endobj <>/Subtype/Form/Type/XObject>>stream xPpurb & <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 296.88 213.36 354.72 231.12]/Subtype/Widget/T(Policy)/TU(Policy #)/Type/Annot>> endstream Our innovative solutions identify emerging products and trends for better member engagement, improved outcomes and lower costs. endobj endobj Whether you're building an employee benefits program, researching your member benefits or offering support to your patients, we're ready to help you do more with your health plan. Meritain Healths claim appeal procedure consists of three levels: There are two forms listed below that a member must complete and give to the provider submitting the formal written appeal. 2JSt}Np~}y7i6i~..jnfE6zS\0 u}&p[ @68_=emL&Zqk$AT1KY$C#}Ra|h0{81[Gd8mdmmS4i\&;E 29 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 208.56 352.32 218.64 362.4]/Subtype/Widget/T(Group)/TU(Group)/Type/Annot>> When on the portal, you can also download our free mobile app. 128 0 obj endobj 141 0 obj endstream 154 0 obj H23U0t.=s#0agf!R@PBLX n 25 16 1000 or toll free 7) 232-3863 With wellness programs, on-demand tools, resources and caring support, Meritain Health puts easy-to-use health care at your fingertips. 0000002365 00000 n <> Allstate Health Solutions P.O. endobj xPpurb & You can also click here for our Member User Guide. <>/Subtype/Form/Type/XObject>>stream 102 0 obj 21 0 obj Box 30111 Lansing, MI 48909 Fax to: 888.837.3725 https://www.meritain.com/wp-content/uploads/2021/02/Microsoft-Word-FSA-Claim-Form_MI_2018.pdf endobj 0000091570 00000 n endobj 38 0 obj endobj Meritain is a division of Prodigy Health Group, the nations largest independent third-party administrator of self-funded health plans.Meritain part of $600M Aetna purchase - Buffalo Business Firstwww.bizjournals.com/buffalo/news/2011/04/28/meritain-Does meritain health require referrals?meritain or call 1-800-847-8361 for a list of network providers. <>/Subtype/Form/Type/XObject>>stream 5 0 obj 40 0 obj<>stream endobj <>/Subtype/Form/Type/XObject>>stream endstream %%EOF N.-BE+!W9wX4]c&OGQ endobj Mail completed Meritain Health form to: P.O. endobj Aetna Claim Address , https://medicalbillingrcm.com/aetna-claim-address-phone-number/, Health (4 days ago) WebList of Accounts managed by Mercy Managed Behavioral Health - effective 7/01/17 **Send claims directly to the third party administrator. 133 0 obj 0000007217 00000 n endstream <>/Subtype/Form/Type/XObject>>stream Submission of these forms to the Meritain Health Appeals Department without a formal written appeal from the provider will not be reviewed. endstream endstream endobj Contact us If you have questions about claims or benefits, we're happy to help. endstream 134 0 obj endstream 48 0 obj 0000243858 00000 n 0000002847 00000 n 0000075478 00000 n If you have any questions about your benefits or claims, were happy to help. }i&;nHf%l#%YYN:,#OY%, O$S-]2!Q` [Bp 106 0 obj endobj endobj endstream 140 0 obj At Meritain Health, our jobs are simple: we're here to help take care of you. xPpurb & <>/Subtype/Form/Type/XObject>>stream <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 128 0 R /Rect[ 234.36 198.96 244.44 209.04]/Subtype/Widget/Type/Annot>> endstream 0000124097 00000 n xPpurb & <>/Subtype/Form/Type/XObject>>stream Aetna Open Choice PPO Network. <>stream Or fax to (763)-852-5057. endobj 0000002362 00000 n 40 0 obj <>/Subtype/Form/Type/XObject>>stream %PDF-1.4 % xPpurb & Producer. <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 143.52 401.52 153.6 411.48]/Subtype/Widget/T(No go to section 4)/TU(No \(go to section 4)/Type/Annot>> endstream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 344.836 599.04 449.16 617.818]/Subtype/Widget/T(Identification Number)/TU(Identification Number)/Type/Annot>> Learn how to partner with us. 0000006809 00000 n <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream endstream endobj endstream 174 0 obj <> endobj endobj endobj endstream endobj endstream Our navigation partnerships and holistic approach to plan design helps support member health journeys. endobj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Tabs/W/Type/Page>> Claims Mailing Address: Meritain Health PO Box 853921 Richardson, TX 75085-3921 EDI: WebMD/Emdeon 41124 McKesson/Relay Health 1761 Dental Claims Paper Claim Mailing Address: Anthem Dental Claims PO Box 659444 San Antonio, TX 78265-9444 Electronic claims are submitted via payor ID 84105 Dental Claims Inquiries Paper Fax: 314.984.8653 Electronic Fax: 0000262751 00000 n endstream 13 0 obj The latest from Meritain Health Offering Easy Access to Virtual Mental Well-being Providers April 9, 2023 Today's employees crave support for their emotional and mental well-being. <>/Subtype/Form/Type/XObject>>stream xPpurb & hbbd```b`` "A"BA$0"Y)0 * dP=&m$ N r 63 0 obj If you have questions about claims or benefits, were happy to help. Box 853921 Richardson, TX 75085-3921 Fax: 1.763.852.5057 If the patient is a dependent, please complete ALL of the following. endobj 1 Health and Welfare IBEW Local 1 Health & Welfare Fund 103 0 obj Together, well explore your ideal plan to meet your endstream endstream endobj 26 0 obj<> endobj 27 0 obj<> endobj 28 0 obj<>/ColorSpace<>/Font<>/ProcSet[/PDF/Text/ImageC]/ExtGState<>>> endobj 29 0 obj<> endobj 30 0 obj<> endobj 31 0 obj<> endobj 32 0 obj[/ICCBased 38 0 R] endobj 33 0 obj<> endobj 34 0 obj<> endobj 35 0 obj<> endobj 36 0 obj<>stream endobj 132 0 obj Meritain Health. 113 0 obj endobj 0000222118 00000 n 27 0 obj 139 0 obj endobj <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 95.16 267.36 105.24 277.44]/Subtype/Widget/T(undefined_2)/TU(undefined)/Type/Annot>> endobj endobj <>/Subtype/Form/Type/XObject>>stream {For the status of submitted claims. endstream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 418.2 395.16 579.6 417.36]/Subtype/Widget/T(Name of Policy Holder)/TU(Name of Policy Holder:)/Type/Annot>> 119 0 obj H23U0t.=s#0ag h\O(DaDHK%aai"bca3e1KN[2F7pt;==:D/dHie,C6nkd0l`r xPpurb & For 24-hour access to your patients health information,log in to your account. 0000221647 00000 n We are your Advocates for Healthier Living, and we're here to connect you and your family to the care you need, right when you need it. H23U0t.=s#0agf!R@PBLX n 112 0 obj 14 0 obj endstream If you need help registering or logging in, contact Meritain customer service at 866.761.3018 3. Member. %PDF-1.4 % <>/Subtype/Form/Type/XObject>>stream %%EOF 86 0 obj endobj Access information quickly For 24-hour access to your patient's health information, log in to your account. H23U0t.=s#0agf!R If you havent created an account, click Register at the top right of this page and follow the prompts. HWr|WyOIT81+\{E ),X'5{q_~rv4McC}=er,LN| endobj <>/Subtype/Form/Type/XObject>>stream endstream We are your Advocates for Healthier Living, and were here to connect you and your family to the care you need, right when you need it. 0000261367 00000 n 0000077747 00000 n endstream If you're a Member or Provider please call 888-509-6420. Are you doing all you can to keep it healthy? 19 0 obj You can get medical advice, a diagnosis or a prescription by video or phone. We're a proud subsidiary of Aetna and CVS Health . H23U0t.=s#0ag 39 0 obj 0000026709 00000 n Your patient's health and your ability to access their information is important to us. 0000002916 00000 n 0000244289 00000 n endobj endstream endobj 140 0 obj <>/Metadata 4 0 R/Pages 3 0 R/StructTreeRoot 6 0 R/Type/Catalog/ViewerPreferences<>>> endobj 141 0 obj <. 42 0 obj Provider services - Meritain Health. x 0000030825 00000 n 105 0 obj xPpurb & Not only can we customize your plan, we want to. endobj HMO Based Plans (California) 800-624-0756. 17 0 obj Box 27267 Minneapolis, MN 55472 , https://www.nwarctic.org/cms/lib/AK01001584/Centricity/Domain/37/Meritain-Info.pdf, Health (3 days ago) WebAetna Provider Phone number and Aetna Claim address are updated from trusted and authorized online resources as per the latest updates. 9 0 obj If the patient is the employee, go directly to the area below the shaded box. x 0 0000263474 00000 n 0 <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 356.16 213.36 462.84 225.24]/Subtype/Widget/T(Name of insurance company)/TU(Name of insurance company)/Type/Annot>> 0000195637 00000 n "LR@PBPBLM, k Purpose: why do you want the information released? 84 0 obj 159 0 obj <>/Subtype/Form/Type/XObject>>stream 4. <>/Subtype/Form/Type/XObject>>stream <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 266.76 352.32 276.84 362.4]/Subtype/Widget/T(Individual)/TU(Individual)/Type/Annot>> For more information, please call Meridian Member Services at 888-437-0606 (Michigan) or 866-606-3700 (Illinois). endobj endobj 0000003072 00000 n endstream Box 27267 Minneapolis, MN 55472-0267 The primary Preferred Network Hospital will remain Providence Hospital in Anchorage. If you have questions about claims or benefits, were happy to help. <>/Subtype/Form/Type/XObject>>stream <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 235.56 541.08 245.64 551.16]/Subtype/Widget/T(Employees Spouse)/TU(Employees Spouse)/Type/Annot>> endobj 0000006310 00000 n 137 0 obj endobj 0000020823 00000 n Customer Service for answers to questions you might have about your benefits, eligibility, claims and more. 2 0 obj 0000075777 00000 n Copyright 2023 Meritain Health. Address, phone number, and practice changes Contact us online Contact us by phone For non-participating health care professionals Network applications (behavioral health, dental, facility, and pharmacy) Practice changes and provider termination Request a medical application Request Part D pharmacy participation Note: , https://www.pangeafg.us/s/article/National-General-Meritain-Health-How-to-Submit-a-Medical-Claim, Health (2 days ago) WebBelow is the claims submission information: All Providers Send Claims to: Preferred Provider Network: Meritain Health P.O. 107 0 obj 0000015983 00000 n Listen to Your Gut to Improve Your Health March 13, 2023 Sure, you've probably trusted a gut feeling when deciding something. Enter a name to find & verify an email >>> Rocketreach finds email, phone & social media for 450M+ professionals. endobj endstream 0000071557 00000 n 0000263097 00000 n Aetna HMO Plans (California) 888-702-3862 (Benefit Questions or Claim Inquiries) <>/Subtype/Form/Type/XObject>>stream 158 0 obj 0000000016 00000 n <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 442.92 483.36 579.72 499.68]/Subtype/Widget/T(Childs Social Security Number)/TU(Childs Social Security Number)/Type/Annot>> endstream %R@PBL1X Kh H23U0t.=s#0agf$LR@PBPBLDA k H23U0t.=s#0agf!R Via Meritain's Provider Relations Team: 866-761-3018 a. endstream To reach us by phone, dial the toll-free number on the back of the patient's ID card. <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 127.56 541.08 137.64 551.16]/Subtype/Widget/T(The employee)/TU(The employee)/Type/Annot>> x Have you checked out your personalized web site? I am very impressed with Meritain Health. endobj startxref <>/Subtype/Form/Type/XObject>>stream <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 128 0 R /Rect[ 190.56 198.96 200.64 209.04]/Subtype/Widget/Type/Annot>> endobj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 124.92 301.56 579.6 323.76]/Subtype/Widget/T(Spouses Employers Address_2)/TU(Spouses Employers Address)/Type/Annot>> xPpurb & Copyright 2023 Meritain Health. hb``c``ja```01G30323Zq@ [s8cz^TV`8A X/@` u 0000001388 00000 n endobj The form linked below should used by a member who would like to grant permission to another individual to act on their behalfin connection with an appeal. <>/Subtype/Form/Type/XObject>>stream 36 0 obj 0000262626 00000 n 98 0 obj 0000075451 00000 n endobj Signature of member or members guardian. Click the Register button to get started. 79 0 obj 0y\Eo^M dT<4 _i ihU;qrxR4RN7gjbLnIiW/{VPnhhu. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. . <>/Subtype/Form/Type/XObject>>stream Meritain Health Claim Mailing Address Health (9 days ago) Web (Just Now) WebHealth Claim Form Complete and send to: Meritain Health P.O. endobj 0000016302 00000 n 0000263019 00000 n xPpurb & <>/Subtype/Form/Type/XObject>>stream The formal written appeal and these forms would then be sent to the address of the Meritain Health Appeals Department (listed on form) by the provider. endobj endstream All rights reserved. 0000009558 00000 n Meritain Health Claims Mailing Address Health (9 days ago) WebClaims Information UFCW Local 655 Welfare Fund. endobj 55 0 obj 127 0 obj <>/Subtype/Form/Type/XObject>>stream 82 0 obj You might occasionally. By providing this information, Meritain Health is not exercising discretionary authority or assuming a plan fiduciary role, nor is Meritain Health providing legal advice. Copyright 2023 Meritain Health. <>/Subtype/Form/Type/XObject>>stream If you have questions about claims or benefits, were happy to help. 67 0 obj Have your ID card with you so set-up is fast and easy. 160 0 obj It is believed to be accurate at the time of posting and is subject to change. <> endstream Comprehensive cost management helps eliminate waste and generates an additional 4 percent savings from billed charges. 144 0 obj 0000220357 00000 n All rights reserved. 0000243461 00000 n All other Plans (California) 888-632-3862. endobj Electronic Claims Address CLAIM STATUS/ PROVIDER RELATIONS Carpenters' Health & Welfare Trust Fund Coventry Health Care P.O. endstream Aetna Claim Address|Aetna Provider Phone Number Updated (2023) December 23, 2022 by NSingh Aetna Provider Phone number and Aetna Claim address are updated from trusted and authorized online resources as per the latest updates. Complete and send to: Meritain Health P.O. Sure, youve probably trusted a gut feeling when deciding something. 1-866-221-4988. 117 0 obj 0000018717 00000 n Each member may setup a Login for themselves as well as any minor children covered by the plan. But do you listen to your gut when it comes to your health? xb```f`` |@1V Xpc>'Y&y7PhKZVQH0XDA1 endstream 0000002739 00000 n 0000090829 00000 n <>/Subtype/Form/Type/XObject>>stream H23U0t.=s#0agf!R@PBLX n endobj 0000269194 00000 n Please have your tax ID number, provider name and address exactly as it appears on the W-9 you submitted along with your NPI and phone number. Shop Insurance. x3P0 t.C=30agE\i\ gs endstream <>/Subtype/Form/Type/XObject>>stream 0000071023 00000 n <>/Subtype/Form/Type/XObject>>stream Learn more about whats covered and what you need to do to get reimbursed and get answers to other frequently asked questions about at-home COVID-19 self-test coverage. 0000047941 00000 n 0000030531 00000 n <>/Subtype/Form/Type/XObject>>stream xPpurb & 0000221902 00000 n 73 0 obj You can submit . 0000030938 00000 n 0000002399 00000 n endstream 2. H23U0t.=s#0agf!R@PBLX n endobj <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream Contact Information 400 Highway 169 S Ste 800 Minneapolis, MN 55426-1141 Visit Website Email this Business (952) 546-0062 Customer Complaints 13 complaints closed in last 3 years 4 complaints. 0000047633 00000 n <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 464.16 213.36 579.84 225.24]/Subtype/Widget/T(Address city state zip)/TU(Address \(city, state, zip\))/Type/Annot>> endobj <>/Subtype/Form/Type/XObject>>stream Questions? 0000000016 00000 n hbbbd`b``3h7 / The Authorization for Release of Information form is required according to the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), specifically 45 CFR 164.508 of the HIPAA Regulations. 78 0 obj All rights reserved. endstream Provider. Call Meritain (866) 209-3061 to obtain claim #; then call IBEW-IL (618) -2002 to get claim status. Looking to build a benefits plan? Your patients health and your ability to access their information is important to us. 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STATUS AND BENEFIT INFORMATION: 1.800.925.2272 Send to: Meritain Health P.O. To reach us by phone, dial the toll-free number on the back of the patient's ID card. Employee information: if you are NOT the employee of the plan Toll free number 800.877.1444 Clients/Payers: For claims and other inquiries, you can request service online here or call 800.877.1444 Healthcare Providers: For the fastest service, please contact us online here or use the contact information provided here. endstream 33 0 obj H23U0t.=s#0ag <>/Subtype/Form/Type/XObject>>stream 0000014276 00000 n 109 0 obj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 376.92 75.6 579.6 95.64]/Subtype/Widget/T(Employees Signature)/TU(Employees Signature)/Type/Annot>> 143 0 obj This will delay the processing of the claim. <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 33.12 267.36 43.08 277.44]/Subtype/Widget/T(undefined)/TU(undefined)/Type/Annot>> 0000078515 00000 n endobj For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. {1O endobj <>/Subtype/Form/Type/XObject>>stream 0000007254 00000 n endobj endobj All rights reserved | Email: [emailprotected], Unitedhealthcare medicare advantage claims address, Drexel behavioral health continuing education, Prohealth westwood health and fitness center, Shadow health gastrointestinal subjective. x3P0 t.C=3C=3=3 6P(JJ grs endobj <>/Subtype/Form/Type/XObject>>stream 75 0 obj endstream endobj <>/Subtype/Form/Type/XObject>>stream x3P0 t.C=63E\i\ g3s <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 397.92 348.36 453.6 370.56]/Subtype/Widget/T(Group Number_2)/TU(Group Number)/Type/Annot>> Mail completed Meritain Health form to: P.O. 26 0 obj 136 0 obj hmo6 190 0 obj <>/Filter/FlateDecode/ID[<523141E2911DB04EA723064AFA5186F5>]/Index[174 50]/Info 173 0 R/Length 88/Prev 119184/Root 175 0 R/Size 224/Type/XRef/W[1 3 1]>>stream xref 0000071642 00000 n 0000047749 00000 n The following is a description of how to complete the form. IMPORTANT: Please have your doctor or supplier of medical services complete the reverse of this form or attach a fully itemized bill. endstream 149 0 obj 53 0 obj 41 0 obj 10 0 obj <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 27.84 51.72 251.28 68.64]/Subtype/Widget/T(Providers tax ID number or Social Security Number)/TU(Providers tax ID number or Social Security Number)/Type/Annot>> endstream PO Box 853921 endobj endobj endobj endobj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 278.04 506.76 302.88 528.96]/Subtype/Widget/T(Sex_2)/TU(Sex)/Type/Annot>> endobj <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream For 24-hour access to your personal health information,log in to your account. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 390.6 371.76 471.6 393.96]/Subtype/Widget/T(City_2)/TU(City)/Type/Annot>> endobj "LR 0000220644 00000 n 28 0 obj endobj xPpurb & xPpurb & To reach us by phone, dial the toll-free number on the back of the patient . 66 0 obj Our industry-leading programs and partnerships with health care innovators allow us to connect our plan sponsors with the right benefits to meet commonand not-so-commonself-funding challenges.