How Do I Register For Pehp For Providers
Insurance Plans Accepted
Do You Accept My Insurance?
University of Utah Health contracts with most major health insurance carriers and transplant networks. Please call your insurance company and ask if you have access to health care services at University of Utah Health locations, and what (if any) co-payments, co-insurances, and deductibles will be your responsibility.
This list covers insurance plans accepted by University of Utah Health in 2020. It is not all-inclusive, is updated periodically, and may be subject to change. This list is not a guarantee of network participation with any payer.
U of U Health is contracted and in-network with the following plans:
Aetna
If you have Aetna Standard Network, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- Aetna Standard Network
- Aetna Medicare Advantage & Mail Handlers
American Health Plans
U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- American Health Plans Medicare Advantage
Blue Cross Blue Shield
If you have one of these plans, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- Regence PPO (ValueCare)
- Traditional
- Focal Point
- Federal
- Regence Medicare Advantage
Blue Cross Blue Shield (out of state)
U of U Health facilities and physicians are in-network with out of state Blue Cross Blue Shield plans as long as the plan uses the BlueCard network. You can usually identify BlueCard eligibility by looking at your insurance ID card and locating a suitcase logo.
- Blue Cross Blue Shield (out of state)
If you see a blank suitcase or a suitcase with PPO inside and the plan is NOT through the ACA/Insurance Marketplace, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
If you cannot see a suitcase logo or if you receive your coverage through the ACA/Insurance Marketplace, U of U Health facilities and physicians are NOT in-network. Please check with your benefits department or call BlueCard Access at 800-810-BLUE (2583) to verify that your plan covers services at U of U Health before scheduling your visit.
Cigna
If you have one of these plans, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- Cigna PPO and HMO
- Cigna Medicare Advantage
Cigna ACA/Insurance Marketplace plans are NOT in-network with U of U Health facilities and physicians. Please check with your benefits department or call the customer service number on the back of your insurance card to find an in-network provider.
Deseret Mutual Benefit Administration (DMBA)
If you have one of these plans, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- DMBA Premier
- Protect
- Value
- Student
- Missionary
Health Choice
If you have one of these plans, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- Health Choice UT Medicaid
- Health Choice Generations Medicare Advantage
Humana
Humana: U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
Imperial Insurance Medicare Advantage
U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
Molina
If you have any one of these plans, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- Molina Core Care
- Molina Constant Care
- Molina Confident Care
- Molina Medicare Choice Care (HMO)
- Molina Medicare Complete Care (HMO SNP)
- Molina Medicaid
- Molina CHIP
PEHP
If you have one of these plans, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- PEHP Capital
- Preferred
- Summit
- Summit Exclusive
Tricare
If you have one of these plans, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- Tricare West
- Tricare For Life
United HealthCare
If you have one of these plans, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- United HealthCare Options PPO
- Student Resources
- United Health Medicare Advantage
- OptumCare Medicare Advantage
- AARP Medicare Advantage, GEHA
University of Utah Health Plan
If you have one of these plans, U of U Health is in-network for all facilities and physicians. This includes specialty and primary care services.
- University of Utah Health Plan
- Advantage U Medicare Advantage
- Healthy Preferred
- Healthy Premier
- Grand Valley
- Mountain Health CO-OP
- Montana Health CO-OP
- Healthy U Medicaid
Understanding Your Health Insurance Card
Insurance Provider Not Listed
My Insurance Provider Is Not on This List. Does That Mean You Do Not Accept My Insurance?
Not necessarily. This list is not all-inclusive and is subject to change. To check your in-network status with University of Utah Health, contact your insurance company to determine your plan benefits.
Coordination of Benefits: More Than One Insurance Coverage
As a patient it is important to understand how your insurance plans work together when you are covered by more than one insurance. The process of determining which insurance is the first to be billed (primary) is called Coordination of Benefits (COB). Understanding COB processes and rules helps make sure your claims are paid timely and appropriately.
Patients are responsible for notifying their insurance of any changes to their coverage that may affect their COB. If you do not provide these changes to your insurance, insurance payments may be denied until you update your COB information.
Common Coordination of Benefits Circumstances
The following are the most common types of combined insurance coverage or COB circumstances:
One Person Has Two Health Insurance Plans
If you have two health insurance plans, the health insurance where the patient is the subscriber (the carrier) is the primary payer. The secondary payer is the health insurance plan that covers the patient as a dependent, meaning you are covered under another plan as the spouse, child, or other dependent.
If the patient is a child and carries two health insurance plans, then the birthday rule will be applied. The birthday rule states that the parent who's whose birthday falls first will be the parent whose insurance is billed first.
The birthday rule only looks to the month and day and does not take birth year into consideration.
Health Insurance and Auto Insurance
If you are involved in an auto accident, your auto insurance is the primary insurance. The patient's health insurance is secondary.
If you are involved in an auto accident as a passenger, pedestrian, or bicyclist, the driver's auto insurance is primary and the patient's health insurance is secondary.
If you are involved in an accident on a recreation vehicle, your health insurance is primary.
Workers Compensation Fund
If you are involved in an accident while on the job, workers compensation insurance is typically the primary payer; however, if the claim is denied, we will bill your health insurance.
Government Insurance Processes
Medicare will be the primary insurance unless one of the following scenarios applies:
- If you are covered through either your own current employment or the current employment of a family member, Medicare will be the secondary payer (depending on the employer size).
- If you have end stage renal disease (ESRD) and qualify for Medicare.Our staff will help you determine the order of your benefits by using the Medicare questionnaire
- Medicare supplemental plans will be billed secondary to Medicare.
Medicare will not be billed:
- When a liability insurance (such as auto, home, and the like) is responsible for payment.
- Veterans Affairs has authorized payment for services.
- When a patient is being seen for a work-related accident.
- If you are enrolled in a Medicare Advantage Plan.
Medicaid plans are typically the coverage of last resort. We will bill any available insurance before Medicaid.
What If I Do Not Have Insurance or My Insurance Is Not Accepted
No Insurance?
In you are having a scheduled service/procedure, such as surgery, testing, or imaging, you pay the total estimated charges before the time of service.
If you are unable to pay the full estimated charges, you must deposit half of the cost before or at the time of the service before you receive it.
Please contact one of our Patient Financial Advocates at 801-581-2957 if you have questions about the estimated charges or are unable to meet these requirements. You may also estimate your cost by using our easy to use estimate tool.
Can I Still Go to University Of Utah Health If My Insurance Plan Is Not Covered?
In cases of emergency, go to the nearest emergency room. Your insurance may cover the ER costs or will transfer you to an in-network hospital once you are stable.
For other services, you may be required to pay a larger out of pocket portion on your bill. To be sure, contact your insurance company directly to discuss.
Check Your Medicaid Eligibility
Options to Determine Your Cost
Estimate How Much You'll Pay for Out-of-Pocket Health Care Costs
If you apply for Medicaid and aren't eligible, here are your options to determine your out of pocket health care costs:
We've developed a tool that helps you compare and estimate how much you'll pay out-of-pocket for different health services and procedures.
Don't have a MyChart account?
Use our online tool to get an estimate.
Have a MyChart account?
MyChart also gives estimates for how much you'll pay out-of-pocket for common health care services using your actual insurance information.
Need assistance?
Call a financial advocate at 801-581-2957
View Our Standard Charges
Contact Us by Online Billing Consult
How Do I Register For Pehp For Providers
Source: https://healthcare.utah.edu/bill/insurance-information.php
Posted by: sargentproutiting1980.blogspot.com
0 Response to "How Do I Register For Pehp For Providers"
Post a Comment