December 6, 2018
Welcome new Medicare Advantage network providers! We’re excited that you’re part of our Medicare Advantage network. To help you get ready for 2019, we’ve put together a list of important information to know about our plans and a few resources.
- Website: Go to our Medicare Advantage medical home page for anything you need for Medicare Advantage. Online tools, forms, policies, and resources are different for Medicare Advantage. You can’t use our regular provider website for Medicare Advantage.
- Referrals: PCPs are responsible for making sure all referrals are on file for their patients. This includes all requests for services performed by a specialist. You can submit referrals online by logging into OneHealthPort or fill out and fax our Medicare Advantage referral form on our Medicare Advantage forms page.
- Medicare Advantage Network: Our plans don’t cover non-emergency care from out-of-network providers or facilities. When you refer members to other providers for care, check our Medicare Advantage provider directory to make sure you’re referring only to in network providers.
- Policies and prior authorization requests: We have a different prior authorization list and separate policies for Medicare Advantage. Check the Medicare Advantage prior authorization list located on our Medicare Advantage policy page before submitting your requests.
- Plans: We have nine different Medicare Advantage plans with different benefit levels. All will have the prefix ZNP, plan name, and Medicare Advantage listed on the front of the card. Make sure you check out the back of the ID card for important phone numbers and information.
- Have more questions? We’ve posted up-to-date training materials on our Medicare Advantage home page to help you learn how to use our Medicare Advantage provider online tools or answer general questions about our plans. If you need more help with:
- General questions about member benefits or eligibility or claims, call customer service 888-850-8526.
- Changing your practice information, call physician and provider relations 877-342-5258.
- Questions about referrals or prior authorizations, call 855-339-8127.
- How can I learn more? We’ll continue to provide updates and details regarding Medicare Advantage plan changes through Provider News, email alerts, and information on our Medicare Advantage website. To make sure you receive the latest information, sign up for email notifications.