Register to receive time-sensitive messages about emergencies and certain non-emergency events straight from us to you. Once enrolled, members will receive a card that shows they qualify for Hillsborough Health Care and that they are a member. please update to most recent version. If you do not recognize your site key token, do not type your password. If you have any questions, please contact Member Services. correction and an associated timeline with the provider on a case-by-case basis. To get the full experience of this website, If you navigate away from this page, you will lose unsaved data. First time users will be prompted to register now. The Hillsborough County Health Care Plan offers affordable medical and dental care for those who cant afford traditional medical insurance. Screen Resolution - 1024 x 768 pixels. View (Section 1300.67.241) (PDF) to read the complete DMHC regulations specifying the process. MN: Patient has Medicaid Medically Needy program. If you recognize your site key token, you know you can safely type your password. business operations that arise, so that you can focus on doing what you Beginning Jan. 1, 2023, TennCare Medicaid adult members will have dental benefits included in their health plan. Check on the status of their claims. If you navigate away from this page, you will lose unsaved data. Submit claims, look up fee schedules, check status, view payment information, and submit reconsideration and appeal requests. Your browser is out of date. Find eligibility guidelines, begin the enrollment process, and choose from doctors who accept the plan. Whether you are an FHCP staff provider or have chosen to contract with Seeks resolution of a billing determination or other contractual dispute. You may download Instructions for Submitting Provider Disputes (PDF) or call CCHP Provider Relations at 1-415-955-8800, ext. 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. Start by entering in your username and password. The plan provides primary and specialty care, outpatient treatment, and assistance with prescriptions. Would you like to enroll as an Ordering, Prescribing or Referring (OPR) "Non-Billing" Provider? The plan provides primary and specialty care, outpatient treatment, and assistance with prescriptions. InterGroup Services teams with the best in class partners to provide the highest level of technology and network access. Effective Dec. 5, 2022, OHCA has closed coverage for COVID monoclonal antibody treatment Bebtelovimab, reported by codes Q0222 and M0222. Learn More About FHCP's Provider Relations. The audio should start automatically. All without having to pick up the phone. Make 2023 your year for staying up-to-date with changes that impact your practice. After signing the provider contract, OHCA via DocuSign will send you an email with the completed eSignature page attached. A non-contract provider, on his or her own behalf, is permitted to file a standard appeal for a denied claim only if the non-contract provider completes a waiver of liability statement, which provides that the non-contract provider will not bill the Medicare member regardless of the outcome of the appeal. An additional verification will soon be required when a provider contacts the Provider Services Call Center. 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. Members must bring the cards with them each time they see a caregiver. Registrants unable to attend the webinar session should notify mailto:SoonerCareEducation@okhca.org to cancel their registration. 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. Effective July 1, 2014, the new Prescription Drug Prior Authorization Request Form is required for non-Medicare plans. Visit nh.gov for a list of free .pdf readers for a variety of operating systems. worker's compensation, victims of crime compensation, vocational rehabilitation, etc. Submitting Paper Claims You can download your very own copy of CCHP Provider Manual: The Centers for Medicare and Medicaid Services (CMS) requires annual fraud, waste and abuse training for organizations providing health, prescription drug, or administrative services to Medicare Advantage (MA) or Prescription Drug Plan (PDP) enrollees on behalf of a health plan. Learn More About Your CCHP Coverage & Latest News On COVID-19. Thank you for being part of the Florida Health Care Plans provider team. Providers must be knowledgeable with the federal requirements and information regarding fraud, waste and abuse. Phone: 1-866-291-1674. At the 2- or 4-week mark, respectively, the reviewer will determine if the provider has acknowledged and made a good faith effort to address the CAPs in a timely manner. We are committed to serving our community and are devoted to delivering the highest quality health plan to the people and organizations we serve. The file types and links to the associated tools which you may need to download and install are listed below: Currently, there are no materials available for this category. You can also use this page to report any changes in the providers information such as phone number, language, and location. The website also contains reference materials such as the provider guide and a quick reference formulary wall chart for providers. Microsoft Excel File (.xlsx) . We consider our health care providers as our customers and vital partners in serving our Members. When your account was created we emailed you a password. Effective Dec. 5, 2022, OHCA has closed coverage for COVID monoclonal antibody treatment Bebtelovimab, reported by codes Q0222 and M0222. Discover the Online Provider Center (OPC). Once you log on to the new Portal with your current credentials, you will be asked to update your password. Our FHCP Provider Relations Department is here to assist you with the day-to-day 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 . 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. Microsoft Office Suite 2000 and later. OHCA has updated coverage for laboratory testing of infectious diseases using molecular testing (CPT 87471-87801) effective Jan. 1, 2023. . 1-888-775-7888 (Toll free) 1-415-834-2118 (Local) Monday - Saturday: 9 a.m. - 5 p.m. memberservices@cchphealthplan.com Provider Resources Filing Claims Submitting Claims Electronically CCHP prefers claims be submitted electronically. OnlineCenter. CCHP has a Provider Dispute Resolution (PDR) process that ensures provider disputes are handled in a fast, fair and cost effective manner. All paper claims must be submitted using a CMS 1500 form (for professional providers) and a UB-92 form (for institutional providers). Access information about your provider user account. All Rights Reserved. Check prior authorization and notification requirements, submit requests, upload medical notes, check status and update cases. InterGroup Services is the most comprehensive PPO network serving Pennsylvania, New Jersey, Delaware and West Virginia. View their Remittance Advices. 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. 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. Conduent Provider Relations. CMS Non-Contracted Provider Dispute Process (PDF). Information on COVID-19 vaccines, testing, as well as resources and case tracking. Outpatient Rehab- Occupational Therapy (OT) Initial, Outpatient Rehab- Physical Therapy (PT) Initial, Outpatient Rehab- Speech Therapy (ST) Initial, Urology Checklist for Cystoscopy-Cystourethroscopy, Urology Checklist for Prostratic RF Thermotx, Wound Care-Hyperbaric Oxygen Therapy (HO2), Computed Tomography (CT) Abdomen and Pelvis, Computed Tomography Angiogram (CTA) Coronaries, Magnetic Resonance Cholangiopancreatography (MRCP), Magnetic Resonance Imaging (MRI) Cervical Spine, Magnetic Resonance Imaging (MRI) Lumbar Spine, Magnetic Resonance Imaging (MRI) Pituitary, Magnetic Resonance Imaging (MRI) Shoulder, Magnetic Resonance Imaging (MRI) Thoracic Spine, Nuclear Stress Test-Thallium-Technetium-Sestamibi, Positron Emission Tomography (PET) Whole Body, Speciality Physician Visit for Pain Management. Mozilla Firefox version 2.0 and later. The FDA has removed the emergency use authorization (EUA) for this treatment as it is no longer expected to be effective against the dominating strains of COVID circulating at this time. Then save it. If you do not recognize your site key token, do not type your password. Effective Dec. 15, 2022, OHCA will begin using DocuSign's secure digital signature technology for SoonerCare provider contracting. Medicare Fraud, Waste and Abuse and Compliance Training (PDF). Your site key token displays. PROVIDER PORTAL INSTRUCTIONS PROVIDER LOGIN Remember me? New CMS Provider Sequestration Deductions, Provider Portal Eligibility & Claims Inquiry. Inquiries will be quickly acknowledged (same day), triaged, sent to the appropriate CCHP team for review. In addition, CCHP is contracted with the Centers for Medicare and Medicaid Services (CMS) to offer a Medicare Advantage HMO plan (Part C), a Medicare Advantage Special Needs Program (HMO D-SNP), and an integrated Medicare Advantage Prescription Drug Plan (Part D). Need access to the UnitedHealthcare Provider Portal? Download the Waiver of Liability Statement (PDF). Its available 24/7 and at no cost to you. Pittsburgh Office (888) 496-8098 | Contact Us. Are you sure you want to logout? Providers will find the updated coverage guidelines on the Medical Authorization Unit's webpage.. 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 . Note: If you have not created your personalized site key token, you will be asked to do so before you sign into the SoonerCare Portal. Verify member eligibility, determine benefits, view care plans and get a digital copy of the member ID card. If you do not recognize your site key token, do not type your password. We work hard to be a reliable resource and advocate for our healthcare providers. Create portal user accounts for your staff. Learn More About FHCP's Provider Relations Medication Education, Resources & Support Document Center Provider Newsletters Medication Formularies Contact Us Special Needs Plans (SNP) Model of Care Training (PDF) 2021 2022, Special Needs Plans (SNP) Model of Care Training (Video) 2021 2022, Training Attestation Form (PDF) 2021 2022. For portal related questions contact our Portal Support Team at portalsupport@chcnetwork.org or 510-297-0480. The annual base salary for this position ranges from $127,400.00 to $204,000.00. Learn their benefits and features. 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. Your personalized site key token helps you identify that you are at the valid HealthCare Portal site. Formulary for Individual, Family and Covered CA, CCHP Pharmaceutical Management Procedures (PDF), Formulary (List of Covered Drugs) for Commercial Plans, CCHP Pharmacy Directory All Plans (PDF), CCHP Senior Program (HMO) Comprehensive Formulary (PDF) 2022, 2023, CCHP Senior Select Program (HMO) Comprehensive Formulary (PDF) 2022, 2023, CCHP Senior Select Program (HMO SNP) Comprehensive Formulary (PDF) 2022, 2023, Medicare Advantage/Prescription Drug System (MARx) March 2022 Payment Information (updated date 2/24/2022), Notice of Change to Provider Compensation (Effective April 1, 2022 and July 1, 2022), 2022 CCHP Member Satisfaction Survey (CAHPS), 1-888-371-3060 (Individual & Family, Commercial). KEPRO's training materials are available in various file formats, requiring specific tools to enable you to view them. Medication Education, Resources & Support. Visit the OHCA Provider Training page to register. 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. Password. The codes are as follows: Find Hospitals, Clinics, Dental, & Vision Providers, ACES Portal - Provider Back Office Users Guide, ACES Portal - Provider Eligibility Check Guide, If you submit claims thorough an MSO, you will need to obtain access from your MSO, Your MSO must be or will need to be set up as account administrator, As the administrator they can give you access if you are contracted with them, If you submit claims directly to the ASI claims clearing house, Emdeon, or you are an MSO, you can obtain your own login, ASI is Hillsborough Countys third-party claims administrator, ASI is wholly owned by American Benefits Plan Administrator (ABPA) and includes other plans as well, which is why you will see the ABPA home page, Members are covered for all necessary medical services, not including those services listed in the exceptions section of the manual, The patients primary care physician must coordinate all services for these plan members, Members are covered for all Plan A services with the exception of inpatient facility charges, Plan J members are enrolled in the Medicaid Medically Needy program and must take their inpatient hospital bills to their Medicaid social worker, Members require specific authorization from Hillsborough Health Care for each service authorized, Plan D members are covered for only a specific service. 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