For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. Your heart is a hard worker. endobj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 433.2 622.44 579.6 644.52]/Subtype/Widget/T(Employer Name)/TU(Employer Name)/Type/Annot>> xPpurb & 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. If you're a Client or Broker, please contact your Meritain Health Manager. Box 853921 Richardson, TX 75085-3921 Fax: 1.763.852.5057 <>/Subtype/Form/Type/XObject>>stream endstream What are the hallmarks of a good provider network? <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 142.44 254.76 219.48 279]/Subtype/Widget/T(Injury Illness Date and time of accident)/TU(Injury Illness Date and time of accident:)/Type/Annot>> endstream endobj Mississippi Physicians Care Network (MPCN), Presbyterian Select Provider Network (SPN). <>/Subtype/Form/Type/XObject>>stream endobj 0000221902 00000 n x33U0t.=s#0agf$LR To reach us by phone, dial the toll-free number on the back of the patients ID card. Copyright 2023 Meritain Health. 0000124845 00000 n Our phone lines are open 24 hours a day, seven days a week. endstream endobj endstream xPpurb & endobj <>/Subtype/Form/Type/XObject>>stream and helpful tips for boosting good healthfor you, and your family. If you're a Member or Provider please call 888-509-6420. 116 0 obj With wellness programs, on-demand tools, resources and caring support, Meritain Health puts easy-to-use health care at your fingertips. xPpurb & endstream <>/Subtype/Form/Type/XObject>>stream <>/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>> 0000070600 00000 n 0000000016 00000 n Our navigation partnerships and holistic approach to plan design helps support member health journeys. endstream endstream endobj 140 0 obj <>/Metadata 4 0 R/Pages 3 0 R/StructTreeRoot 6 0 R/Type/Catalog/ViewerPreferences<>>> endobj 141 0 obj <. Addresses and accounts , https://www.mbh-eap.com/wp-content/uploads/Claim-Submission-and-Payment-Addresses-7-1-2017.pdf, Health (2 days ago) WebContact us. Sure, youve probably trusted a gut feeling when deciding something. 91 0 obj endstream Enter a name to find & verify an email >>> Rocketreach finds email, phone & social media for 450M+ professionals. endobj 58 0 obj endstream Mail the Claims Form and supporting documents to the address on the Claim Form or on the back of your Member ID Card. <>/Subtype/Form/Type/XObject>>stream To reach us by phone, dial the toll-free number on the back of the patients ID card. <>/Subtype/Form/Type/XObject>>stream 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. 87 0 obj H23U0t.=s#0ag 136 0 obj xPpurb & 73 0 obj xPpurb & Contact us at 1.800.925.2272 if you have . 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 xPpurb & With wellness programs, on-demand tools, resources and caring support, Meritain Health puts easy-to-use health care at your fingertips. :Y iy}3q:tGp#bI4jH"KAmME#LVAdE!Q(?PS-uxqGkF&oeNwuS%uARm3E|wpy % Your patient's health and your ability to access their information is important to us. %PDF-1.4 % endstream endstream <>/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 Service address(es) Telephone number(s) Website address Specialty(ies) Accepting new patients Oce hours Languages spoken Cultural competency training completed ADA Accessibility For Commercial Health Plans: Email Fax Mail registrar@multiplan.com* 781-487-8273 MultiPlan, ATTN: Registrar, 16 Crosby Drive, Bedford, MA 01730 Signature of member or members guardian. <>/Subtype/Form/Type/XObject>>stream 0000030597 00000 n x3P0 t.C=C=33=aP gos endstream endobj 151 0 obj 0000047567 00000 n For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. <>/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>> PO Box 853921 Note: Incomplete Claims Forms will be returned to you for missing information. Section 4. x endstream 104 0 obj 105 0 obj 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. endobj 0000243792 00000 n xPpurb & Box 30111 Lansing, MI 48909 Fax to: 888.837.3725 https://www.meritain.com/wp-content/uploads/2021/02/Microsoft-Word-FSA-Claim-Form_MI_2018.pdf 2. endobj x3P0 t.C=63E\i\ g3s endstream xPpurb & 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. C endstream 120 0 obj 122 0 obj 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. 0000006310 00000 n 59 0 obj endobj 0000124097 00000 n This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. endobj endobj Were adding new tools and resources all the time. <>/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>> endobj <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 33.12 401.52 43.08 411.48]/Subtype/Widget/T(Yes then complete)/TU(Yes \(then complete)/Type/Annot>> 26 0 obj For ALL claims, this area must be filled in completely. x3P0 t.C=C=33=aP gos endobj 96 0 obj 0000222040 00000 n endstream 25 0 obj <> endobj endstream endstream startxref Weve got more than a few tricks up our sleeves to help you live your best life, and keep your cost of care budget-friendly. <>/Subtype/Form/Type/XObject>>stream 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. H23U0t.=s#0agf!R Resources. 128 0 obj x For 24-hour access to your personal health information,log in to your account. endstream 0000030825 00000 n <> 0000026121 00000 n endstream endobj 178 0 obj <>stream endobj 52 0 obj endstream <> <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 344.836 599.04 449.16 617.818]/Subtype/Widget/T(Identification Number)/TU(Identification Number)/Type/Annot>> Todays employees crave support for their emotional and mental well-being. endstream endobj <>/Subtype/Form/Type/XObject>>stream <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Tabs/W/Type/Page>> If you need mental health, behavioral health, or substance abuse services .Summary of Benefits and Coverage - content.meritain.comwww.uslegalforms.com/form-library/314394-meritain-healDoes meritain cover telehealth?Telehealth visits are a useful way for Meridian members to get health services. endobj We're a proud subsidiary of Aetna and CVS Health . 0000007254 00000 n endstream xPpurb & Via Meritain's Provider Relations Team: 866-761-3018 a. If the patient is the employee, go directly to the area below the shaded box. endobj endstream endobj 26 0 obj<> endobj 27 0 obj<> endobj 28 0 obj<>/ColorSpace<>/Font<>/ProcSet[/PDF/Text/ImageC]/ExtGState<>>> endobj 29 0 obj<> endobj 30 0 obj<> endobj 31 0 obj<> endobj 32 0 obj[/ICCBased 38 0 R] endobj 33 0 obj<> endobj 34 0 obj<> endobj 35 0 obj<> endobj 36 0 obj<>stream 0000195637 00000 n Toll free number 800.877.1444 Clients/Payers: For claims and other inquiries, you can request service online here or call 800.877.1444 Healthcare Providers: For the fastest service, please contact us online here or use the contact information provided here. 0000000934 00000 n 0000222181 00000 n 22 0 obj endobj endobj endstream x3P0 t.C=63E\i\ g3s endobj Meritain is a division of Prodigy Health Group, the nations largest independent third-party administrator of self-funded health plans.Meritain part of $600M Aetna purchase - Buffalo Business Firstwww.bizjournals.com/buffalo/news/2011/04/28/meritain-Does meritain health require referrals?meritain or call 1-800-847-8361 for a list of network providers. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 27.84 371.76 201.72 388.08]/Subtype/Widget/T(Name of Other Health Insurance Carrier or Plan)/TU(Name of Other Health Insurance Carrier or Plan)/Type/Annot>> %PDF-1.7 0 5 0 obj Our innovative solutions identify emerging products and trends for better member engagement, improved outcomes and lower costs. 86 0 obj 145 0 obj All rights reserved. <>/Subtype/Form/Type/XObject>>stream 140 0 obj For privacy purposes, the member's spouse and adult dependents, covered by the plan, must each establish logins to access their individual information. endobj (5 days ago) WebClaims Mailing Address: Meritain Health PO Box 853921 Richardson, TX 75085-3921. 0 0000003072 00000 n xPpurb & You can get medical advice, a diagnosis or a prescription by video or phone. <>/Subtype/Form/Type/XObject>>stream endobj 0000220396 00000 n 30 0 obj 0000071642 00000 n endobj Please forward this completed form to the privacy officer of the employer or to: Meritain Health 112 0 obj endstream endobj 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. 72 0 obj 0000002739 00000 n endobj 7 0 obj endstream Patient Information <>/Subtype/Form/Type/XObject>>stream [ 6 0 R 10 0 R 12 0 R 14 0 R 16 0 R 18 0 R 20 0 R 22 0 R 24 0 R 26 0 R 28 0 R 30 0 R 32 0 R 37 0 R 42 0 R 47 0 R 49 0 R 51 0 R 53 0 R 55 0 R 57 0 R 59 0 R 61 0 R 63 0 R 65 0 R 67 0 R 72 0 R 77 0 R 79 0 R 81 0 R 83 0 R 85 0 R 87 0 R 89 0 R 91 0 R 96 0 R 101 0 R 103 0 R 105 0 R 107 0 R 109 0 R 111 0 R 116 0 R 121 0 R 123 0 R 128 0 R 133 0 R 135 0 R 137 0 R 139 0 R 144 0 R 149 0 R 151 0 R 153 0 R 155 0 R 157 0 R ] You can get answers to what you need, around the clock. endobj If you have any questions about your benefits or claims, were happy to help. 0000221112 00000 n <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 296.88 213.36 354.72 231.12]/Subtype/Widget/T(Policy)/TU(Policy #)/Type/Annot>> The member whose information is to be released is required to sign the authorization form. <>/Subtype/Form/Type/XObject>>stream endobj <>/Subtype/Form/Type/XObject>>stream x3P0 t.C=63E\i\ g3s endstream 107 0 obj 152 0 obj The form linked below should be completed by a member who needs togrant access to their PHIto another individual in connection with an appeal. <>/Subtype/Form/Type/XObject>>stream For language services, please call the number on your member ID card and request an operator.Is meritain the same as Aetna?psichologyanswers.com/library/lecture/read/489793-is-meIs meritain part of Aetna?Meritain Health will become part of the Aetna family, part of a $600 million acquisition of Meritains parent company announced Thursday at Aetnas quarterly shareholders meeting. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 513.84 599.04 579.72 615.24]/Subtype/Widget/T(Group Number)/TU(Group Number)/Type/Annot>> 0000244550 00000 n <>/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>> Copyright 2023 Meritain Health. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 552.6 506.76 579.6 528.96]/Subtype/Widget/T(Sex_3)/TU(Sex)/Type/Annot>> To reach us by email:service@meritain.com. endstream <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 95.16 267.36 105.24 277.44]/Subtype/Widget/T(undefined_2)/TU(undefined)/Type/Annot>> 144 0 obj 0000263210 00000 n <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 205.92 575.64 237.6 597.84]/Subtype/Widget/T(State)/TU(State)/Type/Annot>> endstream H23U0t.=s#0ag MERITAIN HEALTH - 117 Reviews - 1405 Xenium Ln, Minneapolis, Minnesota - Insurance - Phone Number - Yelp Restaurants Home Services Auto Services Meritain Health 117 reviews Unclaimed Insurance Write a review Add photo Photos & videos See all 7 photos Add photo xPpurb & Get contact details including emails and phone numbers (business & personal). 0000195598 00000 n endobj 44 0 obj 153 0 obj endobj HMO Based Plans (California) 800-624-0756. H|VYOF~G[Z7} X#`) 4cb{X_5 <>/Subtype/Form/Type/XObject>>stream xPpurb & 18 0 obj <>/Subtype/Form/Type/XObject>>stream "LR endstream If you have questions about claims or benefits, were happy to help. %R@PBL1X Kh 4 0 obj 0000153847 00000 n Aetna Open Choice PPO Network. endobj <>/Subtype/Form/Type/XObject>>stream endstream <>/Subtype/Form/Type/XObject>>stream endobj x Aetna Claim Address And Aetna Provider Phone Number: Aetna Medicare Providers Claim Address and Phone Number 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. 23 0 obj 0000221498 00000 n At Meritain Health, we create unrivaled connections. endobj 138 0 obj Mail completed Meritain Health form to: P.O. <>/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>> endstream Your health and your ability to access your information is important to us. Were making access just a click away. Have you checked out your personalized web site? endobj xPpurb & <>/Subtype/Form/Type/XObject>>stream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 464.16 213.36 579.84 225.24]/Subtype/Widget/T(Address city state zip)/TU(Address \(city, state, zip\))/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream 156 0 obj Your patients health and your ability to access their information is important to us. endobj Submission of these forms to the Meritain Health Appeals Department without a formal written appeal from the provider will not be reviewed. 0000222118 00000 n endstream 0000002399 00000 n 0000005626 00000 n Your network, benefit plans, programs and member communications will be tailored to you. <>/Subtype/Form/Type/XObject>>stream 8 0 obj endobj 0000247732 00000 n 0000244289 00000 n %R Richardson, TX 75085. Aetna Claim Address|Aetna Provider Phone Number Updated (2023) December 23, 2022 by NSingh Aetna Provider Phone number and Aetna Claim address are updated from trusted and authorized online resources as per the latest updates. endobj 25 0 obj 53 0 obj Aetna Claim Address , https://medicalbillingrcm.com/aetna-claim-address-phone-number/, Health (4 days ago) WebList of Accounts managed by Mercy Managed Behavioral Health - effective 7/01/17 **Send claims directly to the third party administrator. 55 0 obj 78 0 obj No. <>/Subtype/Form/Type/XObject>>stream Contact Information 400 Highway 169 S Ste 800 Minneapolis, MN 55426-1141 Visit Website Email this Business (952) 546-0062 Customer Complaints 13 complaints closed in last 3 years 4 complaints. 41 0 obj If you have questions about claims or benefits, were happy to help. 0000000854 00000 n "LR <>/Subtype/Form/Type/XObject>>stream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 90.84 483.36 164.52 505.56]/Subtype/Widget/T(Spouses Birthdate)/TU(Spouses Birthdate)/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream trailer endobj endstream hbbd```b`` "A"BA$0"Y)0 * dP=&m$ N r To reach us by phone, dial the toll-free number on the back of the patient's ID card. endstream Learn how to partner with us. If youve already registered, we hope youll visit again. %PDF-1.4 % 0000075451 00000 n endobj 160 0 obj 135 0 obj 79 0 obj xPpurb & 106 0 obj 0000015983 00000 n s0G}JbfX^Z@0R ;]Vomm.mu:bq[0iiz=s7^weqE|ZV%%|-%9 <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 92.28 324.96 579.6 347.04]/Subtype/Widget/T(Spouses Employer_2)/TU(Spouses Employer)/Type/Annot>> 0000016302 00000 n Aetna Provider Phone Number List (California) Aetna Medicare Advantage Plans and. 0000000616 00000 n ,L"\H4~Zzyv4vet{&+8*BYOl+:;C ks#6i}$9wNB;I@~d hop^F. endobj endobj For 24-hour , https://qa.meritain.com/about-us-self-funded-employee-benefit-plans/meritain-health-provider-services/, Health (8 days ago) WebMailing Address. endobj 132 0 obj endstream But do you listen to your gut when it comes to your health? 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. <>/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>> <> 127 0 obj endstream By providing this information, Meritain Health is not exercising discretionary authority or assuming a plan fiduciary role, nor is Meritain Health providing legal advice. 142 0 obj <>/Subtype/Form/Type/XObject>>stream endobj <>/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>> <>/Subtype/Form/Type/XObject>>stream N.-BE+!W9wX4]c&OGQ <>/Subtype/Form/Type/XObject>>stream 0000030531 00000 n <>/Subtype/Form/Type/XObject>>stream 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. xref If you havent created an account, click Register at the top right of this page and follow the prompts. Box 2070 Milwaukee, WI 53201-2070 Short Term Medical. 157 0 obj 0000001063 00000 n If you have questions about claims or benefits, were happy to help. endstream endobj H23U0t.=s#0ag 0 endobj xPpurb & Meritain Health. <>/DR<>/Font<>>>/F 4/P 4 0 R /Parent 130 0 R /Rect[ 496.92 51.72 579.48 74.28]/Subtype/Widget/Type/Annot>> 34 0 obj <>/Subtype/Form/Type/XObject>>stream endobj 566.9311. 83 0 obj xPpurb & x IMPORTANT: Please have your doctor or supplier of medical services complete the reverse of this form or attach a fully itemized bill. 141 0 obj endstream Your patients health and your ability to access their information is important to us. 1 Health and Welfare IBEW Local 1 Health & Welfare Fund %%EOF Looking to build a benefits plan? endobj <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 235.56 541.08 245.64 551.16]/Subtype/Widget/T(Employees Spouse)/TU(Employees Spouse)/Type/Annot>> Short term medical; . endobj endobj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 226.094 254.76 579.48 273.867]/Subtype/Widget/T(Describe injury when and how it happened or nature of illness)/TU(Describe injury, when and how it happened or nature of illness:)/Type/Annot>> <>/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>> 77 0 obj xPpurb & endobj endobj The Authorization for Release of Information form is required according to the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), specifically 45 CFR 164.508 of the HIPAA Regulations.
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