Prior Authorization Request Form - AARP
This document and others if attached contain information that is privileged, confidential and/or may contain protected health information (PHI). The Provider named above is required to safeguard PHI by applicable law. The information in this document is for the sole use of OptumRx. ... Get Document
Medicare Part B Medication PRIOR AUTHORIZATION Request Form
Medicare Part B Medication PRIOR AUTHORIZATION Request Form Blue Cross and Blue Shield of Texas refers to HCSC Insurance Services Company (HISC), which is a wholly-owned subsidiary of Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC). These companies are independent licensees of the Blue Cross and Blue Shield Association ... Visit Document
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SMG KC SMG KC Insurance Participation -TIN # 45-3074284 Rev 2 ...
SMG KC Insurance Participation -TIN # 45-3074284 rev 2-29-2016 SMG KC Participation Exceptions Advantra Medicare_Coventry HMO, PPO, POS Yes Aetna – All Commercial Products Yes Aetna Better Health (formerly Healthcare USA) Yes - Only Dr. Foster, IWC, ISC, Mid-America Urology and Northland OB ... Document Retrieval
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BCBS South Carolina-Preferred Health Systems-HMO Blue 403 BCBS South Carolina-Thomas Cooper 315 BCBS TN 00390 BCBS TX 84980 COVENTRY ADVANTRA MEDICARE ADVANTAGE Coventry Cares of Kentucky Coventry Dental CX049 Health America Health Care LA IPA MPM06 Health Care LA IPA (HCLA) ... Get Doc
Determining If A Doctor Is In Your Network Can Be Puzzling
OHB represents major carriers like AARP, Advantra, Aetna, Anthem Blue Cross Blue Shield, Coventry, Humana, HealthSpan, Medical Mutual of Ohio, SummaCare, United Healthcare, and more. Visit us online at www.OhioHealthBenefits.net for a complete list. ... Fetch Full Source
PRESCRIPTION DRUG MEDICATION REQUEST FORM FAX TO 1-866-240-8123
1. Submit a separate form for each medication. 2. Complete ALL information on the form. NOTE:The prescribing physician (PCP or Specialist) should, in most cases, complete the form. 3. Please provide the physician address as it is required for physician notification. ... Fetch Full Source
Helping Insured Patients Get Quality Testing At Lower Costs
Private Health Plans Accepted Accel Health Smart Acordia National Inc. Admar Health Network PPO, EPO ADMR Administrative Concepts Advantage by Superior Health Plan (Centene) Advantage Care Network Advantra Freedom Aetna Better Health of Texas Affiliated Healthcare* Allegian Health Plan Alliance PPO* Allwell Superior Healthplan (Centene) ... Read Here
Helping Insured Patients Get Quality Testing At Lower Costs
Accel Health Smart Acordia National Inc. Admar Health Network PPO, EPO ADMR Administrative Concepts Advantage by Superior Health Plan (Centene) Advantage Care Network Advantra Freedom Aetna Better Health of Texas Affiliated Healthcare* Allegian Health Plan Alliance PPO* Allwell Superior Healthplan (Centene) ... Retrieve Content
CARRIER CODE - LaMedicaid.com
Lam1r032 run: 12/22/18 07:14:29 louisiana department of health - medical assistance program page: 2 carrier name american medical security american national ins. co. 0041-00 one moody plz galveston tx 77550 american pioneer american postal workers union 0706-00 po box 3279 silver spring md 20918 american public life ins. co. 0045-00 po box 925 ... Retrieve Full Source
Www.cms.gov
AETNA HEALTH, INC. Coventry Advantra Silver (HMO) H1659 PIEDMONT COMMUNITY HEALTHCARE, INC. Piedmont Select Medicare Option One (PPO) Piedmont Medicare Advantage Piedmont Select Medicare Option Two (PPO) HCSC INSURANCE SERVICES COMPANY Advantra Silver (HMO) Advantra Gold (HMO) H1716 HumanaChoice H1716-001 (PPO) H1777 CATHOLIC SPECIAL NEEDS PLAN ... Fetch Content
HeW To RCM Payer List - Realmed.com
Advantra Freedom ADVANTRA/HEALTH AMERICA, INC ALTA HEALTH STRATEGIES ALTIUS HEALTH PLANS Altius Silver Cross Managed Care Organization (For dates of service prior to 1-1-15) UNITED BEHAVIORAL HEALTH NON HMO TEAMSTERS CONSTRUCTION INDUSTRY TRU ... Doc Viewer
AEVS: Carrier Codes For Other Health Coverage (aev Ohc Car)
C883 coventry advantra rx d001 denticare d002 health plan services d003 diversified group admin d004 elder health insurance co. premier plan h172 hmo health ohio h173 healthmax of america h175 hotel employees restaurant h178 health corp of america h179 hometown health network h180 humana ... View Document
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Advantra - Health Assurance - Health America, Inc. NIA11 Silver Cross Managed Care Org Oak West Primary Physician Assoc PacifiCare of Washington-Secure Horizon/HMO claims only Planned Administrators, Inc. (PAI) PacifiCare of Arizona - For payable PacifiCare - Secure Horizons HMO claims ... Retrieve Document
2016 Aetna Medicare First Look - Eldercare Insurance Services
Advantra Silver (PPO) Advantra Gold (PPO) Why You Should Sell This Plan $0 plan premium PPO, low PCP copay, $0 Tier 1 preferred generic and in-network access to providers in the Tri-State area of OH, PA, WV In-Network access to providers in the Tri-State area of OH, PA, WV. Lower than average co-pays, Embedded dental, ... Read More
Professional (Medical) Payer List - Payer Name Order
Professional (Medical) Payer List Payer Name Order Administrative Services of Kansas Updated October 2017 Administrative Services of Kansas (ASK) is Blue Cross and Blue Shield of Kansas DBA ASK. ... View Full Source
INSURANCE/PAYERS CURRENTLY FILED BY LABCORP IN Mid-Atlantic
Advantra-Coventry (Medicare Advantage) Aetna Better Health Aetna Medicare Open Plan (private, fee-for-service) Aetna*** Affordable Health Choices (formerly Strategic Resource Co) American Postal Workers Union (APWU) Health Plan** Amerigroup** AmeriHealth Administrators AmeriHealth Caritas Delaware^ AmeriHealth District of Columbia and ... View Full Source
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ADVANTRA COMMERCIAL- PPO/HMO AETNA- AEXCEL verbal referral only BCBS- VEL BLUE ADVANTAGE PLUS MEDICAL HMO CIGNA- FocusIN Flex Silver EPO QHP HEALTH PARTNER ** Cigna Network** all locations are in network PHCS- Freedom Life Ins Company of America (all locations are in network) ... Visit Document
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Elder Health HMO of Pennsylvania 53085 Wisconsin Auto and Truck Dealers Advantra/ Health Assurance/ Health America, Inc. WellPath MCDID Northern California Sheet Metal Workers Health Care Plan Silver Cross Managed Care Org ... View Doc
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