endstream endobj 238 0 obj <>/Filter/FlateDecode/Index[6 133]/Length 27/Size 139/Type/XRef/W[1 1 1]>>stream 2 0 obj <>/Subtype/Form/Type/XObject>>stream endstream xPpurb & Click the Register button to get started. endstream endstream 26 0 obj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 483.12 599.04 512.16 621.24]/Subtype/Widget/T(Birthdate)/TU(Birthdate)/Type/Annot>> 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. Signature of member or members guardian. Each member may setup a Login for themselves as well as any minor children covered by the plan. endstream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 134.04 506.76 260.16 528.96]/Subtype/Widget/T(Spouses Name last first initial)/TU(Spouses Name \(last, first, initial\))/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream endstream endobj Mississippi Physicians Care Network (MPCN), Presbyterian Select Provider Network (SPN). I have never dealt with a large company who answers their phone right away and always gives good service. <>/Subtype/Form/Type/XObject>>stream <>/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>> <>/Subtype/Form/Type/XObject>>stream <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream 41 0 obj Well share all our advice endobj If youve already registered, we hope youll visit again. Section 2. x3P0 t.C=C=33=aP gos <>/Subtype/Form/Type/XObject>>stream For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. x3P0 t.C=63E\i\ g3s xb```f`` |@1V Xpc>'Y&y7PhKZVQH0XDA1 If you have questions about claims or benefits, were happy to help. endstream endobj 140 0 obj <>/Metadata 4 0 R/Pages 3 0 R/StructTreeRoot 6 0 R/Type/Catalog/ViewerPreferences<>>> endobj 141 0 obj <. Copyright 2023 Meritain Health. 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. 131 0 obj endobj 17 0 obj You can locate the number on the back of your ID Card. If you havent created an account, click Register at the top right of this page and follow the prompts. 122 0 obj endobj endobj For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. 0000262751 00000 n Attn: HIPAA Compliance Officer endstream 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. 0000071487 00000 n Box 30111 Health (3 days ago) WebAddress: Telephone #: City: State: Zip: Is this a change of address? x33U0t.=s#0agf$LR xPpurb & <>/Subtype/Form/Type/XObject>>stream We're a proud subsidiary of Aetna and CVS Health . endobj In a year sure to be filled with many milestones, For some people, memory loss can simply occur as a natural part of getting older. <>/Subtype/Form/Type/XObject>>stream endstream endobj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 455.28 348.36 579.72 364.68]/Subtype/Widget/T(Contract or Policy Number)/TU(Contract or Policy Number)/Type/Annot>> Member. 27 0 obj x 0000221498 00000 n endobj Purpose: why do you want the information released? endobj 13 0 obj endstream <>/Subtype/Form/Type/XObject>>stream Protect yourself and your community.Telehealth for Cold and Flu - Meritain Healthwww.meritain.com/telehealth-for-cold-and-flu/FeedbackMeritainhttps://www.meritain.com/about-us-self-fundedProvider services - Meritain HealthWebIf you have questions about claims or benefits, were happy to help. <>/Subtype/Form/Type/XObject>>stream 0000002923 00000 n 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. endobj 9 0 obj 88 0 obj endobj endobj xPpurb & endobj endobj x 0000091570 00000 n endobj 80 0 obj trailer H23U0t.=s#0ag Copyright 2023 Meritain Health. Our phone lines are open 24 hours a day, seven days a week. Box 853921 Richardson, TX 75085-3921 Fax: 1.763.852.5057 If the patient is a dependent, please complete ALL of the following. endobj 127 0 obj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 205.92 575.64 237.6 597.84]/Subtype/Widget/T(State)/TU(State)/Type/Annot>> Meritain Health PO Box 853921 Richardson, TX 75085-3921 WEBMD/Emdeon #41124, Mckesson/Relay Health #1761 (618) 344-2002 IBEW Local No. Access information quickly For 24-hour access to your patient's health information, log in to your account. <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream Mail completed Meritain Health form to: P.O. specific needs. endobj Copyright 2023 Meritain Health. Below is the claims submission information: All Providers Send Claims to: Preferred Provider Network: Meritain Health P.O. 36 0 obj For 24-hour access to your personal health information,log in to your account. No. 128 0 obj For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. Producer. 95 0 obj Try for free at rocketreach.co . endobj Sign Up For Free G2Crowd Trusted. 72 0 obj x All rights reserved. 4. xPpurb & If you need mental health, behavioral health, or substance abuse services .Summary of Benefits and Coverage - content.meritain.comwww.uslegalforms.com/form-library/314394-meritain-healDoes meritain cover telehealth?Telehealth visits are a useful way for Meridian members to get health services. 102 0 obj AZ Foundation for Medical CareOpens in new window, Baptist Health Plan (formerly Bluegrass)Opens in new window, California Foundation for Medical CareOpens in new window, Century Health SolutionsOpens in new window, Community Health Alliance (CHA)Opens in new window, Evolutions Healthcare SystemsOpens in new window, First Choice Health NetworkOpens in new window, First Choice of the MidwestOpens in new window, Freedom Networks (PHP)Opens in new window, Frontpath Health CoalitionOpens in new window, Gulf Coast Provider NetworkOpens in new window, Idaho Physicians Network (IPN)Opens in new window, Mississippi Physicians Care Network (MPCN)Opens in new window, Nevada Preferred(UHN)Opens in new window, North American Preferred (NAP)Opens in new window, Ohio Health Choice (OHC)Opens in new window, Parkview Signature CareOpens in new window, Preferred Community Choice (PCC OK)Opens in new window, Presbyterian Select Provider Network (SPN)Opens in new window, Private Health Care Systems (PHCS)Opens in new window, The Alliance of WisconsinOpens in new window, Virginia Health NetworkOpens in new window. %R H23U0t.=s#0ag <> 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 Our Meritain Health client management team is by far the best weve ever worked with. endobj For 24-hour automated phone benefits and claims information, call us at 1.800. The form linked below should be completed by a member who needs togrant access to their PHIto another individual in connection with an appeal. Meritain Health Claim Mailing Address Health (9 days ago) Web (Just Now) WebHealth Claim Form Complete and send to: Meritain Health P.O. Combined with our own in-house products and valued vendor partnerships, our . 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. To reach us by phone: For the fastest service, dial the toll-free number on the back of your ID card or call 1.888.324.5789 ** This is a general line, so you may experience hold times and/or need to be transferred. <>/Subtype/Form/Type/XObject>>stream Claims can be submitted for any covered member. xPpurb & 77 0 obj 15 0 obj 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. 0000244435 00000 n H23U0t.=s#0agf!R endstream Do you need a referral to see a specialist? Mail completed Meritain Health form to: P.O. <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 281.52 238.2 291.6 248.16]/Subtype/Widget/T(undefined_4)/TU(undefined)/Type/Annot>> 45 0 obj endstream For privacy purposes, the member's spouse and adult dependents, covered by the plan, must each establish logins to access their individual information. 114 0 obj Once you register, youll be able to view: If you are a client or broker with questions about an existing plan, please contact your client solutions manager. The following is a description of how to complete the form. H23U0t.=s#0ag (5 days ago) WebClaims Mailing Address: Meritain Health PO Box 853921 Richardson, TX 75085-3921. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 92.28 459.96 579.6 482.04]/Subtype/Widget/T(Spouses Employer)/TU(Spouses Employer)/Type/Annot>> 57 0 obj All rights reserved. endstream 53 0 obj 103 0 obj <>/Subtype/Form/Type/XObject>>stream 124 0 obj 147 0 obj 0000244550 00000 n endobj endstream <>/Subtype/Form/Type/XObject>>stream Customer service representatives are available to help you Monday through Fridayjust call 1.800.925.2272. . 0000077747 00000 n 47 0 obj Learn how to partner with us. 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. <>/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>> 74 0 obj 0000002916 00000 n 0000154272 00000 n 86 0 obj <>/Subtype/Form/Type/XObject>>stream IMPORTANT: Please have your doctor or supplier of medical services complete the reverse of this form or attach a fully itemized bill. For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. <>/Subtype/Form/Type/XObject>>stream By providing this information, Meritain Health is not exercising discretionary authority or assuming a plan fiduciary role, nor is Meritain Health providing legal advice. 0000221647 00000 n The amount paid. endobj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 142.44 254.76 219.48 279]/Subtype/Widget/T(Injury Illness Date and time of accident)/TU(Injury Illness Date and time of accident:)/Type/Annot>> xPpurb & <>/Subtype/Form/Type/XObject>>stream 55 0 obj If you havent created an account, click Register at the top right of this page and follow the prompts.
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