Group 3. Products Provider Customer Service Internal Use Information
|
|
|
- Susan Chase
- 6 years ago
- Views:
Transcription
1 Go to Group 3 Medical Plans (pp 1-5) Go to Group 3 Government Plans (pp 6) Go to Group 3 Plans (pp 6) Go to Group 4 Medical Plans (pp 7-8) Go to Group 4 Government Plans (pp 8-9) Group 3 Products Provider Customer Service Internal Use Information Medical Plans Aetna HealthScope Coventry Choice POS II Healthfund POS Healthfund PPO Managed Choice POS Medicare Advantage Plan (PPO) Open Access Elect Choice Open Access Managed Choice Open Access Select Open Choice PPO Select (PCP referral required) Amerigroup Community Care Medicare Advantage Beech Street Indemnity & PPO-based plans: Medicare: Medicare: DaVita Medical Group is not contracted with HMO in New Mexico; patients with Aetna HMO products will be self-pay unless it's Urgent/Emergent. *Medicare group numbers will have to start with the alpha prefix ME to be considered contracted. Member eligibility is available via Availity. Beech Street is a network for several have the Beech Street logo, which identifies the insurance as a participant in the Beech Street network. Contact the insurance company directly through the phone
2 BlueCross BlueShield of New Mexico Blue Community HMO Blue Medicare Advantage (HMO) Centennial Care Commercial In-State Federal (Basic or Standard) Concord ROTC Candidates CorVel Coventry/Aetna Automobile Insurance Managed Care Commercial Network Access () Worker s Compensation First Care PPO Blue Medicare Advantage: Federal: Commercial: N/A numbers on the patient's ID card in order to obtain benefits, eligibility, and prior Out-of-state plans utilize phone numbers on the back of the cards for eligibility, benefits, prior authorization.. NOTE: Any out-of-state Medicare Advantage plans are not capitated and must be uploaded as BCBS Medicare. Submit in-state and out-of-state claims to our local BCBS plan, dependent on the line of business. Centennial members with ABP (Alternative Benefits Plan) benefits differ. Service agreement is for ROTC candidates for Pulmonary services only. CorVel is a network for several different CorVel logo, which identifies the insurance as a participant in the CorVel network. Contact the insurance company directly through the phone numbers on the patient's ID card in order to obtain benefits, eligibility, and prior Network Access is a rental network portion of the contract for Coventry. The Coventry logo will be on the card with the employer name.
3 First Health Network Fortified Provider Network HCH Administration HealthSmart firsthealth.coventryhealthcare.com Refer to patient s ID card Refer to patient s ID card First Health Network is a network for several have the First Health Network logo, which identifies the insurance as a participant in the First Health Network. Contact the insurance company directly through the Fortified Provider Network is a network for several different payers. The patient's ID card will have the Fortified Provider Network logo, which identifies the insurance as a participant in the Fortified Provider Network. Contact the insurance company directly through the phone numbers on the patient's ID card in order to obtain benefits, eligibility, and prior HCH Administration is a network for several have the HCH Administration logo, which identifies the insurance as a participant in the HCH Administration network. Contact the insurance company directly through the HealthSmart is a network for several have the HealthSmart logo, which identifies the insurance as a participant in the HealthSmart network. Contact the insurance company directly through the phone numbers on the patient's ID card in order to obtain benefits, eligibility, and prior
4 Humana Medicare Advantage Humana Gold Plus HMO Humana Choice PPO Humana Gold Choice (PFFS) Multiplan New Mexico Health Connections (NMHC) Member eligibility is available via Availity. Multiplan is a network for several different payers. The patient s ID card will have the Multiplan logo, which identifies the insurance as a participant in the Multiplan network. Contact the insurance company directly through the phone numbers on the patient s ID card in order to obtain benefits, eligibility and prior Prior Auth: Pharmacy Prior Auth: New Mexico Mutual Worker s Compensation Presbyterian Health Plan Commercial City of Albuquerque LoboCare Three Rivers Provider Network (TRPN) or NMMClaims@newmexicomutual.com (All Pres) (City of ABQ direct line) Multiplan is a network for several different Multiplan logo, which identifies the insurance as a participant in the Multiplan network. Contact the insurance company directly through the phone numbers on the patient's ID card in order to obtain benefits, eligibility, and prior County of Bernalillo employees and dependents are not covered under the City of Albuquerque agreement. We can see County of Bernalillo members with out of network benefits. If they do not have out of network benefits we must obtain a prior authorization. TRPN is a network for several different TRPN logo, which identifies the insurance as
5 Total Community Care (TCN) United Healthcare AARP Medicare Complete Centennial Care Medicare SNP UMR Commercial (Ardent employees only) UNM Health LoboCare USA Managed Care Organization (USA MCO) Medicare: Medicaid: UMR: Websites: a participant in the TRPN network. Contact the insurance company directly through the TCN is a network for several different TCN logo, which identifies the insurance as a participant in the TCN network. Contact the insurance company directly through the DaVita Medical Group is now contracted with the United Commercial product called UMR for Ardent employees, effective 1/1/17. Note: Patients with other UHC Commercial Products will be self-pay, unless Urgent /Emergent care. The insurance card is BC/BS and has UNM Health as the identifier. Please load as BCBS and select UNM LoboCare as the Financial Status Classification. Phone Number for Prior Auth: Fax for Prior Auth: USA MCO is a network for several different USA MCO logo, which identifies the insurance as a participant in the USA MCO network. Contact the insurance company directly through the phone numbers on the patient's ID card in order to obtain benefits, eligibility, and prior
6 Government Plans (DaVita Medical Group is not contracted with the government payers, but we are enrolled with them) CHAMPVA nmmedicaid.acs-inc.com/nm/general/home.do Participating provider for current DaVita Medical Group VA patients. New patients may not be accepted by certain specialties. Medicaid NM (ACS) or nmmedicaid.acs-inc.com/nm/general/home.do Medicare (Novitas) Railroad Medicare (Palmetto GBA) IVR: Medicaid ID #: Medicare PTAN#: Medicare Railroad PTAN #: DE6513 Plans Davis EyeMed Care March Care Superior Services VSP or
7 Group 4 Products Provider Customer Service Additional Information Medical Plans Aetna Coventry Choice POS II Healthfund POS Healthfund PPO Managed Choice POS Medicare Advantage Plan (PPO) Open Access Elect Choice Open Access Managed Choice Open Access Select Open Choice PPO Select (PCP referral required) Amerigroup Community Care Medicare Advantage BlueCross BlueShield of New Mexico Blue Community HMO Blue Medicare Advantage (HMO) Centennial Care Commercial In State Federal (Basic or Standard) Indemnity & PPO-based plans: Medicare: Medicare: Blue Medicare Advantage: Federal: Commercial: DaVita Medical Group is not contracted with HMO in New Mexico; patients with Aetna HMO products will be self-pay unless it's Urgent/Emergent. *Medicare group numbers will have to start with the alpha prefix ME to be considered contracted. Eligibility can be accessed through Availity. Out-of-state plans utilize phone numbers on the back of the cards for eligibility, benefits, prior authorization.. NOTE: Any out-of-state Medicare Advantage plans are not capitated and must be uploaded as BCBS Medicare. Submit in-state and out-of-state claims to our local BCBS plan, dependent on the line of business. HCH Administration Refer to patient s ID card Centennial members with ABP (Alternative Benefits Plan) benefits differ. HCH Administration is a network for several have the HCH Administration logo, which identifies the insurance as a participant in the
8 New Mexico Health Connections (NMHC) United Healthcare (UHC) AARP Medicare Complete Centennial Care Medicare SNP UMR Commercial (Ardent employees only) UNM Health LoboCare Medicare Medicaid: UMR: HCH Administration network. Contact the insurance company directly through the Prior Auth: Pharmacy Prior Auth: DaVita Medical Group is now contracted with the United Commercial product called UMR for Ardent employees, effective 1/1/17. Note: Patients with other UHC Commercial Products will be self-pay, unless Urgent /Emergent care. The insurance card is BC/BS and has UNM Health as the identifier. Please load as BCBS and select UNM LoboCare as the Financial Status Classification. Phone Number for Prior Auth: Fax for Prior Auth: Government Plans (DaVita Medical Group is not contracted with the government payers, but we are enrolled with them) CHAMPVA or nmmedicaid.acs-inc.com/nm/general/home.do Participating provider for current DaVita Medical Group VA patients. New patients may not be accepted by certain specialties. Medicaid NM (ACS) or nmmedicaid.acs-inc.com/nm/general/home.do Medicaid ID #:
9 Medicare (Novitas) Railroad Medicare (Palmetto GBA) Tricare IVR: Medicare PTAN #: NMB2116 Medicare Railroad PTAN #: DE6513 Participating provider for current DaVita Medical Group Tricare patients. New patients may not be accepted by certain specialties.
2018 Miscellaneous Plans
2018 PLANS WE DO NOT PARTICIPATE IN Aetna TRS Gold Choice POS II Seton Health Alliance* Amerigroup Amerivantage BCBS Blue Advantage * BCBS CHIP BCBS Empire Plan * Cigna Connect* Humana * IdealCare Scott
Claims Inquiry Phone # Authorization Process. Fee Schedule Notes. Claims Address
Inquiry ADVANTAGE 360 ( Self-funded) Optional Advantage 360 (call # on ID for add'l (www.advantageplan.com) Terming 12/31/2016 ADVANTAGE Health Solutions HMO Prime ProHealth Risk ProHealth ing P.O. Box
UC Health Accepted Insurance Plans
INSURANCE CARD TYPICAL NAME PRODUCT TYPE Medical Daniel Drake 3-hab Ohio Worker's Comp ID Card Worker's Comp YES YES YES YES AARP Medicare Complete (underwritten by United Health Medicare Advantage YES
Holy Cross Hospital/Holy Cross Medical Group/POSC Commercial HMO/PPO Plans
Commercial HMO/PPO Plans The Following is a list of Commercial HMO & PPO Plans in which Holy Cross (HCH); Holy Cross HCMG) and the Physicians Outpatient Surgery Center () participate. AETNA HMO/PPO Y Y
Holy Cross Hospital/Holy Cross Medical Group/POSC Commercial HMO/PPO Plans
Commercial HMO/PPO Plans The Following is a list of Commercial HMO & PPO Plans in which Holy Cross (HCH); Holy Cross (HCMG) and the Physicians Outpatient Surgery Center () participate. AETNA HMO/PPO Y
Mount Sinai Radiology Insurance Information
Mount Sinai Radiology Insurance Information Insurance Carrier Plan Eligibility Precertification Precert. Phone Number 1199 Care to Care 1199 Home Care & Multiplan (646) 473-7160 Care to Care (888) 910-1199
NPI# PHYSICAL THERAPY MANAGED CARE BENEFITS/PRIOR AUTHORIZATION. Outpatient Physical Therapy Centers
NPI#1780614453 Scheduling and Billing 1 800 783 1008 www.theptgroup.com PHYSICAL THERAPY MANAGED CARE BENEFITS/PRIOR AUTHORIZATION Outpatient Physical Therapy Centers Apollo, Derry, Greensburg Pellis Rd.,Greensburg
Effective 01/1/2019. Payor Payor Type Product Transplants (some exclusions apply, contact your carrier for further information)
Effective 01/1/2019 1199 Union PPO ADAP (opd only) NYS HIV program NYS HIV program Y N N Aetna U.S.Healthcare Insurance Co. HMO/POS/PPO Indemnity NYC Community Plan International plans Medicare Student
Medicare Advantage FAQ
Medicare Advantage FAQ Contents Medicare Advantage Talking Points... 2 University of Richmond Medicare Advantage Plan Questions... 3 Provider Acceptance Questions... 4 Claims Processing... 6 Frequently
Mount Sinai Brooklyn. Beth Israel/ Petrie. Y Y Beacon Y Y Y Beacon. Y Y Beacon Y Y Y Beacon. Y Y Beacon Y Y Y Beacon. Y Y Beacon Y Y Y Beacon
Effective 01/01/2019 Moun St Luke's & West (Roosevelt) 1199 Union ADAP (opd only) NYS HIV program NYS HIV program Aetna U.S.Healthcare Insurance Co. HMO/POS/ Y Y Indemnity Y Y NYC Community Plan Y Y International
Electronic Claims Submission (EDI) Training
Electronic Claims Submission (EDI) Training Part 1 How to complete the CMS-1500 form Contact Information: EDI@I-AHC.net 866-374-9558 770-455-0040 1 Two parts of Training Part 1: How to complete CMS-1500
Direct Data Submission (DDS) 2014 Report Year Insurance Coverage Data Field Specifications & Codes
Why is submitting accurate insurance data important? The insurance coverage code and member ID number are required data for Direct Data Submission (DDS). MNCM shares this information with the identified
ROCHESTER INSTITUTE OF TECHNOLOGY
ROCHESTER INSTITUTE OF TECHNOLOGY 2017 Information on Medical and Rx Plan Changes Due to Medicare Eligibility This information is designed to help you understand the differences between the employee and
2010 Health Care Trend Survey
Aon Consulting 2010 Health Care Trend Survey Summer Contributed by: Bill Sharon National H&B Consumer Driven Healthcare Practice Leader 2010 Health Care Trend Survey Summer Contents 4. 5. 7. 10. 11. Overview
WellCare TexanPlus HMO 2019 Employer Group Enrollment Individual Enrollment Form. How to Enroll With Our Plan
WellCare TexanPlus HMO 2019 Employer Group Enrollment Individual Enrollment Form How to Enroll With Our Plan 1. Please read this entire enrollment form to make sure you understand the information. An incorrect
Insurance & Billing Information
Insurance & Billing Information Insurance and Billing Information With DLO, you re good to GO DLO has comprehensive insurance partnerships that provide broad coverage for patients. This means dealing with
TODAY S AGENDA. Opening Comments, Kevin B. Huber, CTPF executive director. Open Enrollment Overview. Enrollment and Eligibility
2 TODAY S AGENDA Opening Comments, Kevin B. Huber, CTPF executive director Open Enrollment Overview Enrollment and Eligibility 2013 Health Plan Options 3 STATE OF PENSION FUND Illinois Pension Reform The
Individual MAPD HMO. Member/Provider Service: If you use a TTY, call 711
Individual MAPD HMO 1 HUMANA GOLD PLUS (HMO) A Medicare Health Plan with Prescription Drug Coverage RxBIN: XXXXXX RxPCN: XXXXXXXX RxGRP: XXXXX IPA/Center Name: XXXXXXX Telephone: 3
Insurance & Billing Information
Insurance & Billing Information Insurance & Billing Information With DLO, you re good to GO DLO has comprehensive insurance partnerships that provide broad coverage for patients. This means dealing with
Servicing Out-of-Area Blue Members
Servicing Out-of-Area Blue Members BlueCross BlueShield of Tennessee BlueCard 101 Servicing Out-of-Area Members Overview BlueCard Program Blue Products Member ID Cards Verifying Eligibility Utilization
2017 NMRHCA Benefits Presentation
2017 NMRHCA Benefits Presentation Presbyterian Senior Care (HMO-POS) Plan I and Plan II _[code]_[mmddyyyy] Who we are Started in 1908 as a Tuberculosis Sanatorium Presbyterian Today Locally owned, nonprofit
CENT Participating Insurances
CENT Participating Insurances 1199 National Benefit Fund 21 st Century Auto Insurance AAA Keystone Insurance AARP AARP Medicare AARP Medicate Advantage Administrative Concepts Administrative Services Aetna
65+ Retiree Medical and Dental Plans 2019 Open Enrollment Guide
The University of New Mexico 65+ Retiree Medical and Dental Plans 2019 Open Enrollment Guide Open Enrollment begins: Monday, October 15, 2018 Open Enrollment ends: 5 p.m. MST Friday, November 16, 2018
Select (HMO POS) SNP $65 per month LAST Name: FIRST Name: Middle Initial: Mr. Mrs. Ms. Birth Date: Home Phone Number: ( )
Superior Select Health Plans PO Box 3630 Little Rock, AR 72202 SuperiorSelectMedicare.com Please contact Superior Select if you need information in another language or format (Braille). To Enroll in a
Servicing Out-of-Area Blue Members
Servicing Out-of-Area Blue Members BlueCross BlueShield of Western New York BlueCard 101 May 31, 2011 A presentation of the Blue Cross and Blue Shield Association. All rights reserved. Servicing Out-of-Area
Blue care network pre authorization. Blue care network pre authorization
Paieška Paieška Paieška Blue care network pre authorization Blue care network pre authorization > > Blue Cross Complete (Medicaid) BCN Advantage HMO-POS Formulary Custom Formulary Prior Authorization and
2018 BlueCross Total SM (PPO) Individual Enrollment Request Form
P.O. Box 100191, Columbia, SC 29202-3191 2018 BlueCross Total SM (PPO) Individual Enrollment Request Form Please contact BlueCross BlueShield of South Carolina if you need information in another language
Cigna Medicare Advantage HMO Plans
Cigna Medicare Advantage HMO Plans 2018 Enrollment Request Form Please contact Cigna if you need information in another language or format (Braille). New enrollment Plan change To enroll in Cigna, please
Anthem Blue Cross. CCHCA Physician Handbook (7 th Edition)
Part II Section B Introduction 1 Verifying Member Eligibility and Benefits 1 Sample Member ID Card 2 Eligibility Certification Form 3 CCHCA Physician Handbook (7 th Edition) INTRODUCTION, created in 1986
2019 BlueCross Secure SM (HMO) Individual Enrollment Request Form
P.O. Box 100191, Columbia, SC 29202-9954 2019 BlueCross Secure SM (HMO) Individual Enrollment Request Form Please contact BlueCross BlueShield of South Carolina if you need information in another language
Appendix C Most Common Payer ID/Health Plan ID Numbers (NAIC Codes)
Most Common Payer ID/Health Plan ID Numbers ( s) Aetna Better Health, Inc. Medicaid HMO 25 13735 Aetna Health, Inc. HMO 45 95109 Aetna Health, Inc. Medicare HMO 15 95109 Golden Medicare Aetna Health, Inc.
Enrollment Application
2014 MEDICARE ADVANTAGE Enrollment Application Senior Blue HMO and HMO-POS Forever Blue Medicare PPO Optional Supplemental Dental If you have any questions, we re here to help! www.bsneny.com/medicare
Provider Orientation 2009
Provider Orientation 2009 1 This orientation will cover the following topics: Who is Coventry Health Care? Products and Networks Product and Network Basics How to Identify the Members Useful References
2014 Excellus BlueCross BlueShield Medicare PPO Individual Enrollment Request Form
2014 Excellus BlueCross BlueShield Medicare PPO Individual Enrollment Request Form Excellus BlueCross BlueShield contracts with the federal government and is a PPO plan with a Medicare contract. Enrollment
Servicing Out-of-Area Blue Members
Servicing Out-of-Area Blue Members BlueShield of Northeastern New York BlueCard 101 May 31, 2011 Servicing Out-of-Area Members Overview BlueCard Program Blue Products Member ID Cards Verifying Eligibility
To Enroll in Cigna Medicare Select Plus Rx, Please Provide the Following Information:
Cigna Medicare Select Plus Rx (HMO) Medicare Advantage Plans 2014 Enrollment Request Form Please contact Cigna Medicare Select Plus Rx if you need information in another language or format (Braille). To
To Enroll in a Superior Select Health Plan, Please Provide the Following Information: Please check which plan Tribute (HMO POS) SNP $0 per month
Superior Select Health Plans PO Box 3630 Little Rock, AR 72202 SuperiorSelectInc.com/Medicare Please contact Superior Select if you need information in another language or format (Braille). To Enroll in
Understanding Health Insurance A beginner s guide to helpful resources, terms to know, and much more
Understanding Health Insurance A beginner s guide to helpful resources, terms to know, and much more www.communitycare.com Let s Start With the Basics: Common Terms to Know: Claim a request by a plan member,
ENROLLMENT REQUEST FORM
ENROLLMENT REQUEST FORM Please contact Affinity Health Plan if you need information in another language or format (Braille). To Enroll in Affinity Health Plan, Please Provide the Following Information:
Golden State Medicare Gold (HMO)
Medicare Advantage Enrollment Form for: Golden State Medicare Gold (HMO) Typically, you may enroll in a Medicare Advantage plan only during the annual enrollment period from October 15 through December
Bcbs network cheat sheet
Mix with the Best Bcbs network cheat sheet 2-5-2018 Medical Billing & Coding For Dummies Cheat Sheet.. Medical Billing & Coding For Dummies Cheat Sheet; the patient to a specialist within the network..
THANK YOU FOR YOUR INTEREST IN A MEDICARE SUPPLEMENT PLAN
PDF AMERIGROUP - WIKIPEDIA THANK YOU FOR YOUR INTEREST IN A MEDICARE SUPPLEMENT PLAN 1 / 6 2 / 6 3 / 6 medicare amerigroup pdf Amerigroup is a United States health insurance and managed health care provider.
Memorial Hermann Advantage (PPO)
Memorial Hermann Advantage (PPO) 2016 Enrollment Form Follow these easy steps to enroll in a Memorial Hermann Advantage Preferred Provider Organization (PPO). 1. Each applicant must fill out a separate
Mount Sinai Hospital/Mount Sinai Queens Listing of Contracted Insurance Carriers
Listing of Contracted Insurance Carriers Mount Sinai Hospital/Mount Sinai Queens 1199 Union PPO ADAP (opd only) NS HIV program NS HIV program N N Aetna U.S.Healthcare Insurance Co. HMO/POS/Indemnity MSBISLR
4 Learning Objectives (cont d.)
1 2 Learning Objectives Define pertinent TRICARE and CHAMPVA terminology and abbreviations. State who is eligible for TRICARE. Explain the differences of the TRICARE Standard government program. List the
2015 Enrollment Form. H5471_SHPE02R2067 Approved 9/18/2014. White Copy Enrollment Yellow Copy Agent Pink Copy Member
2015 Enrollment Form White Copy Enrollment Yellow Copy Agent Pink Copy Member Please Read This Important Information If you currently have health coverage from an employer or union, joining Simply Healthcare
Office Policies. Clinic Timing: Monday to Friday: 8 am to 7 pm
Office Policies Thank you for choosing Progressive Medical Care (PMC) for your healthcare needs. Our mention is to provide you best available care in our resources and knowledge. Please take time to read/understand
2018 BlueCross Rx Value SM (PDP) BlueCross Rx Plus SM (PDP)
P.O. Box 100191, Columbia, SC 29202-3191 2018 BlueCross Rx Value SM (PDP) BlueCross Rx Plus SM (PDP) BlueCross Rx Value/BlueCross Rx Plus Medicare Prescription Drug Plan Individual Enrollment Form Please
2019 Medicare Advantage Enrollment Form
Arizona 2019 Medicare Advantage Enrollment Form Please contact Bright Health at 844-667-5502 (TTY: 711) if you need information in another language or format (Braille). To Enroll in Bright Health Please
Medicare Alert: Temporary Member Access
Medicare Alert: Temporary Member Access Plan Sponsor: Coventry/Aetna Medicare Part D Effective Date: Jan. 12, 2015 Geographic Area: National If your pharmacy is a Non Participating provider in the Aetna/Coventry
2017 Medicare Benefits Choices and Enrollment Guide
For Sandia Medicare Eligible Participants 2017 Medicare Benefits Choices and Enrollment Guide For Medicare Retirees, Surviving Spouses, Long-Term Disability (LTD) Terminees, and/or Medicare Dependents
*2017 Plan Cost Comparison
*2017 Plan Cost Comparison The following health insurance plans are available to Medicare-eligible plan participants enrolled in both Medicare Part A and Part B, unless you have Medicare due to ESRD and
6/1/2017. Payor Payor Type Product Transplants (some exclusions apply, contact your carrier for further information)
6/1/2017 Mount Sinai Hospital/Mount Sinai Queens 1199 Union ADAP (opd only) S HIV program S HIV program Aetna U.S.Healthcare Insurance Co. HMO/POS/Indemnity MSBISLR non par with Indemnity C Community Plan
Please contact Molina Healthcare if you need information in another language or format (Braille).
Please contact Molina Healthcare if you need information in another language or format (Braille). To Enroll in Molina Healthcare, Please Provide the Following Information Enrollment Form Please check which
Member Fact Sheet Medicare Secondary Payer Small Employer Exception
Member Fact Sheet Medicare Secondary Payer Small Employer Exception The Episcopal Church Medical Trust (Medical Trust) is providing eligible employers with the option to apply for the Medicare Secondary
Medicare Advantage True Blue HMO and Secure Blue PPO Election Form Instructions
Medicare Advantage True Blue HMO and Secure Blue PPO Election Form Instructions Follow these easy steps to enroll now! 1 Please provide your name, address, birthday and phone number(s). 2 3 Have your red,
How to Assist Beneficiaries Impacted by Aetna/Coventry 2015 Part D Plans
**SPECIAL ALERT** How to Assist Beneficiaries Impacted by Aetna/Coventry 2015 Part D Plans Due to inaccurate information posted about in-network pharmacies and cost-sharing for certain Aetna/Coventry Part
STEPS TO RETIREMENT CERTIFIED RETIREES. March 2, 2017
STEPS TO RETIREMENT 2016-2017 CERTIFIED RETIREES March 2, 2017 AGENDA ARTICLE 33A SEVERANCE PAY REA RETIREMENT GROUP RETIREMENT FROM A PAYROLL PERSPECTIVE ARTICLE 33B EARLY RETIREMENT INSURANCE Dawn Granath,
Allwell from Louisiana Healthcare Connections 2018 Individual Enrollment Form
Allwell from Louisiana Healthcare Connections 2018 Individual Enrollment Form Please contact Allwell if you need information in another language or format (Braille). To enroll in Allwell, please provide
Overview of Plans for Medicare Eligible Members
Overview of Plans for Medicare Eligible Members The following pages offer general descriptions of the types of plans offered to CTPF retirees who are eligible for and maintain active enrollment in Medicare
INSTRUCTIONS for COMPLETING Optima Community Complete (HMO SNP) Enrollment Request Form
INSTRUCTIONS for COMPLETING Optima Community Complete (HMO SNP) Enrollment Request Form IMPORTANT: Please PRINT information in pen and DO NOT SKIP any steps. Fill all information in as completely as possible.
Individual Enrollment Request Form Please contact Denver Health Medical Plan, Inc. if you need information in another language or format (Braille).
Individual Enrollment Request Form Please contact Denver Health Medical Plan, Inc. if you need information in another language or format (Braille). To Enroll in Denver Health Medical Plan, Inc., Please
Required Fields Are Indicated With An Asterisk* AGENT NUMBER (SAN)* MEDICAID NUMBER. Stamp Date. 1 Humana Medicare Enrollment Form
1 Humana Medicare Enrollment Form If you re currently enrolled in an OSB, you MUST choose PLAN OPTION*: it on this form to continue receiving this benefit. Not all OSB offerings are available in all areas.
2019 BlueCross Rx Value SM (PDP) BlueCross Rx Plus SM (PDP)
P.O. Box 100191, Columbia, SC 29202-9954 2019 BlueCross Rx Value SM (PDP) BlueCross Rx Plus SM (PDP) BlueCross Rx Value/BlueCross Rx Plus Medicare Prescription Drug Plan Individual Enrollment Form Please
Medical Eligibility & Benefits Lookup Tips
Medical Eligibility & Benefits Lookup Tips Excellus BlueCross BlueShield requires providers to use its self-service tools to determine patient eligibility and benefits. Provider Portal Note: Please see
Aetna Medicare Open Plan (Medicare Advantage Plan-Private Fee For Service) No Yes PET, CT Virtual Colonoscopy, and CTA Coronary
AARP / AARP Medicare Complete Usually secondary to Medicare - verify card states Medicare Supplemental Coverage. AARP Medicare Complete thru United Healthcare (Medicare Replacement) Medicare Supplement
COMPARISON CHART MEDICARE SUPPLEMENT INSURANCE. and. MEDICARE CONTRACTING HMOs. Available in Hunterdon County
COMPARISON CHART of MEDICARE SUPPLEMENT INSURANCE and MEDICARE CONTRACTING HMOs Available in Hunterdon County Prepared by the The Hunterdon County Division of Senior Services PO Box 2900, 4 Gauntt Place
Benefit Choices and Enrollment Guide For Individuals Who Retired Prior to January 1, 2012
2018 Benefit Choices and Enrollment Guide For Individuals Who Retired Prior to January 1, 2012 For PreMedicare and Medicare Retirees, Surviving Spouses, Long-Term Disability (LTD) Terminees, and/or PreMedicare
4C: PAYOR CONTRACT NEGOTIATIONS. All Rights Reserved. Objectives:
4C: PAYOR CONTRACT NEGOTIATIONS Marcia Brauchler, MPH, CMPE, CPC, CPC-H, CPC-I, CPHQ April 14, 2014 3:45 5:00 p.m. All Rights Reserved. 1 Objectives: Get organized for successful payer contracting negotiations
TO ENROLL IN KEYSTONE FIRST VIP CHOICE, PLEASE PROVIDE THE FOLLOWING INFORMATION Last name:
Please contact Keystone First VIP Choice (HMO SNP) if you need information in another language or format (for example, Braille). TO ENROLL IN KEYSTONE FIRST VIP CHOICE, PLEASE PROVIDE THE FOLLOWING INFORMATION
2018 Medicare Advantage Prescription Drug Plan (MAPD) Individual Enrollment Form
2018 Medicare Advantage Prescription Drug Plan (MAPD) Individual Enrollment Form Please contact FirstMedicare Direct if you need information in another language or format (Braille or Large Print). To Enroll
BCBSHP MediBlue Dual Advantage (HMO SNP)
BCBSHP MediBlue Dual Advantage (HMO SNP) Individual Enrollment Request Form 2017 Be sure to complete the entire enrollment form. Then, mail the completed form to P.O. Box 659404 San Antonio TX, 78265-9863
M e d i c a r e a n d O t h e r I n s u r a n c e f o r P e o p l e w i t h D i s a b i l i t i e s
M e d i c a r e a n d O t h e r I n s u r a n c e f o r P e o p l e w i t h D i s a b i l i t i e s January 2010 Becoming Eligible for Medicare: When you are entitled to Social Security disability benefits
Memorial Hermann Advantage (HMO)
Memorial Hermann Advantage (HMO) 2017 Enrollment Form Follow these easy steps to enroll in a Memorial Hermann Advantage Health Maintenance Organization (HMO). 1. Each applicant must fill out a separate
2018 NMRHCA Benefits Presentation Presbyterian Senior Care (HMO-POS) Plan I and Plan II
2018 NMRHCA Benefits Presentation Presbyterian Senior Care (HMO-POS) Plan I and Plan II Who we are Started in 1908 as a Tuberculosis Sanatorium Presbyterian Today Locally owned, nonprofit healthcare system
Third Party Liability (TPL) Simplified
Third Party Liability (TPL) Simplified Spring 2018 Agenda What is Third Party Liability (TPL)? How do I know if a member has TPL? Eligibility Commercial Traditional, PPO, HMO Medicare primary, supplements,
Please select a premium payment option: Get a bill
CHRISTUS Health Plan Generations Enrollment Application Please check the plan that you want: CHRISTUS Health Plan Generations (HMO) Plan 003 ($0 monthly premium) CHRISTUS Health Plan Generations Plus (HMO)
Alternate Phone Number: ( ) Address: Sex: 9 M ( ) 9 F. Permanent Residence Address (P.O. Box is not allowed): City: State: Zip Code:
PO Box 9178 Watertown, MA 02472 2018 TUFTS MEDICARE PREFERRED HMO INDIVIDUAL ENROLLMENT FORM Please contact Tufts Health Plan Medicare Preferred if you need information in another language or format (Braille).
To enroll in Vantage Medicare Advantage, please provide the following information:
Medicare Advantage Enrollment Election Form Vantage Medicare Advantage Vantage Health Plan, Inc. 130 DeSiard Street, Suite 300 Monroe, LA 71201 (318) 361-0900 TTY (318) 361-2131 (866) 704-0109 TTY (866)
9 HMO Basic Rx $23.00 per month 9 HMO Value Rx $54.00 per month 9 HMO Prime Rx $79.00 per month 9 HMO Prime Rx Plus $99.
PO Box 9178 Watertown, MA 02472 2019 TUFTS MEDICARE PREFERRED HMO INDIVIDUAL ENROLLMENT FORM Please contact Tufts Health Plan Medicare Preferred if you need information in another language or format (Braille).
BlueCHiP for Medicare 2014 Individual Enrollment Request Form
BlueCHiP for Medicare 2014 Individual Enrollment Request Form Please contact BlueCHiP for Medicare if you need information in another language or format (large print). To Enroll in BlueCHiP for Medicare,
To Enroll in CareOregon Advantage, Please Provide the Following Information: ( ) Please Provide Your Medicare Insurance Information
PLAN USE ONLY: Received Date Time Enter Date ES Submit Date ES To Enroll in CareOregon Advantage, Please Provide the Following Information: Please check which plan you want to enroll in: CareOregon Advantage
Prepared by Marsha Gold and Dawn Phelps i ; and Gretchen Jacobson and Tricia Neuman ii June 2010
MEDICARE ADVANTAGE 2010 DATA SPOTLIGHT Plan Enrollment Patterns and Trends Prepared by Marsha Gold and Dawn Phelps i ; and Gretchen Jacobson and Tricia Neuman ii June 2010 In March 2010, 11.1 million Medicare
UnitedHealthcare IMGMA 2017
UnitedHealthcare IMGMA 2017 Indiana Advocates 2 Exciting changes are forthcoming! 3 eligibilitylink Voluntary usage deployed on 1-18-17, forced usage deployed on 2-8-17 Patient Eligibility & Benefits removed
GlobalHealth Medicare Advantage Plans
GlobalHealth Medicare Advantage Plans Individual Enrollment Request Form (For New Members Only) Attestation of Eligibility for an Enrollment Period Typically, you may enroll in a Medicare Advantage plan
Memorial Hermann Advantage (HMO)
2015 APPLICATION Memorial Hermann Advantage (HMO) Memorial Hermann Advantage (HMO) plan Individual Enrollment Form Be sure to read the important disclosures listed on the back before completing this application.
Understanding Medicare Advantage Plans
Understanding Medicare Advantage Plans Overview Overview of Medicare Advantage Plans Types of Medicare Advantage Plans Eligibility Requirements How Medicare Advantage Plans Work Enrollment Estimating the
PrEP RESOURCE GUIDE san diego
PrEP RESOURCE GUIDE san diego The purpose of this list is to offer guidance for getting a prescription for Truvada as pre-exposure prophylaxis (PrEP). It does not guarantee coverage. Verify that your insurance
Priority Health Medicare
Priority Health Medicare To enroll online please visit our website at prioritymedicare.com Enrollment instructions To avoid delays in processing your enrollment, please follow these helpful tips. Make
Working with Anthem Subject Specific Webinar Series
Working with Anthem Subject Specific Webinar Series BlueCard Program Introduction Access to Audio Portion of Conference: Dial-In Number: 877-497-8913 Conference Code: 1322819809# Please Mute Your Phone
What You Need to Know About
What You Need to Know About Member Identification Cards 2016 Edition Published by Provider Relations and Education Your Partners in Outstanding Quality, Satisfaction and Service Revision: December 2015
BlueMedicare SM Preferred (HMO) BlueMedicare SM Preferred POS (HMO POS)
P.O. Box 45296 Jacksonville, FL 32232-5296 BlueMedicare SM Preferred (HMO) BlueMedicare SM Preferred POS (HMO POS) A Medicare Advantage Health Care Plan Individual Enrollment Form Please contact BlueMedicare
An Analysis of 2017 Medicare Business Competition
An Analysis of 2017 Medicare Business Competition 10/14/2016 by Mark Farrah Associates The Annual Election Period (AEP), or open enrollment, for Medicare Advantage and prescription drug plans (PDPs) will
Empire MediBlue (HMO) Individual Enrollment Request Form 2017
Empire MediBlue (HMO) Individual Enrollment Request Form 2017 Be sure to complete the entire enrollment form. Then, mail the completed form to P.O. Box 659403 San Antonio TX, 78265-9714 or fax the completed
New York Eye and Ear Infirmary at Mount Sinai Listing of Contracted Insurance Carriers
ew ork Eye and Ear Infirmary at Mount Sinai Listing of Contracted Insurance Carriers ew ork Eye and Ear Infirmary at Mount Sinai 1199 Union ADAP (opd only) S HIV program S HIV program Aetna U.S.Healthcare
Allwell from Superior Health Plan 2018 Individual Enrollment Form
Allwell from Superior Health Plan 2018 Individual Enrollment Form Please contact Allwell if you need information in another language or format (Braille). To enroll in Allwell, please provide the following
Generations Medicare Advantage Plans, Offered By GlobalHealth
Generations Medicare Advantage Plans, Offered By GlobalHealth Individual Enrollment Request Form (For New Members Only) Attestation of Eligibility for an Enrollment Period Typically, you may enroll in
Individual Enrollment Request Form
SE Please contact Network Health Medicare Advantage Plans To Enroll in a Network Health Medicare Advantage Plan, Please Provide the Following Information. Please check which plan you want to enroll in.
City: State: Zip Code: Street Address: City: State: Zip Code:
2014 PLAN ELECTION FORM ATRIO Health Plans Marion and Polk County 2270 NW Aviation Drive, Suite 3 Roseburg, OR 97470 (541) 672-8620, (877) 672-8620 or TTY (800) 735-2900 To Enroll in ATRIO HEALTH PLANS,
2018 Medicare Advantage Enrollment Request Form
2018 Medicare Advantage Enrollment Request Form Please contact Florida Hospital Care Advantage if you need information in another language or format (Braille). To Enroll in Florida Hospital Care Advantage,