3214 for assistance. In KePROs medical management system, you can enter referrals, request pre-authorizations and check on the status of existing referrals or pre-authorizations. Members must bring the cards with them each time they see a caregiver. In addition, this position offers an annual bonus with a target of 17.5% of the base salary and eligibility to participate in our share based long term incentive program. 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. 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. Microsoft Office Suite 2000 and later. Effective Dec. 5, 2022, OHCA has closed coverage for COVID monoclonal antibody treatment Bebtelovimab, reported by codes Q0222 and M0222. 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. CCHP is a California licensed Knox-Keene health plan and offers a variety of commercial products for small and large group employers as well as products for individuals. Portable Document Format (.pdf) . Mozilla Firefox version 2.0 and later. Streamlined claims flows, including access to local, regional and national networks, will ensure that you can get your claims at the best possible savings the first time, and not spend a fortune to do it. For information, please call our Member Services at 1-415-834-2118. First time users will be prompted to register now. The health plan cannot undertake a review until or unless such form/documentation is obtained. eHeath care providers can find information about Hillsborough County Health Care Plan (HCHCP) member eligibility, medical services covered by the plan, formulary information, referral and authorization requests, billing inquiries and information, a provider newsletter and links related clinical and educational sites. An additional verification will soon be required when a provider contacts the Provider Services Call Center. We consider our health care providers as our customers and vital partners in serving our Members. Sign-in to get CCHP Member eligibility and claims information: For general provider-based inquiries, such as: Please contact us at Provider.Services@cchphealthplan.com. Your browser is out of date. For portal related questions contact our Portal Support Team at portalsupport@chcnetwork.org or 510-297-0480. Inquiries will be quickly acknowledged (same day), triaged, sent to the appropriate CCHP team for review. For Nevada providers, please contact your IT Department. Language assistance available: English Espaol Franais Deutsche Gujarati Kreyol Ayisien italiano Polskie Portugus Tagalog Ting Vit, Hearing impaired; TRS Relay 711 TTY: 1-800-955-8770. UnitedHealthcare NexusACO plans are growing in 2023. CMS Non-Contracted Provider Dispute Process (PDF). With the portal, you can: Check eligibility and benets information Submit prior authorization requests Your site key token displays. If you do not have the software needed for document viewing, you can download them using the . Verify member eligibility, determine benefits, view care plans and get a digital copy of the member ID card. Through the Indiana Health Coverage Programs (IHCP) secure and easy-to-use internet portal, healthcare providers can: Submit claims. 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. To get the full experience of this website, Would you like to enroll as a Trading Partner? Microsoft Internet Explorer version 7.0 and later. View/Print Information About Subsidized Child Care Contact my local Department of Social Services or Local Purchasing Agency Visit the Division of Child Development and Early Education Website American Rescue Plan Stabilization Grants for Child Care Providers Portal Log On If you navigate away from this page, you will lose unsaved data. Non-Contracted Provider Dispute Resolution Process For CMS Medicare Advantage Plan Members. With our dedicated customer service and easy to use website, InterGroup Services will help you navigate your way to a positive healthcare experience. Your site key token displays. Reduce administrative costs and decrease your revenue cycle while not affecting your current medical practice operations. Are you sure you want to logout? To save the document without opening it: Right-click the link in the document list and select "Save target as". After signing the provider contract, OHCA via DocuSign will send you an email with the completed eSignature page attached. 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. CCHP has a Provider Dispute Resolution (PDR) process that ensures provider disputes are handled in a fast, fair and cost effective manner. Would you like to enroll as a Trading Partner? Group Number for Patients or Tax ID for Providers. Tampa, FL 33602. Comprised of more than 9,000 highly-skilled, compassionate, medical professionals, 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. After registering, you will receive a confirmation email containing information about joining the webinar and reminder emails before the webinar begins. M0222 - INTRAVENOUS INJECTION, BEBTELOVIMAB, INCLUDES INJECTION AND POST ADMINISTRATION MONITORING, What can you do in the Soonercare Provider Portal. Start by entering in your username and password. How do we do this? business operations that arise, so that you can focus on doing what you All rights reserved. Find eligibility guidelines, begin the enrollment process, and choose from doctors who accept the plan. 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 . Screen Resolution - 1024 x 768 pixels. What can you do in the RI Medicaid Health Care Portal. Phone: 1-866-291-1674. Please check back later. 2023 CCHP Health Plan. 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. 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. Your personalized site key token helps you identify that you are at the valid SoonerCare Portal site. If you navigate away from this page, you will lose unsaved data. Please note, this form should also be used to request Prior Authorizations for Medicare plans. To check a CCHP plan drug list, a comprehensive formulary and pharmacy can be found below under CCHP Drug List. Seeks resolution of a billing determination or other contractual dispute. If you recognize your site key token, you know you can safely type your password. If this is your first login with multi-factor authentication, click here to complete your registration. Kepro Employees Use this login button if you have a Kepro domain account. To view a document and then save it: Click on the link in the document list to view the document in your browser. Once enrolled, members will receive a card that shows they qualify for Hillsborough Health Care and that they are a member. These all results are pre-approved and you don't need to take tension for any virus attack, as we also verify this Hchcp Provider Portal page . Discover the Online Provider Center (OPC). We comply with applicable Federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex. 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. 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. Check member eligibility and benefits, status of a claim or prior authorization, and more. VisitKePRO, the Hillsborough County Health Care Plans utilization review and medical management vendor. The plan provides primary and specialty care, outpatient treatment, and assistance with prescriptions. Remember Me Customer/Provider Use this login button if you are a customer or provider user. 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