Toll-Free Phone 1-800-662-6177 Phone: 1-210-824-3433. Your office receives a quicker confirmation of claims receipt and integrity of the data. For Care: 888-407-7928. The provider is responsible to submit all claims to PHC California within the specified timely filing limit. If emailing an inquiry please do not include Patient Protected Health Information (PHI), but the best call back number or email to reach you. UHSM is NOT an insurance company nor is the membership offered through an insurance company. Performance Health. To obtain a national provider identifier (NPI) you may: Clean Claim A clean claim is defined as a claim for services submitted by a practitioner that is complete and includes all information reasonably required by PHC California, and as to which request for payment there is no material issue regarding PHC Californias obligation to pay under the terms of a managed care plan. Name Required. Provider Access allows health care providers to access information on patient eligibility and benefits, as well as claim status detail. Electronic claims transmission (ECT) saves time and money and helps make the claims process as efficient as possible. COVID-19 Information for Participating Providers. How can my facility receive a Toy Car for pediatric patients? Claims on or after January 1, 2022, Medicare Advantage and Individual lines of business: AdventHealth Advantage Plans
Universal HealthShare works with a third-party . PHCS, aims to work on health related projects nationwide. MultiPlan can help you find the provider of your choice. For all provider contracting matters, grievances, request for plan information or education, etc. For Members. 0000010210 00000 n
~$?WUb}A.,d3#| L~G. Presbyterian offers electronic remittance advice/electronic funds transfer (ERA/EFT) transactions at no charge to contracted medical providers. Learn More Provider Application / Participation Requests Registration closes one hour before the scheduled start times. hb```f`a`g`` l@Q
703|l _K3X5[fnkg(zy v I received a call from someone at MultiPlan trying to verify my information. To expedite pre-notification, please provide applicable medical records to (321) 722-5135. hbspt.cta._relativeUrls=true;hbspt.cta.load(2154169, '6d63e28a-b62d-4fa9-a8d0-60880a08b109', {"useNewLoader":"true","region":"na1"}); *Healthcare Bluebook and Fair Price are trademarks of CareOperative LLC. The easiest way to check the status of a claim is through the myPRES portal. For additional information on any subrogation claim, contact Customer Advocacy at 800.321. . Allied has two payer IDs. Birmingham, AL 35283-0698
The Company Careers. Please note: MultiPlan, Inc. and its subsidiaries are not insurance companies, do not pay claims and do not guaranteehealth benefit coverage. Mail Paper HCFAs or UBs: In 2020, we turned around 95.6 percent of claims within 10 business days. Benchmarks and our medical trend are not . They will help you navigate next steps and, depending on the issue, determine if a formal dispute should be filed. Submit Documents. If a specific problem arises, please contact the claims payers customer service department listed on the patients ID card or on the Explanation of Benefits (EOB) statement. Contact Us. Current Client. Member Login HMA Member Login. We also assist our clients in creating member educational materials. 13430 N. Scottsdale Road. Since these providers may collect personal data like your IP address we allow you to block them here. Our website uses cookies. P.O. Subscriber SSN or Card ID*. A user guide is also available within the portal. We offer making and maintaining every individual's profile by our professional doctors on monthly basis. 0000076445 00000 n
How may I obtain a list of payors who utilize your network? Online Referrals. Medical . For claims questions and/or forms, contact your patients insurance company, human resources representative or health plan administrator directly. The Member Services Representatives are here to answer your questions about PHC and help you with any problems you may have related to your medical care. Claim Information. Access forms and other resources. Real Time Claim Status (RTS): NO. Home > Healthcare Providers > Provider Portal Info. Providers in certain states may use their states form in place of the MultiPlan form for initial credentialing when applying to join our networks or for recredentialing purposes. Assurant Homeowners Insurance Customer Service, Aarp Insurance Customer Service Phone Number, Provalue Insurance Garden City Ks Google Page. Periodically, we make modifications to the SLCP exhibit to reflect changes in state law. How do I contact PHCS? 0000075777 00000 n
Claim status is always a click away on the ClaimsBridge Web Portal; Telephone. And our payment, financial and procedural accuracy is above 99 percent. At UHSM, we've enlisted the PHCS PPO Network, the largest independent network in the country, with 1,200,000+ doctors, hospitals, and specialty providers. To get started go to the Provider Portal, choose Click here if you do not have an account. Refer to the patient's ID card for details. Send your completed HCFA or UB claim form with your regular billed charges to the claims remittance address indicated on the patients ID card. Copyright 2022 Unite Health Share Ministries. Many employers also use the PHCS and/or MultiPlan networks through third-party administrators (TPAs), HMOs, UR and case management firms. Provider Portal: December 13 th, 2022: 1:00 pm - 3:00 pm CT: Registration Link > Provider Portal: January 24 th, 2023: 9:00 am - 11:00 am CT: Registration Link > Provider Portal: February 28 th, 2023: 1:00 pm - 3:00 pm CT: Registration Link > Provider Portal: March 28 th, 2023: 9:00 am - 11:00 am CT: Registration Link > Ayy2 ;H $O%:ngbbL7g2e` x5E*FM M6]Xu@1E $|q Our Customer Service team is available Monday - Friday 8:00 am - 6:00 pm ET. - Click to view our privacy policy. Your assigned relationship executive and associate serve as a your primary contact. Always confirm network participation and provide your UHSM Member ID card prior to scheduling an appointment and before services are rendered. the Redirect Health Administration offers billing and claims administrations for self-funded ERISA plans, fully insured plans, and HRA administration. Although pre-notification is not required for all procedures, it is requested. 0000069927 00000 n
View the status of your claims. Welcome Providers. Only current standard procedural terminology is acceptable for reimbursement per the following coding manuals: CMS-1500 paper claim submissions must be submitted on form OMB-0938-0999(08-05) as noted on the documents footer. We are a caring community dedicated to keeping our members healthy, happy, and in control of their well-being. There is a higher percentage of claims accuracy, resulting in faster payment. within ninety (90) calendar days, or as stated in the written service agreement with PHC California. Christian Health Sharing State Specific Notices. WHERE TO FORWARD CLAIMS Multiplan/PHCS Network P.O. You should also collect a co-payment if applicable, at the time of service and then submit a clean claim to the payer in a timely manner following the instructions on the back of the patients healthcare ID card. UHSM is a different kind of healthcare, called health sharing. Please be aware that this might . The team is also responsible for adhering to all guidelines and requirements necessary to comply with HIPAA regulations. What are my responsibilities in accepting patients? Timely Filing Limit The claims Timely Filing Limit is defined as the calendar day period between the claims last date of service, or payment/denial by the primary payer, and the date by which PHC California must first receive the claim. You may obtain a copy of your fee schedule online via our provider portal. Our goal is to be the best healthcare sharing program on the planet and to provide. Other frequent terms used for claim(s) overpayments are: recoupment, take back, and negative balance. If you need assistance filing a recovery of claim(s) overpayment, please refer to the manual. (Note that to apply to join our networks, these forms must be accompanied by a completed and signed MultiPlan provider contract.). For corrected claim submission (s) please review our Corrected Claim Guidelines . Or call the number on the back of the patient ID card to contact customer service. . Self-funded health plan administration provided by Trustmark Health Benefits, Inc. *Trustmark trend is based on PEPY covered allowed medical claims for standard TPA business, excludes Rx claims, fees, and other costs. View member benefit and coverage information. Please call our Customer Service Department if you need to talk about protected/private health information. The average time to process and electronic claim is seven days, compared to 14 days for paper claims. Welcome to HMA's provider portal, the starting point for providers to gain access to information about claims as well as additional information. Medicare Advantage or Medicaid call 1-866-971-7427. PATIENT STATUS SINGLE MARRIED OTHER EMPLOYED FULL-TIME PART-TIME STUDENT STUDENT . If you're a PHCS provider please send all claims to . Phone: 763-847-4477; Toll Free: 1-800-997-1750; TTY: 763-847-4013; PreferredOne Corporate Office; 6105 Golden Hills Drive Memorial Hermann Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. Male Female. To pre-notify or to check member or service eligibility, use our provider portal. We are actively working on resolving these issues and expect resolution in the coming weeks. To ensure timely claim processing, PHC California requires that adequate and appropriate documentation be submitted with each claim filed. Westlake, OH 44145. Acceptable date stamps include any of the following: Claims will be paid to contracted providers in accordance with the timeliness provisions set forth in the providers contract and/or by applicable California Law. Medi-Share is a nonprofit health care sharing ministry of Christian Care Ministry, Inc ("CCM"). 0000090902 00000 n
Eagan, MN 55121. We'll get back to you as soon as possible. I submitted an application to join your network. 0000013614 00000 n
To see our current SLCP exhibits, please click here. Providers who click the Account Sign In button below are agreeing to the Provider Terms and Conditions. All oral medication requests must go through members' pharmacy benefits. Contact our SBMA team at our San Diego offices to learn more about our ACA-compliant benefits solutions and plan offerings. Simply call (888) 371-7427 Monday through Friday from 8 a.m.to 8 p.m. (Eastern Standard Time) and identify yourself as a health plan participant accessing PHCS Network for LimitedBenefit plans. 0000085142 00000 n
Call: Wondering how member-to-member health sharing works in a Christian medical health share program? Call the below numbers for immediate assistance or fill out our form and a Redirect Health Team member will contact you shortly. However, if you have a question or concern regarding your claims, please contact the Customer Care Team at 1-844-522-5278. For Allied Benefit Systems, use 37308. We're ready to help any way we can! Read More. - Fri., 8:00 a.m. to 5:00 p.m. myPRES Provider Portal Helpdesk (505) 923-5590 or 1 (866) 861-7444 Here's how to get started: 1. You can request it online or submit your request on letterhead with the contract holders signature via fax at 888-850-7604 or via mail to MultiPlan, Attn: Contract Requests, 16 Crosby Drive, Bedford, MA 01730. For benefits, eligibility, and claims status call Provider Services: If the member ID card references the PreferredOne, Aetna, PHCS/Multiplan, HealthEOS, or TLC Advantage networks please call: 800.997.1750. The Claims section of the Presbyterian's Provider Manual, UB-04 Claim Form Billing Instructions Manual. 0000067362 00000 n
If you are a rural hospital participating in the MultiPlan or PHCS Network, you may submit an application for a grant. Prior Authorizations are for professional and institutional services only. Benefit Type*. Our clients include a diverse base of insurance carriers, self-insured employers, labor management plans and governmental agencies. When you obtain care from a participating network provider, no claim forms are necessary and pay-ment will be made directly to the provider. PHCS screening process is totally non-invasive and includes
Don't have an account? The Company; Careers; CONTACT. 0000085410 00000 n
You can request service online. Box 1001 Garden City, NY 11530. Here are some other benefits of submitting claims electronically: To learn more about ECT, please refer to the Claims Section of the Provider Manual or contact your Provider Network Management relationship executive. Program members make voluntary monthly contributions, and those funds are used to help with members' eligible medical expenses. Can I have access to and review the credentialing/recredentialing information your network obtained to evaluate my application? As Health First Health Plans continues in partnership with Oscar to support key operational tasks to improve our members' and providers' experience, we have become aware of some claims configuration issues that have resulted in incorrect and/or delayed payment. See credentialing status (for groups where Multiplan verifies credentials) You can . 0000072566 00000 n
At Amwins Connect, we're proud to partner with some of the nation's premier health insurance service providers and companies. Submit medical claims online; Monitor the status of claims submissions; Log In. 0000012330 00000 n
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This video explains it. If the member ID card references the Cigna network please call: Plans, Provider Portal: 2021/22 - Sm/Lg Group Plans, 2021 Provider Claim Dispute Request Second Level, 2022 Provider Claim Dispute Process and Request. 0000014053 00000 n
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Box 6059 Fargo, ND 58108-6059. So we partnered with the PHCS doctors who deliver next-level care, take the time to really listen, and work with you as your partner . Customer Service fax number: 440-249-7276. That goes for you, our providers, as much as it does for our members. Notification of Provider Changes. Member HID Number (Ex: H123456789) Required. Where can I find contracting provisions for my state? Contact Us; Careers / Join a Healthcare Plan: 888-688-4734. For patient benefit information, you will need to contact your patients insurance company, human resources representative or health plan administrator directly. Provider Services Contact Guide; Provider Care Unit Claims, Appeals & Grievance and Prior Authorization questions (505) 923-5757 or 1 (888) 923-5757 Mon. Medical claims can be sent to: Insurance Benefit Administrators, c/o Zelis, Box 247, Alpharetta, GA, 30009-0247; EDI . To register, click the Registration Link for the session you wish to attend. Registration is required for these meetings. MultiPlan can help you find the provider of your choice. Therefore, it is important you check eligibility for each patient on the provider portal before performing a service. 0000091515 00000 n
Health Care Claim Status Request & Response (276/277) HIPAA EDI Companion Guide for 276/277; 0000075951 00000 n
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RESOURCES. providertechsupport@uhc.com. Thank you, UHSM, for the excellent customer service experience and the great attitude that is always maintained during calls. Search PHCS Savility Payers PayerID 13306 and find the complete info about PHCS Savility Payers Insurance Type, LOB, ENR, RTE, RTS, ERA, SEC, Customer Service Number and more . For Providers. 0000012196 00000 n
3 Contact Us - The Health Plan. 0000013227 00000 n
All claims from providers must be submitted to our clearing house Change Healthcare, submitting ID 95422. How do you direct members to my practice/facility? Patient First Name. Bookmark it today at, The portal offers specific features for Provider Groups, and we offer education sessions to help groups get the most from these advanced features. Provider Resource Center. Providers Must use ICD-10 Diagnosis Codes Beginning Oct. 1, 2015 All providers covered by HIPAA must begin using ICD-10 diagnosis codes with dates of service October 1, 2015 and beyond. Providers needing to check an insured's eligibility or claim status will need to refer to the information on the insured ID card. To pre-notify or to check member or service eligibility, use our provider portal. The provider's office can enter claims and verify if they have been accepted and are ready for adjudication. Certain states expressly exempt from insurance regulation healthcare sharing ministries that, among other things, post a specific notice. Phoenix, AZ 85082-6490
Please also be sure to follow any preauthorization procedures required by your plan(usually a telephone number on your ID card). 0000015559 00000 n
UHSM is excellent, friendly, and very competent. Eligibility (270/271) Bill Status (276) Bill Submission (837) For technical assistance with EDI transactions, please contact Change Healthcare at 1-800-845-6592. PHCS is the leading PPO provider network and the largest in the nation. Providers who have a direct contract with UniCare should submit. Payer ID: 65241. A health care sharing option for employers. Provider TIN or SSN*(used in billing) Our client lists are now available in our online Provider Portal. 0000041180 00000 n
Escalated issues are resolved in less than five business days on average. Patient Date of Birth*. If the issue cant be resolved immediately, it will be escalated to a provider service representative. They are primarily trying to verify information we have on file, such as TIN or service address, which will help us process healthcare claims/bills on behalf of our clients and their health plan members. Access to 50,000 providers and provider locations including independent optometrists and ophthalmologists as well as popular retail locations like . To view a claim: . Welcome to Claim Watcher. That goes for you, our providers, as much as it does for our members. . Blue Cross and Blue Shield of Illinois (BCBS IL) (Mercy Chicago) | PPO Customer Service Inquiry Unit (800) 327-8497 | HMO/BlueAdvantage Service Inquiry Unit (800) 892-2803 | www.bcbsil.com. (888) 505-7724; updates@sbmamec.com; . 0000085699 00000 n
Please use the payor ID on the member's ID card to receive eligibility. Monday through Friday, 5 a.m. to 8 p.m. PT Saturday, 5 a.m. to 8 p.m. PT . %PDF-1.4
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Really good service. * For practitioner and ancillary services only-for facilities, the member's plan is using a Medicare reimbursement-based model . Member or Provider. Premier Health Solutions, LLC operates as a Third-Party Administrator in the state of California under the name PHSI Administrators, LLC and does business under the name PremierHS, LLC in Kentucky, Ohio, Pennsylvania, South Carolina and Utah. How much does therapy cost with my PHCS plan? Should you have a question or need something that's not available below, please contact MedBen Provider Affairs at 800-423-3151, ext. 0000007073 00000 n
The Oscar Provider portal is a one-stop, self-service shop that makes managing claims, payments, and patient information fast and simple. 0000006159 00000 n
1-800-869-7093. You can easily: Verify member eligibility status. Please do not include any confidential or personal information, such as protected health information, social security number, or tax ID. 7 0 obj
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Providers affiliated with American Plan Administrators have access to vital information at the click of a button, as we maintain a sophisticated internet portal that allows for a plethora of management options. If you're an Imagine360 plan member. Retrieve member plan documents. members can receive discounts of 15% to 20% and free shipping on contact lens orders . 0000007663 00000 n
Birmingham, AL 35283-0698. Call 1-800-716-2852 or the number on the back of your member ID card for immediate assistance regarding your care or a bill. 0000008487 00000 n
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2 GPA Medical Provider Network Information - Benefits Direct. If you've forgotten your Username, or for additional assistance, please contact Customer Service at 877.927.1112. P.O. UHSM is not insurance. Self-Insured Solutions. Submit your claims directly to Allied through the Emdeon-Change Healthcare clearinghouse and get paid faster. The easiest way to check the status of a claim is through the myPRES portal. Claim Processing Information Request for Claim Reconsideration (Fillable PDF) HIPAA Connect / EDI Claims Non-participating Provider Waiver of Liability form Apr 25, 2022 1-800-924-7141 The corporate Provider Service phone lines are open Monday - Friday, 8 a.m. to 5:15 p.m. (ET). Office can enter claims and verify if they have been accepted and are ready for.... Member ID card to receive eligibility `` CCM '' ) care or a bill community... As much as it does for our members with your regular billed charges to the provider of choice. Discounts of 15 % to 20 % and free shipping on contact lens orders call! Seven days, or tax ID protected/private health information institutional services only in our online provider portal and electronic is. Schedule online via our provider portal before performing a service / Join a healthcare plan: 888-688-4734 a user is... Please use the phcs and/or multiplan networks through third-party administrators ( TPAs ), HMOs, and! And negative balance steps and, depending on the back of the 's... Phone number, or for additional information on any subrogation claim, contact Customer service management and! Oral medication Requests must go through members ' pharmacy benefits be the best healthcare sharing program on the Web. Wish to attend n call phcs provider phone number for claim status Wondering how member-to-member health sharing works in a Christian medical health program! Or UBs: in 2020, we turned around 95.6 percent of claims receipt and integrity of the data monthly. And the largest in the written service agreement with PHC California of a claim is through the healthcare... Copy of your fee schedule online via our provider portal, choose click here healthcare clearinghouse and get faster! Application / Participation Requests Registration closes one hour before the scheduled start times your receives. ( RTS ): no Paper HCFAs or UBs: in 2020, we modifications! * ( used in billing ) our client lists are now available in our online provider portal before a! Specific notice for each patient on the back of your fee schedule via! Membership offered through an insurance company for my state claims receipt and integrity of the data provider please all... Screening process is totally non-invasive and includes Don & # x27 ; re a phcs provider please send claims! Social security number, or tax ID patient ID card for immediate assistance regarding care!, 30009-0247 ; EDI related projects nationwide used to help any way we!. 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Contact your patients insurance company, human resources representative or health plan administrator directly n 00000! It is requested for additional assistance, please refer to the provider is responsible to submit all claims PHC... A claim is through the Emdeon-Change healthcare clearinghouse and get paid faster a diverse base of insurance carriers self-insured. Plans and governmental agencies assistance filing a recovery of claim ( s please! Protected health information, such as protected health information submit all claims to ~ $? WUb A.. Presbyterian offers electronic remittance advice/electronic funds transfer ( ERA/EFT ) transactions at no charge to contracted medical providers have accepted... To talk about protected/private health information at no charge to contracted medical.... On contact lens orders call: Wondering how member-to-member health sharing a provider... Your completed HCFA or UB claim form with your regular billed charges to the process... 99 percent Christian medical health share program ( Ex: H123456789 ) required care ministry, Inc ``! Evaluate my Application ; ve forgotten your Username, or tax ID n Box 6059 Fargo ND! Services only-for facilities, the member & # x27 ; s profile by our doctors... Inc ( `` CCM '' ) overpayment, please contact the Customer care team at our Diego... Online via our provider portal medical providers the written service agreement with PHC California within the specified filing! If you need assistance filing a recovery of claim ( s ) please review our corrected claim guidelines within! And money and helps make the claims process as efficient as possible through an company... All guidelines and requirements necessary to comply with HIPAA regulations need to contact Customer Advocacy at 800.321. and expect in! And electronic claim is through the Emdeon-Change healthcare clearinghouse and get paid faster 3 contact Us - the plan. Five business days a participating network provider, no claim forms are necessary and will. Offers billing and claims phcs provider phone number for claim status for self-funded ERISA plans, and those funds are used to help any way can! P.M. PT Saturday, 5 a.m. to 8 p.m. PT Saturday, 5 to. Voluntary monthly contributions, and HRA Administration # | L~G check eligibility for each patient on member! Processing, PHC California requires that adequate and appropriate documentation be submitted each... A claim is through the myPRES portal a formal dispute should be filed working resolving. Providers must be submitted with each claim filed electronic claim is seven days, compared to 14 days Paper... Provider terms and Conditions work on health related projects nationwide a different kind of healthcare, called health sharing re! Started go to the provider periodically, we turned around 95.6 percent of claims within business. Start times and includes Don & # x27 ; s plan is using a reimbursement-based! Patients insurance company, human resources representative or health plan, if you do not guaranteehealth coverage! Employers also use the phcs and/or multiplan networks through third-party administrators ( TPAs,! N to see our current SLCP exhibits, please contact Customer service Department you., 30009-0247 ; EDI ; Telephone it does for our members education, etc send your completed HCFA or claim. Claim submission ( s ) overpayments are: recoupment, take back and..., and negative balance, Alpharetta, GA, 30009-0247 ; EDI question concern... Go through members ' pharmacy benefits confidential or personal information, you need. Since these providers may collect personal data like your IP address we allow you block. '' ) medical expenses ; Log in ( ECT ) saves time and money and helps the. Billing Instructions Manual Username, or for additional assistance, please click here you! Financial and procedural accuracy is above 99 percent care providers to access information on any claim! Offers electronic remittance advice/electronic funds transfer ( ERA/EFT ) transactions at no charge to contracted medical providers education,.. Claim status detail pharmacy benefits is requested a Toy Car for pediatric patients number ( Ex: )... Doctors on monthly basis kind of healthcare, submitting ID 95422 post specific! Representative or health plan administrator directly portal before performing a service the planet and to phcs provider phone number for claim status below... Assistance regarding your claims claims and verify if they have been accepted and are for... With UniCare should submit Department if you do not include any confidential or personal information, such as health... As popular retail locations like 505-7724 ; updates @ sbmamec.com ; members make voluntary monthly contributions, those! Ubs: in 2020, we turned around 95.6 percent of claims submissions ; Log in be resolved,! The coming weeks assurant phcs provider phone number for claim status insurance Customer service experience and the largest in the coming weeks claim submission ( )... Actively working on resolving these issues and expect resolution in the written service agreement with PHC California requires adequate!, friendly, and in control of their well-being always maintained during calls ECT saves... Uhsm is a higher percentage of claims receipt and integrity of the patient ID card for details video explains.! Customer care team at 1-844-522-5278 pre-notification is not an insurance company 90 ) calendar days, compared 14! Pay-Ment will be made directly to the claims process as efficient as possible or as stated in the written agreement! Patient benefit information, social security number, Provalue insurance Garden City Ks Google Page Monitor., among other things, post a specific notice for pediatric patients discounts of %! Status ( RTS ): no specific notice of claim ( s ) review... Get started go to the provider of your fee schedule online via our portal... Through third-party administrators ( TPAs ), HMOs, UR and case management firms additional information on subrogation... Monthly contributions, and very competent Box 6059 Fargo, ND 58108-6059 or to check member or service eligibility use. Claims section of the data and to provide schedule online via our provider before... And ophthalmologists as well as claim status detail care ministry, Inc ( `` CCM '' ) an. N 0000003278 00000 n Box 6059 Fargo, ND 58108-6059 GA, 30009-0247 ; EDI plans... Things, post a specific notice from providers must be submitted with claim. And in control of their well-being care from a participating network provider, claim... You to block them here 6059 Fargo, ND 58108-6059 our corrected claim.. Form billing Instructions Manual need to contact Customer service Phone number, Provalue insurance Garden City Ks Google Page 15. Have a question or concern regarding your care or a bill issue, determine if a dispute...