Provider Guide - the Culinary Health Fund

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Provider Guide October 2012 Resources IVR IVR, the Culinary Health Fund’s automated telephone system, can be used to check participant eligibility and claims status. • Call 702-733-9938 and select option 1. • Services are available 24 hours a day, 7 days a week. • In most cases eligibility is given for a 2-month period. Vision IVR This is a dedicated IVR for ophthalmology and optometry providers, and can be used to check participant eligibility and hardware benefits status. • Call 702-216-1298. • Services are available 24 hours a day, 7 days a week. • In most cases eligibility is given for a 2-month period. Customer Service Office The Culinary Health Fund’s Customer Service Office can be reached Monday through Friday from 8am to 6pm at 702-733-9938 to answer any questions you may have. Provider Services To reach Provider Services, please call 702-892-7313 or fax 702-892-7326. Provider Reconsiderations To reach Provider Reconsiderations, please call 702-691-5625 or fax 702-216-9525. 28 Culinary Health Fund Administrative Services, LLC
October 2012 Provider Guide Information Update Providers Changes in address and/or contact information can be submitted using the Provider Address Information Form, located in the back of this book or on the website. When a new provider is added to a practice, Culinary Health Fund Administrative Services, LLC must be notified immediately so that credentialing can be completed. Please Note: Providers must pass credentialing and receive an effective date under the current provider agreement in order to see Culinary patients as a PPO provider. Some updates, including staff changes within a practice, may require additional information (i.e. a credentialing application). Culinary Health Fund Administrative Services, LLC will notify you once the physician is credentialed and when they will become a PPO provider with the Culinary Network. Information on the addition of providers to your practice can be submitted on our Group Add Request Form, located in the back of this book or on our website. Please complete the form and submit to the fax number listed on the form. Please remember that a provider should not see Culinary participants until they have been credentialed and added to your provider agreement. Additionally, if a provider leaves a practice, this information should be communicated to us in writing. Letters can be faxed to the attention of Provider Services at 702-892-7365. Practice information can be verified by contacting Provider Services at 702-892-7313 or by checking the online Provider Directory at www.culinaryhealthfund.org. Ancillary Providers Keep information up to date by submitting any changes in names, facility locations, phone numbers, and tax identification numbers to Culinary Health Fund Provider Services at the address listed below: Culinary Health Fund Attn: Provider Services 1901 Las Vegas Blvd. South, Suite 101 Las Vegas, NV 89104 Phone: 702-892-7313 Fax: 702-892-7365 Information regarding a facility can be verified by checking the online Provider Directory at www.culinaryhealthfund.org or by contacting the Culinary Health Fund’s Customer Service Office at 702-733-9938. Culinary Health Fund Administrative Services, LLC 29
Page 1: Provider Guide Administrative Servi
Page 4 and 5: Provider Guide October 2012 Introdu
Page 6 and 7: Provider Guide October 2012 Who We
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Page 16 and 17: Provider Guide October 2012 Program
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Page 26 and 27: Provider Guide October 2012 Credent
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Page 35 and 36: CULINARY HEALTH FUND ADMINISTRATIVE
Page 37: HIGH TECH DIAGNOSTIC SERVICE REVIEW
Page 41: 1901 Las Vegas Blvd. So. Suite 101
Page 45: CULINARY PROVIDER RECONSIDERATIONS
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Provider Guide - the Culinary Health Fund

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