Allegiance provider portal

    • [PDF File]Provider Add Form / Credentialing Application

      https://info.5y1.org/allegiance-provider-portal_1_f12508.html

      Provider Add Form / Credentialing Application ... Please print this and mail to: Allegiance Provider Direct P.O. Box 3018 - Missoula, MT 59801 or fax to (406) 523-3139 If you do not have a CAQH account, please contact credentialing@askallegiance.com for more information.

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    • [PDF File]MHO Claim Reconsideration Form - Molina Healthcare

      https://info.5y1.org/allegiance-provider-portal_1_0e83af.html

      Provider Portal, or fax to (800) 499-3406. Attach all required supporting documentation. Incomplete forms will not be processed. Forms will be returned to the submitter. Please refer to the Molina Provider Manual for timeframes and more information. Appeals related to Authorizations should be submitted using the

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    • [PDF File]Allegiance ERA & EFT Online Instructions

      https://info.5y1.org/allegiance-provider-portal_1_c4fe36.html

      Provider Contact Information All Remittances wil be pushed directly to your clearinghouse Please provide us a contact at your office should their be any quesüons or issues with delivering your data Contact Name Contact Telephone checking this box, I affirm that I am a corporate representative of (provider group name will be here) and authorizedto

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    • [PDF File]PROVIDER PORTAL - Your Benefits At Work™ - Allegiance

      https://info.5y1.org/allegiance-provider-portal_1_a58004.html

      OVERVIEW The Provider Web Portal serves as your resource for detailed information on payments and configuration settings for day-to-day business operations.

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    • [PDF File]CIGNA AND HEALTHPARTNERS STRATEGIC ALLIANCE

      https://info.5y1.org/allegiance-provider-portal_1_e2ef8b.html

      To help answer your questions about Cigna and HealthPartners Strategic Alliance plan administration, refer to the chart below. For individuals with Cigna coverage (ID cards issued by Cigna, including GWH-Cigna and “G” ID cards), use the information in the middle column.

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    • [PDF File]Prior Authorization Request Form–OUTPATIENT

      https://info.5y1.org/allegiance-provider-portal_1_17dd85.html

      provider must include documentation to substantiate the reason for the request. (When all required information has been submitted we will complete your request within 5 business days.) Expedited – defined as danger to a member’s health if not provided within 72 hours.

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    • [PDF File]Health Plan/Payer List Availity Clearinghouse and Web Portal

      https://info.5y1.org/allegiance-provider-portal_1_3f1404.html

      include OSCAR, NSC, PINs, UPINs, Blue Cross provider numbers, and other payer-designated identifiers. (+) Indicates the payer has requested a front-end taxonomy code edit. Health Plan/Payer List Availity Clearinghouse and Web Portal 4 of 138 Visit our web site: www.availity.com

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    • [PDF File]Behavioral Health Services Quick Facts and Phone Guide

      https://info.5y1.org/allegiance-provider-portal_1_74b011.html

      Behavioral Health Services Quick Facts and Phone Guide As a global health service company, Cigna aligned with HealthSpring in 2012 to assist the growing ... Access to on-line provider portal for verification of member eligibility, authorization, and claim payment review. …

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    • [PDF File]Provider - PHP

      https://info.5y1.org/allegiance-provider-portal_1_017a72.html

      Provider portal, log into your MyPHP account and click on Medical Policies in the green toolbar. PHP will monitor and update the portal monthly to ensure the Medical Policies are accurate and up to date. Any changes or updates to the Medical Policies will be reflected here in the quarterly Provider Connection. If you have any questions about

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    • [PDF File]Allegiance Provider Direct Credentialing Documents ...

      https://info.5y1.org/allegiance-provider-portal_1_af5815.html

      Allegiance Provider Direct Credentialing Documents Requirements – Type I For Represented Providers with the following degrees: MD, DO, DPM, DDS, DMD, DC, and OD, nurse practitioners, certified midwives, certified nurse midwives, physician assistants, certified registered nurse anesthetists: Signed Credentialing Application

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