Note: , https://www.pangeafg.us/s/article/National-General-Meritain-Health-How-to-Submit-a-Medical-Claim, Health (2 days ago) WebBelow is the claims submission information: All Providers Send Claims to: Preferred Provider Network: Meritain Health P.O. endstream endobj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 102.24 622.44 341.16 644.52]/Subtype/Widget/T(Name last first initial)/TU(Name \(last, first, initial\))/Type/Annot>> 0000030531 00000 n Have you checked out your personalized web site? endobj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 124.92 436.56 579.6 458.76]/Subtype/Widget/T(Spouses Employers Address)/TU(Spouses Employers Address)/Type/Annot>> endobj <> 2JSt}Np~}y7i6i~..jnfE6zS\0 u}&p[ @68_=emL&Zqk$AT1KY$C#}Ra|h0{81[Gd8mdmmS4i\&;E <>/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>> <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 397.92 348.36 453.6 370.56]/Subtype/Widget/T(Group Number_2)/TU(Group Number)/Type/Annot>> 2 0 obj H23U0t.=s#0agf$LR@PBPBLDA k <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 128 0 R /Rect[ 234.36 198.96 244.44 209.04]/Subtype/Widget/Type/Annot>> <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream 47 0 obj 0000269194 00000 n <>/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>> 0000006809 00000 n <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 359.04 622.44 377.16 644.52]/Subtype/Widget/T(Sex)/TU(Sex)/Type/Annot>> %R@PBL1X Kh endstream endstream endobj 0000030597 00000 n PDF Claims Submission and Payment - mbh-eap.com endobj x3P0 t.C=63E\i\ g3s endobj H23U0t.=s#0ag IMPORTANT: Please have your doctor or supplier of medical services complete the reverse of this form or attach a fully itemized bill. endobj Contact Allstate Health Solutions with questions around your policy, claims or more. endobj 26 0 obj endstream xPpurb & 113 0 obj To reach us by phone: For the fastest service, dial the toll-free number on the back of your ID card or call 1.888.324.5789 ** This is a general line, so you may experience hold times and/or need to be transferred. endobj )wA If you have questions about claims or benefits, we're happy to help. endstream <>/Subtype/Form/Type/XObject>>stream endstream 0000439614 00000 n 86 0 obj 144 0 obj <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 266.76 352.32 276.84 362.4]/Subtype/Widget/T(Individual)/TU(Individual)/Type/Annot>> <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 455.28 348.36 579.72 364.68]/Subtype/Widget/T(Contract or Policy Number)/TU(Contract or Policy Number)/Type/Annot>> Its important to recognize not all networks are equal, Today, were proud to announce an important update for our brand. xPpurb & Short term medical; . 119 0 obj endobj endstream 91 0 obj endstream <>/Subtype/Form/Type/XObject>>stream <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 127.56 541.08 137.64 551.16]/Subtype/Widget/T(The employee)/TU(The employee)/Type/Annot>> endobj endstream 0000090829 00000 n 116 0 obj Transition or Continuity of Care (in Spanish). x33U0t.=s#0agf$LR Your patients health and your ability to access their information is important to us. %PDF-1.7 [ 313 0 R 160 0 R 161 0 R 162 0 R 163 0 R 164 0 R 165 0 R 166 0 R 167 0 R 314 0 R 315 0 R ] endobj 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. startxref We're making access just a click away. Copyright 2023 Meritain Health. 146 0 obj 0000002739 00000 n 300K . 0000023547 00000 n The form linked below should used by a member who would like to grant permission to another individual to act on their behalfin connection with an appeal. Not only can we customize your plan, we want to. <>/Subtype/Form/Type/XObject>>stream xPpurb & 40 0 obj H23U0t.=s#0ag x Electronic Claims Address CLAIM STATUS/ PROVIDER RELATIONS Carpenters' Health & Welfare Trust Fund Coventry Health Care P.O. <<786CC871D6E58841AFFFF22908309F57>]/Prev 447040/XRefStm 2739>> <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream H23U0t.=s#0ag x 0000026482 00000 n Aetna Claim Address|Aetna Provider Phone Number Updated (2023) endobj Sure, youve probably trusted a gut feeling when deciding something. bmV= 2)2`mXYg lUR(4uI?6"kwvdQBf-0d\+;#OA':(+ H23U0t.=s#0agf!R@PBLX n "LR@PBPBLM, k The member whose information is to be released is required to sign the authorization form. endobj 52 0 obj <>/Subtype/Form/Type/XObject>>stream Hl Provider Quick Reference Guide - MultiPlan endobj 0000222259 00000 n <>/Subtype/Form/Type/XObject>>stream 14 0 obj Provider services - Meritain Health endstream endobj 238 0 obj <>/Filter/FlateDecode/Index[6 133]/Length 27/Size 139/Type/XRef/W[1 1 1]>>stream 28 0 obj 68 0 obj 99 0 obj Note: Incomplete Claims Forms will be returned to you for missing information. Box 27267 Minneapolis, MN 55472-0267 The primary Preferred Network Hospital will remain Providence Hospital in Anchorage. Listen to Your Gut to Improve Your Health March 13, 2023 Sure, you've probably trusted a gut feeling when deciding something. 0000221985 00000 n Employee information: if you are NOT the employee of the plan Aetna Open Choice PPO Network. 0000005765 00000 n 20 0 obj endobj <>/Subtype/Form/Type/XObject>>stream 0000047567 00000 n <>/Subtype/Form/Type/XObject>>stream 0000071642 00000 n 120 0 obj 9fK3J*9zl3$6)6}t+d=u+iTv5G(. h|]1Lf2wO^%L[^'t7o1/ V5?? 25 0 obj <> endobj If you have any questions about your benefits or claims, were happy to help. endobj 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.