Toll Free: (800) UM decision making is based only on appropriateness of care and service and existence of coverage. Provider Customer Service Anthem Blue Cross HMO AHP ASO CL016 AB72 Payments to Non-Contracted Providers.AHP ASO CL015 Timely Filing of claim or PDR.AHP ASO CL011 Interest Requirements for Late Payments, Appeals and PDRs.
AHP ASO CL006 Contested and Denied Claims Notification.AHP ASO CL002 Receipt and Acknowledgement of Claims.AHP ASO CL001 AB1455 Claims Payment Guidelines.Aspire Health providers should review the policies and procedures regarding claims submission and processing, listed below, to ensure they are up-to-date on the current practices of the plan. AHP-PS006 Provider Network Notification to Authorities and Practitioner Appeal Rights – CR 6Īspire Health complies with all the claims payment requirements set forth in the Knox-Keene Health Care Service Plan Act of 1975.AHP-PS005 Provider Network Ongoing Monitoring and Interventions – CR5.AHP-PS004 Provider Network Recredentialing Cycle Length – CR4.AHP-PS003 Provider Network Credentialing – CR3.AHP-PS002 Provider Network Credentialing Committee – CR2.AHP-PS001 Provider Network Credentialing Standards – CR1.Click here to for more information about CAQH.īefore you apply, please review our policies and procedures: The Plan utilizes CAQH for submission of completed, signed and dated applications.
Healthcare professionals who wish to join our managed care commercial HMO network will be subject to credentialing by Aspire Health.
Health Care Coverage During a State of EmergencyĪspire Health, in coordination with its full-service commercial plan partners, must provide enrollees who have been displaced or whose health may otherwise be affected by a state of emergency, as declared by the Governor, or a health emergency, as declared by the State Public Health Officer, with access to medically necessary health care services. If you do not have a portal account and would like to establish one, please call (503) 584-2169 Submit authorization requests electronically at: id. Please review the clinical utilization management guidelines of our partner plans: Providers who care for members in one of our managed care commercial plans must use these guidelines below as the first tier of the decision hierarchy. Medical Policies and Clinical Utilization Management Guidelines
Anthem timely filing manuals#
Please review the provider manuals of our health plan partners:
Anthem timely filing manual#
Providers who care for members in one of our managed care commercial plans must abide by their provider manual requirements.
Anthem timely filing update#
If you’re a member of our Medicare Advantage network through the Monterey Bay Independent Physicians Association (MBIPA), click here for your resources.Ĭommercial Roster Information – Update Form
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