endstream 0000006310 00000 n endstream Claims Processing and Payment: When you see patients who are Meritain Health members, please submit claims to Meritain Health for processing. <>/Subtype/Form/Type/XObject>>stream Select Dental and DVH (Dental Only) ** Network by Aetna. endstream 139 0 obj endobj 134 0 obj For more information, please call Meridian Member Services at 888-437-0606 (Michigan) or 866-606-3700 (Illinois). Plan and member information x33U0t.=s#0agf$LR 56 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 384.12 541.08 394.08 551.16]/Subtype/Widget/T(Employees Child)/TU(Employees Child)/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream endobj PO Box 853921 <>/Subtype/Form/Type/XObject>>stream 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. endstream Your signature and your understanding of what it means s0G}JbfX^Z@0R ;]Vomm.mu:bq[0iiz=s7^weqE|ZV%%|-%9 <>/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>> 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. 107 0 obj xPpurb & . endstream The form linked below should be completed by a member who needs togrant access to their PHIto another individual in connection with an appeal. x x3P0 t.C=63E\i\ g3s All rights reserved. To reach us by email:service@meritain.com. When on the portal, you can also download our free mobile app. At Meritain Health, our jobs are simple: we're here to help take care of you. PDF Claims Submission and Payment - mbh-eap.com x3P0 t.C=63E\i\ g3s x endobj For ALL claims, this area must be filled in completely. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 371.52 575.64 449.16 597.84]/Subtype/Widget/T(Work Telephone)/TU(Work Telephone \( \))/Type/Annot>> endstream 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. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 233.16 371.76 372.6 393.96]/Subtype/Widget/T(Address)/TU(Address)/Type/Annot>> 81 0 obj Your patients health and your ability to access their information is important to us. endobj endstream H23U0t.=s#0ag 94 0 obj Copyright 2023 Meritain Health. <>/Subtype/Form/Type/XObject>>stream Comprehensive cost management helps eliminate waste and generates an additional 4 percent savings from billed charges. xPpurb & 111 0 obj Access information quickly For 24-hour access to your patient's health information, log in to your account. IMPORTANT: Please have your doctor or supplier of medical services complete the reverse of this form or attach a fully itemized bill. 0000090829 00000 n xPpurb & endobj 120 0 obj xPpurb & <>/Subtype/Form/Type/XObject>>stream 0000220396 00000 n x <>/Subtype/Form/Type/XObject>>stream 0000030713 00000 n Are you doing all you can to keep it healthy? 110 0 obj H23U0t.=s#0agf!R@PBLX n x 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. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 27.84 348.36 201.72 364.68]/Subtype/Widget/T(Other Insurance Carriers or Plans Telephone)/TU(Other Insurance Carriers or Plans Telephone #)/Type/Annot>> 36 0 obj 18 0 obj endstream To reach us by phone, dial the toll-free number on the back of the patients ID card. endstream 0000078102 00000 n 144 0 obj <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream endobj 25 16 endstream Meritain Health Member Services - Meritain Health 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>> 0000016302 00000 n 125 0 obj <>/Subtype/Form/Type/XObject>>stream endobj If you havent created an account, click Register at the top right of this page and follow the prompts. Q(e-26ChrQm~*o5+f9L;?5"+wg3^.N?&18/5Nww8,,%j&`f)%i,cdeGZZ yuU`&ZfwZ1)`YO>E+*w* 154 0 obj H23U0t.=s#0ag xPpurb & xPpuVru endobj <>/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>> Lastly, just mail the completed form and original invoice to , https://www.employeeconnects.com/wp-content/uploads/2021/06/Grand-Rounds-Submitting-a-Claim.pdf, Health (9 days ago) WebHealth Claim Form - KP Health (Just Now) WebHealth Claim Form Complete and send to: Meritain Health P.O. 114 0 obj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 43.2 575.64 183.6 597.84]/Subtype/Widget/T(City)/TU(City)/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream For 24-hour access to your patients health information,log in to your account. Your network, benefit plans, programs and member communications will be tailored to you. endobj <>/Subtype/Form/Type/XObject>>stream Todays employees crave support for their emotional and mental well-being. endobj <>/Subtype/Form/Type/XObject>>stream 0000222181 00000 n x 119 0 obj endstream %R@PBL1X Kh <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream Our Meritain Health client management team is by far the best weve ever worked with. endobj 60 0 obj Section 6. x H23U0t.=s#0agf!R@PBLX n endobj 0000010062 00000 n endstream Meritain Health Claims Mailing Address 27 0 obj For tips on taking care of your heart, we asked our friends at Meritain Health Pharmacy Solutions (MPS). Administered by Meritain , Health (3 days ago) WebYou can call Meritain Health Customer Service: {For verification of eligibility and benefit information. A description of the services provided. <>/Subtype/Form/Type/XObject>>stream <> endobj <>/Subtype/Form/Type/XObject>>stream 96 0 obj Sure, youve probably trusted a gut feeling when deciding something. <>/Subtype/Form/Type/XObject>>stream Contact Allstate Health Solutions with questions around your policy, claims or more. endobj H23U0t.=s#0agf!R Meritain Health builds connections and solutions that drive down endstream endobj startxref 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. 0000030938 00000 n I absolutely love placing business with MeritainHealthfrom sales support to serviceexceptional. Questions? x Meritain Health PO Box 853921 Richardson, TX 75085-3921 WEBMD/Emdeon #41124, Mckesson/Relay Health #1761 (618) 344-2002 IBEW Local No. Note: Incomplete Claims Forms will be returned to you for missing information. endobj 139 0 obj <> endobj 0000222146 00000 n 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>> <>/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>> 156 0 obj endobj 174 0 obj <> endobj endobj 85 0 obj 9 0 obj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 542.04 371.76 579.6 393.96]/Subtype/Widget/T(Zip Code_2)/TU(Zip Code)/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream "LR In the meantime, you can check your claims activity by visiting Grandrounds.com/cop, downloading the Grand Rounds Health app, or calling your personal care team at 1.855.498.4661. 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>> %%EOF V>j>Or`DVGlM|v]%Yv+)mv>m{=umfofn]{H+T(T014p0fcO&qtkO^);nu|2@]T Gdd,LO~|4 ^'A{ @21xqW 1`6U hbbbd`b``3h7 / 69 0 obj STATUS AND BENEFIT INFORMATION: 1.800.925.2272 Send to: Meritain Health P.O. 0000244628 00000 n LWp|vMpf ouC;w$[II'r$j*RHV)[r-E_D9X[/'g endobj endobj <>/Subtype/Form/Type/XObject>>stream <>/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>> 17 0 obj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 295.68 51.72 476.04 74.28]/Subtype/Widget/T(NPI Number)/TU(NPI Number)/Type/Annot>> endobj All rights reserved. 0y\Eo^M dT<4 _i ihU;qrxR4RN7gjbLnIiW/{VPnhhu. I absolutely love placing business with Meritain, Offering Easy Access to Virtual Mental Well-being Providers, Listen to Your Gut to Improve Your Health, Five Things to Know About Alzheimers Disease. 89 0 obj Box 853921 Richardson, TX 75085-3921 Fax: 1.763.852.5057 If the patient is a dependent, please complete ALL of the following. endobj Meritain Health - health insurance for employees - self-funding - TPA endobj endobj endobj endobj But do you listen to your gut when it comes to your health? x3P0 t.C=C=33=aP gos 62 0 obj 7 0 obj Box , https://www.health-mental.org/meritain-health-claims-mailing-address/, Health (6 days ago) WebMail the Claims Form and supporting documents to the address on the Claim Form or on the back of your Member ID Card. <>/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>> 0000247732 00000 n 0000015983 00000 n 74 0 obj endstream 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. endstream xPpurb & 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 Section 2. 101 0 obj On-demand services such as Teladoc, giving you access to qualified physicians 24/7/365 by phone, online or app, Convenient access to information and support via our online member portal, Meritain Health app, printed and digital resources, and customer service, Healthcare Bluebook, an online tool that allows you to compare health care services you need to find the best prices, Access to wellness programs like the Healthy Merits Wellness Program, letting you focus on your own wellness journey in areas like nutrition, fitness, financial wellness, and social and emotional health, Aetnas network of providers, connecting you to over 600,000 doctors and ancillary providers nationwide, Nurse Health Coaching and support services for your health care journey, including diabetes care and fertility care. ,L"\H4~Zzyv4vet{&+8*BYOl+:;C ks#6i}$9wNB;I@~d hop^F. Contact Us | Meridian xref endobj The member whose information is to be released is required to sign the authorization form. For privacy purposes, the member's spouse and adult dependents, covered by the plan, must each establish logins to access their individual information. 146 0 obj and helpful tips for boosting good healthfor you, and your family. endobj endobj Provider Quick Reference Guide - MultiPlan As a member, you can log into your member portal for a more personalized experience. <>/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>> H23U0t.=s#0ag 0000071557 00000 n <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 102.24 622.44 341.16 644.52]/Subtype/Widget/T(Name last first initial)/TU(Name \(last, first, initial\))/Type/Annot>> Section 4. 0000005765 00000 n For 24-hour automated phone benefits and claims information, call us at 1.800. xb```f`` |@1V Xpc>'Y&y7PhKZVQH0XDA1 <>/Subtype/Form/Type/XObject>>stream endobj As a Meritain Health member, per the Federal Government, you are eligible for insurance reimbursement under a qualified plan for FDA-authorized COVID-19 at-home tests purchased on or after January 15. endstream endstream Mail the Claims Form and supporting documents to the address on the Claim Form or on the back of your Member ID Card. endstream % Your patients health and your ability to access their information is important to us. <>/Subtype/Form/Type/XObject>>stream 0000261367 00000 n <>/Subtype/Form/Type/XObject>>stream 148 0 obj If youve already registered, we hope youll visit again. endobj 0000018717 00000 n 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. Short term medical; . endobj Our phone lines are open 24 hours a day, seven days a week. endstream endstream 0000244435 00000 n endstream 26 0 obj endstream This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. x 122 0 obj endobj 116 0 obj endstream Email Members: memberservices.mi@mhplan.com Mail Meridian 777 Woodward Ave, Ste 700 Detroit, MI 48226 Meridian Healthy Michigan Phone endstream endobj endstream 55 0 obj Or fax to (763)-852-5057. <>/Subtype/Form/Type/XObject>>stream Contact Us | Allstate Health Solutions 76 0 obj <>/Subtype/Form/Type/XObject>>stream H23U0t.=s#0agf!R endstream 0000221360 00000 n endstream 121 0 obj xPpurb & 0000221985 00000 n 0000221112 00000 n 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. endobj endobj <>/Subtype/Form/Type/XObject>>stream 0000000854 00000 n endobj Health (3 days ago) WebFor 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. 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. <>/Subtype/Form/Type/XObject>>stream startxref endstream endstream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 359.76 483.36 441.24 505.56]/Subtype/Widget/T(Childs Birthdate)/TU(Childs Birthdate)/Type/Annot>> 0000075278 00000 n %R H23U0t.=s#0agf!R@PBLX n endstream endobj Electronic Claims Address CLAIM STATUS/ PROVIDER RELATIONS APPLICABLE STATE Carpenters' Health & Welfare Trust Fund Meritain Health PO Box 853921 Richardson, TX 75085-3921 (87 Web MD/Emdeon, #41124 or McKesson/Relay Health 1761 (314) 644-4802 ext. "LR 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. MERITAIN HEALTH - 117 Reviews - 1405 Xenium Ln, Minneapolis - Yelp <>/Subtype/Form/Type/XObject>>stream endobj This will delay the processing of the claim. 0 Provider services - Meritain Health. endobj This content is being provided as an informational tool. 35 0 obj <>/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>> 82 0 obj endstream endstream <>/Subtype/Form/Type/XObject>>stream 1-866-221-4988. 63 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. 91 0 obj endobj 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. <>/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>> 16 0 obj What are the hallmarks of a good provider network? With wellness programs, on-demand tools, resources and caring support, Meritain Health puts easy-to-use health care at your fingertips. Purpose: why do you want the information released? <>/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>> <>/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>> endobj Meritain Health Email Format | meritain.com Emails - RocketReach Business Profile for CBSA Performax, A Meritain Health Company <>/Subtype/Form/Type/XObject>>stream If you have any questions about your benefits or claims, were happy to help. 0000262626 00000 n endstream endstream endobj xPpurb & endstream <>/Subtype/Form/Type/XObject>>stream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 272.04 575.64 314.16 597.84]/Subtype/Widget/T(Zip Code)/TU(Zip Code)/Type/Annot>> Please note, the claims appeal procedure is explained at length within each groups Summary Plan Description (SPD). endstream 11 0 obj 136 0 obj