BadgerCare Plus & Medicaid SSI Provider Manual - Group Health ...
BadgerCare Plus & Medicaid SSI Provider Manual - Group Health ...
BadgerCare Plus & Medicaid SSI Provider Manual - Group Health ...
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<strong>BadgerCare</strong> <strong>Plus</strong> & <strong>Medicaid</strong> <strong>SSI</strong> <strong>Provider</strong> <strong>Manual</strong> - GHC of Eau Claire June 2012<br />
ADMINISTRATIVE CONTACTS<br />
<strong>Group</strong> <strong>Health</strong> Cooperative of Eau Claire Contacts for <strong>Provider</strong>s<br />
Call your <strong>Provider</strong> Services Department for:<br />
Patient Benefits, Coverage or Eligibility<br />
Patient Concerns<br />
Claims Status<br />
Billing & / Or Payment Procedures<br />
<strong>Medicaid</strong> Enrollment, Membership, Eligibility<br />
Electronic Billing<br />
PROVIDER SERVICES DEPARTMENT<br />
715-552-4333, or toll free 1-866-563-3020<br />
MEMBER SERVICES DEPARTMENT<br />
715- 552-4300, or toll free 1-888-203-7770<br />
Call your <strong>Health</strong> Management Department for:<br />
<br />
<br />
Prior Authorizations (inpatient admissions,<br />
referrals, elective surgery, etc.)<br />
Mental <strong>Health</strong>/AODA Questions or<br />
Authorizations<br />
HEALTH MANAGEMENT DEPARTMENT<br />
715-552-7200, or toll free 1-800-218-1745<br />
Fax Number: 715-552-7202<br />
Call your <strong>Provider</strong> Relations Department for:<br />
<br />
<br />
<br />
Contractual Arrangements such as fee<br />
schedules or reimbursement<br />
Changes to your Tax ID, Office Address,<br />
additional locations/clinics<br />
<strong>Provider</strong> Log-In Assistance<br />
PROVIDER RELATIONS DEPARTMENT<br />
715-552-4300, or toll free 1-888-203-7770<br />
Call your Credentialing Department for:<br />
Adding a new practitioner<br />
Check on status of a Credentialing Application<br />
CREDENTIALING DEPARTMENT<br />
715-552-4300, or toll free 1-888-203-7770<br />
Call our Pharmacy Benefits Manager (PBM) for:<br />
Formulary questions<br />
PHARMASTAR PBM<br />
715-552-4320, or toll free 1-888-298-7770<br />
Call Quality Improvement Department for:<br />
Questions or requests for information on GHC’s<br />
Quality Improvement Activities<br />
QUALITY IMPROVEMENT MANAGER<br />
715-552-4300, or toll free 1-888-203-7770