We consider our health care providers as our customers and vital partners in serving our Members. There are two ways to determine whether a member is eligible for the Hillsborough County Health Plan: Some patients have an exception code on their health care card. In KePROs medical management system, you can enter referrals, request pre-authorizations and check on the status of existing referrals or pre-authorizations. The UnitedHealthcare Provider Portal allows you to quickly get the answers you need so you can save valuable time and get better documentation and visibility. Visit the OHCA Provider Training page to register. Register to receive time-sensitive messages about emergencies and certain non-emergency events straight from us to you. Trading Partners can access eligibility, claim status, file exchange and other Interactive Web Services, using their Trading Partner ID as their User ID. Hillsborough Health Care is not a second-party payer for any service covered by another payer resource. Visit the OHCA Provider Training page to register. The CHP Group (800) 449-9479 (503) 203-8333 info@chpgroup.com. New passwords must be at least 8 characters in length, must have at least one non alpha numeric character and cannot be a recent password. CMS Non-Contracted Provider Dispute Process (PDF). Our FHCP Provider Relations Department is here to assist you with the day-to-day The annual base salary for this position ranges from $127,400.00 to $204,000.00. With the portal, you can: Check eligibility and benets information Submit prior authorization requests do best - helping others. You may download Instructions for Submitting Provider Disputes (PDF) or call CCHP Provider Relations at 1-415-955-8800, ext. You can access both PDF and recorded sessions listed here at your convenience. All without having to pick up the phone. Submitting Paper Claims Changes include reopening coverage for CPT code 87634 (RSV) and 87637 (COVID-19, Flu A&B, and RSV) when performed by hospital labs, independent labs or clinic labs for symptomatic individuals who are immunocompromised, have chronic respiratory illness or influenza complicated by pneumonia, or who are pregnant. It's available 24/7 - and at no cost to you. For questions, please contact Provider Network Management at 1-415-955-8800 #3474. The 291 participating HCPs (40.5% nurses, 23.0% pharmacists, 17.2% physicians, 15.5% technicians, and 3.8% other) selected the following as top-3 barriers to PHR adoption: 1) lack of patient awareness (19.4%), 2 . Here, participating providers also can enroll prospective members online to facilitate patient care. These handy reference lists will help you determine at a glance all the information required for each service type. Remember Me If you don't already have a Kepro account, you can register here. Registrants unable to attend the webinar session should notify mailto:SoonerCareEducation@okhca.org to cancel their registration. o If this can be determined, QSR will work with the provider to address the CAPs appropriately. Healthcare providers and Billing Agents can. Stephen W. Miller, CHCIO (State Coordinator for Health Information Exchange), David C. Kendrick, MD, MPH (CEO, MyHealth Access Network). If you recognize your site key token, you know you can safely type your password. Effective July 1, 2014, the new Prescription Drug Prior Authorization Request Form is required for non-Medicare plans. Always log off and close all of your browser windows. The UnitedHealthcare Provider Portal has more than 40 tools that allow you to take action on claims and get the answers you need quickly. Step-by-step instructions guide you through submitting a negotiation request through the UnitedHealthcare Provider Portal. Thank you for being part of the Florida Health Care Plans provider team. Turn on your computer speakers for the audio portion. Create portal user accounts for your staff. Medicare Fraud, Waste and Abuse and Compliance Training (PDF). YY: Patient has a specific illness or injury that is covered by another payer, i.e. Note: If you have not created your personalized site key token, you will be asked to do so before you sign into the HealthCare Portal. Florida Health Care Plans, we are fortunate to have you. Contracting with InterGroup Services allows you to assist your existing patients to save money while attracting new patients without placing stress to your bottom line. For portal related questions contact our Portal Support Team at portalsupport@chcnetwork.org or 510-297-0480. InterGroup Services' wide range of network products attract payers and employers looking to enhance their benefit plan design while saving money on their healthcare costs. Your personalized site key token helps you identify that you are at the valid SoonerCare Portal site. With our dedicated customer service and easy to use website, InterGroup . After signing the provider contract, OHCA via DocuSign will send you an email with the completed eSignature page attached. Would you like to enroll as a Trading Partner? Download details of the CMS Non-Contracted Provider Dispute Process (PDF). Providers must be knowledgeable with the federal requirements and information regarding fraud, waste and abuse. Ask about how you can gain access to the Green Network. If this is your first login with multi-factor authentication, click here to complete your registration. Learn More About FHCP's Provider Relations. Starting Jan. 1, 2023, UnitedHealthcare Community Plan of Pennsylvania will require prior authorization for some injectable anti-emetics. XX: Patient has other coverage plan which may be primary payer, i.e. Effective Dec. 5, 2022, OHCA has closed coverage for COVID monoclonal antibody treatment Bebtelovimab, reported by codes Q0222 and M0222. | 2014 InterGroup Services . The Oklahoma Health Care Authority's secure portal is intended for providers, clerks and billing agents. If you do not recognize your site key token, do not type your password. Healthy Living Referral Process Provider Instructions, http://www.compression.ru/video/ls-codec/msu-sc-codec.exe, Referrals to specialty providers must be completed by the clients PCP, All visits to specialists must have a current prior authorization. All without having to pick up the phone. Check on the status of their claims. What can you do in the RI Medicaid Health Care Portal. All rights reserved. Members must bring the cards with them each time they see a caregiver. Whether you are an FHCP staff provider or have chosen to contract with automobile insurance, etc. Through the Indiana Health Coverage Programs (IHCP) secure and easy-to-use internet portal, healthcare providers can: Submit claims Check on the status of their claims Inquire on a patient's eligibility View their Remittance Advices Request prior authorization Managed Care Entities can: Enroll, disenroll, and update primary medical providers The file types and links to the associated tools which you may need to download and install are listed below: Want to avoid hold-ups caused by missing information in service requests? Are you sure you want to logout? Verify member eligibility, determine benefits, view care plans and get a digital copy of the member ID card. ABOUT US. Remember Me Customer/Provider Use this login button if you are a customer or provider user. UnitedHealthcare Provider Portal. The Oklahoma Health Care Authority's secure portal is intended for providers, clerks and billing agents. Information on COVID-19 vaccines, testing, as well as resources and case tracking. If you recognize your site key token, you know you can safely type your password. Forgot your password? Tampa, FL 33602. If you are a CHCN provider or health plan partner and would like to use the CHCN Connect portal please take a moment to register yourself. care they need. Microsoft Excel File (.xlsx) . Inpatient facility charges are not covered for payment as Medicaid is primary payer. This site gives you the opportunity to maintain provider information, access claim and prior authorization related functions, and receive messages from the OHCA that apply specifically to you. Microsoft Internet Explorer version 7.0 and later. please update to most recent version. How do we do this? Submit claims, look up fee schedules, check status, view payment information, and submit reconsideration and appeal requests. Password. Request services from Hillsborough County online 24 hours-a-day, 7 days-a-week 24/7 online development permitting solution. Special Needs Plans (SNP) Model of Care Training (PDF) 2021, Special Needs Plans (SNP) Model of Care Training (Video) 2021, (New) Prescription Drug Prior Authorization Request Form (PDF), Medicare Advantage/Prescription Drug System (MARx) March 2022 Payment Information, Notice of Change to Provider Compensation, View patients health plan benefits and summaries, View patients healthcare claims and deductible/out of pocket balances, Challenges, appeals or requests reconsideration of a claim (including a bundled group of similar claims) that has been denied, adjusted or contested. Email Address: nhproviderrelations@conduent.com. Would you like to change or add electronic funds transfer? The plan provides primary and specialty care, outpatient treatment, and assistance with prescriptions. The health plan cannot undertake a review until or unless such form/documentation is obtained. New CMS Provider Sequestration Deductions, Provider Portal Eligibility & Claims Inquiry. Providers Provider Reference Materials for Providers To view a document and then save it: Click on the link in the document list to view the document in your browser. Registrants unable to attend the webinar session should notify mailto:SoonerCareEducation@okhca.org to cancel their registration. Status updates will be provided for managed inquiries. NC FAST Provider Portal Login page I Want To. Attention: Provider Dispute Resolution Area, Disputes can also be faxed to: 1-415-955-8815. InterGroup Services is the most comprehensive PPO network serving Pennsylvania, New Jersey, Delaware and West Virginia. you ensure that our 96,000+ members receive the individual, professional Please take a moment to go over the provided information in the PDF file link below. Register to receive time-sensitive messages about emergencies and certain non-emergency events straight from us to you. Adobe Reader version 8.0 and later. To check a CCHP plan drug list, a comprehensive formulary and pharmacy can be found below under CCHP Drug List. Your site key token displays. Steps to getting contracted plus plan information, Phone numbers and links for connecting with us, List of contracted, high-quality independent lab providers, Update, verify and attest to your practice's demographic data, Provider search for doctors, clinics and facilities, plus dental and behavioral health, Policies for most plan types, plus protocols, guidelines and credentialing information, Specifically for Commercial and Medicare Advantage (MA) products, Pharmacy resources, tools, and references, Updates and getting started with our range of tools and programs, Reports and programs for operational efficiency and member support, Resources and support to prepare for and deliver care by telehealth, Tools, references and guides for supporting your practice, Log in for our suite of tools to assist you in caring for your patients. Listed here at your convenience is your first login with multi-factor authentication, click here to your... 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