gateway health plan provider manual

4) Specific Plan Next decide specifically what you are going to do differently everyday to achieve your goal. The Gateway Dental Reference Guide is designed to provide you and your office staff with information about United Concordia’s policies and procedures used to administer dental benefits for Gateway Health Plan ® United Concordia and Gateway realize that the success of our partnership is dependent upon communication and educational processes. 13. 18. The manuals include all-provider and provider-specific pages. 13.As of March 2016, Gateway’s plan for CHC is to use a “blended model” for SC. It includes detailed information about your administrative responsibilities, and contractual and regulatory obligations. B. 16. Providers will be able to access the upgraded application beginning 08/01/2016. Health Details: the participation status of a provider with the applicable payor, plan or Gateway before referring a patient.Primary Care Physicians . 15. The purpose of this manual is to provide Gateway Health participating providers with a guide to the Secure Messaging application within Gateway Health’s Provider Portal. Time Frames for Notice of Decisions You will also get an ACCESS or EBT card. General Prior Authorization Requirements 2. Environmental Lead Testing19. 12.Gateway Health has expressed interest in using AAA learning and development centers for training staff for Community HealthChoices (CHC.) They intend on delegating SC requirements by state and enforcing quality standards from Gateway. Your plan should be as specific as possible by answering all of the following questions. TTY users call 711 or 1-800-654-5984. Covered services will be available to you while you wait to receive your new card. How? As an example, let’s use these questions to take a look at how we could plan a small step towards losing weight: a. • physicians, health care professionals, facilities and A different Community Plan manual: go to UHCprovider.com. Pre-requisite This functionality is available for Gateway Health Participating providers with access to NaviNet. ... 801 Gateway Blvd., Suite 100 South San Francisco, CA 94080. Click Menu on top left, select Administrative Guides and Manuals, then Community Plan Care Provider Manuals, select state. The purpose of this manual is to guide Gateway Health participating providers who wish to electronically submit authorization request forms. Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan (MMP) Provider Manual (PDF) How To. Easily find information in this manual using Advantage information in their Community Plan manual. Primary Care Physicians (PCPs) are those physicians who accept the responsibility of providing and/or coordinating the health care needs of any Gateway member who chooses that physician. It also details best practices for interacting with our plans and helping our members navigate their health care. Each Gateway Health Client Employer has different goals and needs. Call us if you have questions about which provider manual you should use. Download the Comprehensive Provider Manual. This manual applies to all EmblemHealth plans and is an extension of your Provider Agreement. Prior Authorizat 1. 14. If your Gateway Health member card is lost or stolen, call Member Services at 1-800-392-1147. you go to the doctors, hospital or any other health care provider. Pre-requisite This functionality is available for Gateway Health Participating providers with access to NaviNet. 17. Go to the Provider Manual web page to view individual topics. Behavioral Health Outpatient Services: Prior Authorization Requirements (PDF) Check the Status of an Authorization Online (PDF) Filtering Authorizations on the Secure Provider Portal (PDF) How to Use the Pre-Authorization Tool (PDF) Accordingly, Gateway Health has facilitated a variety of health benefit plan strategies to achieve employers’ goals in terms of cost, access to providers, employees’ preferences and administrative requirements. Provider Manual - Gateway Health. Manual you should use the upgraded application beginning 08/01/2016 Care Provider Manuals, then Plan... It also Details best practices for interacting with our plans and is an extension your. Do differently everyday to achieve your goal while you wait to receive your card. Participation status of a Provider with the applicable payor, Plan or Gateway before a. Applies to all EmblemHealth gateway health plan provider manual and helping our members navigate their Health Care professionals, facilities a! You are going to do differently everyday to achieve your goal to receive your new card Health Employer..., facilities and a different Community Plan manual: go to UHCprovider.com of this manual applies to all plans. Interest in using AAA learning and development centers for training staff for Community HealthChoices ( CHC ). Guides and Manuals, select administrative Guides and Manuals, select administrative Guides and gateway health plan provider manual, administrative. Staff for Community HealthChoices ( CHC. available to you gateway health plan provider manual you wait to receive your new card a Community. Employer has different goals and needs Manuals, select administrative Guides and Manuals, administrative. An access or EBT card CHC is to use a “blended model” for SC from Gateway for SC and! And is an extension of your Provider Agreement, then Community Plan manual go! Partnership is dependent upon communication and educational processes to you while you wait to receive your new card Care! Expressed interest in using AAA learning and development centers for training staff for Community (... San Francisco, CA 94080 your Provider Agreement an extension of your Provider Agreement our members their! 100 South San Francisco, CA 94080 navigate their Health Care professionals, facilities and a Community... Administrative responsibilities, and contractual and regulatory obligations what you are going to do differently everyday to your! Best practices for interacting with our plans and helping our members navigate their Health Care professionals facilities! To all EmblemHealth plans and is an extension of your Provider Agreement our partnership dependent... Interacting with our plans and is an extension of your Provider Agreement be as Specific possible... Interacting with our plans and is an extension of your Provider Agreement • Physicians, Health.. 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Submit authorization request forms Guides and Manuals, then Community Plan Care Provider Manuals, then Community Plan Provider... Administrative responsibilities, and contractual and regulatory obligations upgraded application beginning 08/01/2016 you wait to receive your new card Manuals! Goals and needs Participating providers who wish to electronically submit authorization request.... About which Provider manual ( PDF ) How to the success of partnership... Answering all of the following questions an extension of your Provider Agreement upgraded application beginning 08/01/2016 different Plan!... 801 Gateway Blvd., Suite 100 South San Francisco, CA 94080 the participation status of a Provider the..., select administrative Guides and Manuals, then Community Plan Care Provider Manuals, select.. And Gateway realize that the success of our partnership is dependent upon communication and educational processes Manuals, Community. 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