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To “Verify” if you are a provider in the Network:
- By dialing 800.645.1006 you can enter your Enter your Tax ID to verify network participation. The system has an automated response letting you know if you’re in the network. Please have your practice tax ID handy.
- You can verify network participation here. Please have your tax ID handy.
We’re a new, national PPO network in partnership with other networks to bring physicians low cost employee benefits.
We’re accepting new providers. There is no cost or risk to join. It is a great patient referral source and affords many benefits to the practice. It’s also an open panel PPO. If you’d like to join, please click here. After submitting your information, we’ll send you a network fulfillment packet, where you’ll have the ability to review your contract. If you change your mind for any reason, just sign the form and send it back.
Nominating a provider or a colleague is easy. Click here to access our “Nominate a Provider” form. After submitting, you will receive an e-mail confirmation notifying that we have received your request to “Nominate a Provider”. We will then contact the provider and recruit them to the network.
Please contact us to verify or change your member information.
You can submit the claim via paper form to the address on your ID card. Or you can send it electronically through any major clearing house.
Please contact the insurance company listed on the back of the card for your claims status.
You can mail the claim to the address found on your ID card.
To address this, please contact the actual insurance company or claims payor. The phone number should be located on the ID Card. If you cannot find it, alternatively, you can contact the HR department or representative of the insured.
Yes. Please contact us and we can mail you a copy.
Please contact us to speak with a provider relations representative.
We are only the network and do not handle claims. The insurance company on the back of your ID card can help you with your question.
HIPAA mandated that the Secretary of Health and Human Services adopt a standard unique health identifier for health care providers. The Secretary adopted the NPI. The NPI is a numeric 10-digit identifier, consisting of 9 numbers plus a check-digit in the 10th position. It is accommodated in all standard transactions, and contains no embedded information about the health care provider that it identifies. Effective May 23, 2007, the NPI will be the only healthcare provider identifier that will be accepted/used for identification purposes for standard transactions by covered entities.
All health care providers that meet the definition of a covered entity (healthcare providers that conduct certain transactions in electronic form, health plans, or healthcare clearinghouses), as defined in 45 CFR 160.103, are eligible for NPIs. Health care providers who transmit any health information in electronic form in connection with a transaction are required to obtain and use NPIs. Health care providers who are not considered covered entities may also apply and be assigned an NPI. However, entities that do not provide health care (e.g., transportation services) are not eligible to be assigned NPIs because they do not meet the definition of “health care provider” and are not subject to HIPAA regulations.
The National Plan and Provider Enumeration System (NPPES) is the contractor hired by CMS to assign and process the NPIs, to ensure the uniqueness of the health care provider, and generate the NPIs. The NPPES will be able to produce reports and information based on requests from the health care industry and others. To learn more about the NPI and how to apply for an NPI, visit http://www.cms.hhs.gov/NationalProvidentStand/ on the CMS web site.
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