 1.877.877.0078 . PO Box 211342 Eagan, MN 55121-0800 Electronic Claims The Availity Payor ID will be 94999. 0000031892 00000 n Box 676015 Chicago, IL 60695-6015 . Box 21524 Eagan, MN 55121 Electronic Payer ID: 65-456. Box 211592 Eagan, MN 55121-2892: Payer ID: 06541: Claims Timely Filing Requirement : Submit claims 180 calendar days from date of service or discharge date. Call us Monday 8am to 6pm EST | Tues-Friday 8am to 5pm EST. Please review, complete, and submit our online form. startxref Electronic Funds Transfer (EFT) New registration will be handled via Change Healthcare. 0000024636 00000 n 0000133093 00000 n Varipro is a TPA (Third Party Administrator) with the look and feel of a fully insured plan. Please complete this form and mail in for consideration of coverage. If you have any questions, please contact Empire's Provider Services department at 1-844-990-0255. bH} a1v PL{f0M`g`:5@ 0000124848 00000 n hb``g``` ~Y8!AQ2Jf!LL6L{;E3}crjb5 lSP'h` Claims & Correspondence Information Claims can be filed electronically or by mail. Claim Review Process. %PDF-1.4 % 0000148189 00000 n Baylor Scott & White Health Plan ATTN: Claims Review Dept. 0000181088 00000 n Providers currently enrolled in EFT prior to 07/01/20 will not have to re-register with Change Healthcare. Important Information: In a medical emergency, call 9-1-1 or go to the nearest emergency facility. 0000010397 00000 n 0000014465 00000 n i:&roXq%aVC; $uYTHk:9$p ImrJ::P34jWj\lC%4ucGcN96gmNl1f 10 0 obj <> endobj | 0000074637 00000 n HTn0+x$EM)*"Fm4! 0000001217 00000 n For reimbursement of covered dental care claims. 40 0 obj <>stream 0000000996 00000 n 0000003577 00000 n 0000211984 00000 n Learn More Filing an Appeal Non-IPA providers: Providers who are not contracted with the IPA must continue to follow the Empire processes. Refugee Medical Assistance Program Paper Claims: PO Box 211745 Eagan, MN 55121 . 0000138523 00000 n PO Box 211256 Eagan, MN 55121. You can refer to the answers below. . 49 0 obj <>stream When you use a CIGNA PPO provider, your dentist will submit your claims for you. All claims are processed at the Maximum Allowable Charge, generally a certain percentage above your Medicare rate. 0000024169 00000 n www.countycare.valence.care 312-864-8200, 711 (TTY/TDD) Your information is well-protected, as we adhere . Subscribers on direct bill should send premiums to: WEA Trust P.O. 0000074301 00000 n In the meantime, you can sign up for Office Ally, a full-service clearinghouse offering a web-based service where providers can submit claims to Participating Payers (Premera included) at no cost. P.O. If you include the 2-digit suffix for the member, the claim will reject as "member not on file" Attachment/Appeal Fax# 1-952-992-1427 . 0000010308 00000 n Box 211422, Eagan, MN 55121 PPO Network Your patient's health plan accesses no network. 0000022828 00000 n 0000142368 00000 n startxref If you accidently mail to the Premera commercial PO Box, Premera will forward the claim to Evolent. Complete a claim review form within 60 days of EOP receipt. <<7496874096966B49874FF83460F5D92C>]/Prev 156940>> 0000205016 00000 n 0000074751 00000 n Innovative Health Plan (IHP ll) offers providers a variety of tools and resources to assist with patient care. PO Box 211657 Eagan, MN 55121 www.varipro.com 844.732.3415 4/1/2019 VARIPRO-FH WRAP PBS04 72187 PO Box 211657 Eagan, MN 55121 www.varipro.com 844.732.3415 4/1/2019 WPS HEALTH INSURANCE - FI MICHIGAN WPS01 WPS PO Box 21341 Eagan, MN, 55121 www.wpshealth.com 800 223-6048 4/1/2019 WPS HEALTH INSURANCE - FI MICHIGAN UP WPS04 WPS PO Box 21341 Eagan, 0000137826 00000 n Theres an option to submit HCFA (CMS 1500) claims on the new Individual secure website, however this function isn't available yet. Important Telephone Numbers. MEMBER. Our representatives are available Weekdays 9 a.m . 0000217182 00000 n 0000079771 00000 n Direct Premium Payments. &kAYd?#`gIaKPkqv?wwC1bYYTlpFzQ bZ>z\e'X@(m3L&ad9b5RlaZSW&maC)Y%HqSSf/rL ! m'dPDwk-qX1VAb oMz`c :wO{wfh$ e92N' This plan may be right for you if you if you already have . 0000132796 00000 n 0000018062 00000 n Paper claims address. 0000214583 00000 n 0000005608 00000 n 0000009426 00000 n &R6onao``?Ggw0aii+-XhX15-YZmlcdo5x7r[B2@mn=Q)adp_& ngtq+`I>\hf[[p(n/\2Qz-fq\>N[i;Hu L#24Z4J#'a|nv#}whH " _`qI2Y,c0#fe|0=A[aK"(*0 @4>)*>W\DJR$&}I2':DefmZ=Zbabr+M!ZF:El" 9}bF{Fs#D| 84 wvmlmW}(-c Akd@=rlwVwtp4S8`? 0000018247 00000 n 0000002922 00000 n 0000001684 00000 n 365 0 obj <>/Filter/FlateDecode/ID[<39F78CA27C5E984C890CA58F2276DEA7>]/Index[351 24]/Info 350 0 R/Length 82/Prev 201646/Root 352 0 R/Size 375/Type/XRef/W[1 3 1]>>stream EDI Payer ID: PCU01 . Box 5267 Binghamton, NY 13902-5267. Portugus | 0000004694 00000 n 0000016912 00000 n It's possible your clearinghouse may assign us a custom payer ID. hYo8<6X8D@QG"r7~P-*Ki&E(8 /AE 2%OB#RZA Box 211438 Eagan, MN 55121. 0000010206 00000 n PO Box 211342 Eagan, MN 55121 Prior Authorization: 1-800-884-4905 Card Issue Date: 12/01/2019 FOR MEMBERS This card is for identification only and does not guarantee current membership or coverage. YES. 0000217143 00000 n 0000031511 00000 n 0000028840 00000 n Enclose a copy of the pharmacy receipt with your claim submission. Polski | P.O. PO Box 211197 Eagan, MN 55121 Electronic Payor ID #43185 (918) 615-7972 . PO Box 211502 Eagan, MN 55121 Member complaints & grievances Bright HealthCare Appeals and Grievances P.O. Provides general information of interest to the autism community. 0000074523 00000 n ^I~&\$Cy4Wo. 0000201478 00000 n NYE-NU-0205-20 September 2020. Deutsch | P.O. endstream endobj 352 0 obj <>/Metadata 5 0 R/Pages 349 0 R/StructTreeRoot 9 0 R/Type/Catalog>> endobj 353 0 obj <>/MediaBox[0 0 1008 612]/Parent 349 0 R/Resources<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 354 0 obj <>stream All facilities and non PHCS providers please send all claims to: Group Benefit Services Claim Department P.O. Are you an employer? 0000189889 00000 n 0000147925 00000 n Italiano | You are our favorite part of every day, so send us an email today! 0000002656 00000 n %PDF-1.5 % 317 -210 -2010 service@pointcomfort.com . P.O. To get provider specific information and service, call 844-732-3415. At Health Tradition, we speak Wisconsin! 0000098440 00000 n We work with all major clearinghouses that submit through the Utah Health Information Network (UHIN). Send monthly premiums to: WEA Insurance P.O. 0000080519 00000 n PO Box 211758 Eagan, MN 55121 After a claim has been submitted, quickly check claims status on UHSS.UMR.comor call 1-844-368-6661 to speak with a specially trained UnitedHealthcare Shared Services Provider Service Representative. . 0000005482 00000 n You are looking : po box 211472 eagan mn 55121. 0000099007 00000 n 0 PATIENTS ADDRESS (STREET) (CITY) 3. There have been two test cases in relation to business interruption cover and COVID-19 impacts. Box 211221, Eagan, MN 55121 Also note Paper claim submissions that have multiple pages to a claim should only have the total of the claim submitted on the last page Quartz requires diagnosis codes on dental claims PO Box 21051 Eagan, MN 55121-0051. Univera Healthcare P.O. endstream endobj 7 0 obj <> endobj 8 0 obj <> endobj 9 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/XObject<>>> endobj 10 0 obj <> endobj 11 0 obj <> endobj 12 0 obj [/Indexed/DeviceRGB 255 23 0 R] endobj 13 0 obj <>stream 0000098723 00000 n Send your Po Box 21184 Eagan Mn in a digital form as soon as you are done with completing it. Member Resources. Reminder: All claims should be submitted electronically, unless required documentation is needed to process claim. P | | You may notice slight differences in allowed amounts when compared to Premera due to rounding, edits, or fee schedule update timing, among other factors. Box 211256 Eagan, MN 55121 . Claim Status. h\/qmt#KMt `(jthI&&){d*m[5$BXU\'X`TV/Vg9Aei3Uoh #2ImJbl Contact Info. 8mg7Rs:cPMc? Box 21013 Eagan, 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 may at any time ask Us or Our Administrator for an estimate of the amount We will pay for or reimburse to you for nonemergency health care services that have been . 0 Box 211308, Eagan, MN 55121-2908 contactcustomerservice@fallonhealth.org (800) 868-5200 None None Harvard Pilgrim Health Care, Inc. 96911 1600 Crown Colony Drive, P.O. PO Box 211424 Eagan, MN 55121 Members who need help submitting a dental claim can contact Member Services at 800.613.2624 (TTY: 711). The Healthfirst Coordinated Benefits Plan is a Medicare Advantage plan that offers the benefits of Original Medicare, plus dental, hearing, vision, transportation, SilverSneakers fitness program, and 24/7 access to care via phone or video chat and the Nurse Help Line. Benefits and Eligibility. 0000128196 00000 n PT Mini-Claim Form. If you accidently mail to the Premera commercial PO Box, Premera will forward the claim to Evolent. Box 24992 Seattle, WA 98124-0992 Electronic Payer ID: 84-135. Payer ID: ARGUS NEA: 451001 Argus Dental & Vision, Inc. Claims Department PO Box 211276 Eagan, MN 55121 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. To file a claim electronically: EDI # 73100* To file a claim by mail: P.O. Important Information: In a medical emergency, call 9-1-1 or go to the nearest emergency facility. And, you don't need referrals to see in-network specialists. Provider Relations Department Phone: 303-602-2100 Fax: 303-602-2516. 0000004323 00000 n 0000143030 00000 n If your business has been affected by COVID-19 and you have business interruption cover, talk to us about making a claim on 132 818. 0 To file a claim by mail: P.O. 0000181595 00000 n 0000200915 00000 n Important Phone Numbers Box 21013 Eagan, MN 55121 Toll Free: 800.634.8628 Phone: 610.933.0800 Fax: 610.933.4122 Email: claims@agadm.com Questions regarding payments or claim status can be directed to 610.933.0800 . Claims and Benefits Billing Address: ArchCare Advantage c/o Peak TPA P.O. qNB'C('T\?hlTBE1LpAWo(;Td-@atX0Y!5 ,q,E2("X5+a% Our Corporate Street Address: Univera Healthcare 205 Park Club Lane Buffalo, NY 14221. Box 211395 Eagan, MN 55121. New Claims Mailing Address for 2020 Individual Plans, federal and Washington state civil rights laws. 38999 None (617) 509-1483 Premera Blue Cross complies with applicable federal and Washington state civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, gender identity, Box 21800 Eagan, MN 55121-0800. All paper claims for Federal Employee Health Benefits members must be submitted to: True Health New Mexico P.O. 0000002220 00000 n 0000200041 00000 n 0000128484 00000 n Featured In: October 2020 Empire Provider News. PO Box 853921 Richardson, TX 75085-3921 (877) 232 Web MD/Emdeon #41124 or McKesson/Relay Health #1761 (314) 644-4802 ext. Office Allys online claim entry allows you to create CMS1500, UB04, and ADA claims on their website; or you can use your existing software to create and submit claims electronically. 0000124384 00000 n Bind Benefits, Inc., may be entered as the "insurance" carrier (dependent on your system). YES. AmFirst continues to make outstanding strides in the supplemental market and has increased market share year after year. Always contact your clearinghouse for confirmation of up-to-date submission requirements. 0000128986 00000 n Box 211422, Eagan, MN 55121 PPO Network Your patient's health plan accesses no network. Claims refunds address. For additional information, contact EMI Health's customer service department at 801-262-7475 or toll free at 800-662-5851. EMI Health PO Box 21482 Eagan, MN 55121 As a reminder, claims that do not include attachments must be submitted electronically. 0000080042 00000 n hb``P```1d``` Change Healthcare (EMDEON) Payer ID: 68035 877-469-3263 0000078005 00000 n Claim Adjustment or Appeal Request Form (DOC) Electronic Appeal Submission 1000 Essence Healthcare Essence Healthcare . PO Box 211628 Eagan, MN 55121 . P.O. Contact Us - Blackhawk Claims Service GA, Inc. About Blackhawk Products Providers Brokers Employers Members Contact Us CONTACT US Do you have a question about getting a quote or filing a claim? You can also call the Member Services number on your ID card. 351 0 obj <> endobj endstream endobj startxref | For over two decades, AmFirst has stood strong, stable and secure in both good and difficult economic times, ready to meet the needs of its policyholders. All claims are processed at the Maximum Allowable Charge, generally a certain percentage above your Medicare rate. %%EOF Box 211595 Eagan, MN 55121 What is the Payer ID? 0000025940 00000 n For submitting medical claims. Box 24711 Seattle, WA 98124-0711 Electronic Payer ID: 84-133. . There's an option to submit HCFA (CMS 1500) claims on the new Individual secure website, however this function isn't available yet. While Bind leverages the UnitedHealthcare network, Bind members must present a Bind member ID card to your staff. 2 Claims information Bright HealthCare does not accept faxed claims. 0000025404 00000 n Claims Status Box 211256 Eagan, MN 55121 . Kreyl Ayisyen | Once you fill out the claim form, mail it to: FirstCare Health Plans P.O. %PDF-1.4 % 0000003254 00000 n | Updates to this listing have stopped. hbbd```b``U`D2,A$;] fO=`R,~H2*L@@"30t0 Office Ally Payer ID: HPSJ1 866-575-4120. 0000129056 00000 n o PO Box 211757 Eagan, MN 55121 Claims & Forms. 0000007911 00000 n Submit Claims Submit all claims to: EDI Payer ID: 66701 Group Marketing Services, Inc. PO Box 21044 Eagan, MN 55121 Please submit Cofinity, First Health Network, Lakeland Care, American Health Alliance, Dental and Vision claims electronically to Smart Data Solutions (SDS) claims clearinghouse: EDI Payer ID: 66701 Mail Forms and Payments. The Health Tradition team works hard to answer your health plan questions Monday through Friday, 8:00 a.m. to 4:30 p.m. CST. @0/I S6*R`R60znamc,?1s.qeCs7IcV\9OhwUwkY- K8'/T)k b`(cOVW&[5X^H!0O5xlXMW>L;Q3{:LY[eI~vH,uB_a|_c7iwm%ha Ya'QVMYv9W*cFmrTY0J1y. Box 6090, De Pere, WI 54115-6090 All other claims (Badger Care Plus and non-PPO) - Quartz, P.O. 0000101370 00000 n Availity is solely responsible for its products and services. %%EOF The mission of the AAROC is to provide Hope, Direction & Support to families of individuals diagnosed with an autism spectrum disorder. AmeriHealth HMO, Inc. Payer ID provider number reference Professional Rev. Claim Forms: This listing may be off the market. 0000022579 00000 n Stop by our walk-in customer service units if you'd like to visit us in-person. 0000180819 00000 n You can check the status of your submitted claims and receive a claims list for each of your patients using available tools on the Evolent secure site starting January 1, 2020. Box 16275 Reading, PA 19612 Bright HealthCare . No further information is available at this time. If yes, contact us here: Are you a broker? Medical Claim. 0000025262 00000 n 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. Contact Varipro with any questions or comments. Dental Claim. All CIGNA dental claims should be electronically transmitted to EDI# 30506 or mailed directly to: EWTF PO Box 21274 Eagan, MN 55121 EWTF Group Number The dental group number is 3339689. EMI Health's payer ID is SX110. Note: When submitting claims under this payer ID, use only the 10-digit member ID. 0000148668 00000 n Box 211468 Eagan, MN 55121. | For a complete list of claims submission addresses, refer to the professional and facility payer ID grids at www.amerihealth.com/edi.There . Contact HealthEZ for reimbursement rates for any facility based care. 0000124918 00000 n Page | 4 Medical Coverages & Limitations Please keep this page for your records. color, national origin, age, disability, sex, gender identity, or sexual orientation. Overview This is located at Box 211624, Eagan, MN 55121. 0000124061 00000 n 0000101624 00000 n Provider Portal Our Provider Benefit Portal is your 24/7 connection! Explore Products Individual & Family Plans Sole Proprietor Plans 0000003447 00000 n P.O. 0000002546 00000 n | Oromoo | Eagan, MN 55121. Eagan, MN 55121. P.O. Box 21631 Eagan, MN 55121 Claims and Benefits Guide 2017 Provider Benefits Summary 374 0 obj <>stream Box 37200 Albuquerque, NM 87176. Click the Provider Login button below to: 0000000016 00000 n PO Box 211342 Eagan, MN 55121 Prior Authorization: 1-800-884-4905 Card Issue Date: FOR MEMBERS current membership or coverage. Institutional/UB Claims. 0000007141 00000 n 0000133532 00000 n 0000008858 00000 n Fallon Health & Life Assurance Company 66828 P.O. 0000031152 00000 n Medical Directors. 0000099546 00000 n 0000009409 00000 n Eligibility. c300042,e|!ivf&fIKLLw4M0\eC(AsnlMn[f220| )Y,` P 0000189308 00000 n If you can not find what you are looking for or have additional questions, please call (610) 933-0800 for immediate assistance. No provider contracts are needed, network contracting and Claims mailing address:Premera Blue Cross of WashingtonPO Box 21702Eagan, MN 55121. Get in touch 100 Decker Ct, Suite 250 866-910-6166 Outreach@blackhawktpa.com Name (required) Email (required) Message Find our EDI vendor information through one of the following: 1. 0000001294 00000 n 1000 or toll free -3863 ext. Contact A-G via mail, phone, fax and email: A-G Administrators LLC Attn: Springfield Claims P.O. 0000004999 00000 n endstream endobj 111 0 obj <>/Metadata 4 0 R/Pages 3 0 R/StructTreeRoot 6 0 R/Type/Catalog/ViewerPreferences<>>> endobj 112 0 obj >/PageWidthList<0 612.0>>>>>>/Resources<>/Font<>/ProcSet[/PDF/Text]/Properties<>/XObject<>>>/Rotate 0/StructParents 0/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>> endobj 113 0 obj [114 0 R 115 0 R 116 0 R] endobj 114 0 obj <>/Border[0 0 0]/H/N/Rect[137.765 120.667 232.038 89.1601]/StructParent 3/Subtype/Link/Type/Annot>> endobj 115 0 obj <>/Border[0 0 0]/H/N/Rect[64.8 252.858 163.067 238.748]/StructParent 1/Subtype/Link/Type/Annot>> endobj 116 0 obj <>/Border[0 0 0]/H/N/Rect[79.9742 164.658 178.241 150.548]/StructParent 2/Subtype/Link/Type/Annot>> endobj 117 0 obj <> endobj 118 0 obj <> endobj 119 0 obj <>stream Alliance Medical Supplement For Customer Care & Claims, contact AmFirst Insurance Company: (888) 888-2519 For Sales & Product Inquires, contact Lakeshore Benefit Alliance: (205) 703-9300 Select the tab that best describes you and submit form to contact us via email. You can continue to submit claims electronically as you do today. trailer Here are some ways to get in touch. 0000078265 00000 n Prime. 0000017049 00000 n %%EOF Box 689511 Chicago, IL 60695-9511 . 0000099380 00000 n HWd8kCGlE{Fk `o=z_?|/W7?W| >[m7\~^~ 3 0000129152 00000 n 0000182114 00000 n 0000011981 00000 n To check on the status of a claim, please check our Provider Portal. Please refer to our Receiver and Payer ID codes document. hmo0;?R(lX1";Ju Please be advised that we do not accept email or faxed claims, and any claims sent to us via the mail will incur a fee. Or you can submit a paper HCFA (CMS 1500) claim to the address above. 0000138083 00000 n 0000074375 00000 n 0000074449 00000 n hbbbd`b``3E P.O. 110 0 obj <> endobj Electronic Services Available (EDI) Professional/1500 Claims. 0000031074 00000 n Baylor Scott & White Health Plan c/o Smart Data Solutions 960 Blue Gentian Road Eagan, MN 55121-1500 . Tagalog | 0000142628 00000 n 0000074821 00000 n YES. Grace periods and claims pending policies during the grace period <4-N'p$RZh "('("1 \D1/Yp;BF)/ 6|>PpyJ%adnN5M5&@2=quWzFYB&-: Box 5266 Binghamton, NY 13902-5266. P.O. 0000214544 00000 n 0000024430 00000 n P.O. To learn more about benefits, visit our educational resources page. 0000021452 00000 n Contents. 6S4aB. endstream endobj 11 0 obj <> endobj 12 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC/ImageI]/XObject<>>>/Rotate 0/Type/Page>> endobj 13 0 obj <>stream 0000081070 00000 n Box 840523 Dallas, TX 75284-0523. Box 21545 Eagan, MN 55121 : Eligibility, benefits, and claims status: customerservice@ahatpa.com Contract rates and network status: provrelations@ahatpa.com Website: www.ahatpa.com: The AmeriHealth Administrators website was recently redesigned, and the Providers page continues to give access to the NaviNet . 0000029242 00000 n 0000074920 00000 n 6 0 obj <> endobj 0000003098 00000 n P.O. Our Medical Directors provide a . Claims address: Bind, P.O. For reimbursement of covered prescription drug claims. EHS has done more in 12 months than they did in 20 years to deliver better care to our members and save the company money in our hardest year yet. xref MEDICAL CLAIM FORM Claims Receipt Center P.O. 0000024920 00000 n PO Box 21482 Eagan, MN 55121 If the claim form is not properly completed, it cannot be processed, and it will be returned. Aither Health is a healthcare solutions company offering a full suite of innovative products and services for third-party administrators and risk bearing entities such as self-funded employers, health plans and providers.

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