%%EOF xHMef2'oj,Fm'6bCL{@4t./~I2_d>\@+h?Mu(\bu 7FY,Q$jJ 9fK3J*9zl3$6)6}t+d=u+iTv5G(. h|]1Lf2wO^%L[^'t7o1/ V5?? 73 0 obj xref For 24-hour , https://qa.meritain.com/about-us-self-funded-employee-benefit-plans/meritain-health-provider-services/, Health (8 days ago) WebMailing Address. endstream Lastly, just mail the completed form and original invoice to , https://www.employeeconnects.com/wp-content/uploads/2021/06/Grand-Rounds-Submitting-a-Claim.pdf, Health (9 days ago) WebHealth Claim Form - KP Health (Just Now) WebHealth Claim Form Complete and send to: Meritain Health P.O. 0000154272 00000 n 97 0 obj endstream endstream endstream Try for free at rocketreach.co . <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream 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. xPpurb & 0000002620 00000 n %R Your health and your ability to access your information is important to us. HMO Based Plans (California) 800-624-0756. xb```f`` |@1V Xpc>'Y&y7PhKZVQH0XDA1 159 0 obj 95 0 obj 117 0 obj 46 0 obj endobj endstream endobj 0000263474 00000 n 0 <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 166.2 483.36 303 499.68]/Subtype/Widget/T(Spouses Social Security Number)/TU(Spouses Social Security Number)/Type/Annot>> xPpurb & 122 0 obj xPpurb & endobj For 24-hour access to your personal health information,log in to your account. %PDF-1.4 % specific needs. Comprehensive cost management helps eliminate waste and generates an additional 4 percent savings from billed charges. 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 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. 55 0 obj Mail completed Meritain Health form to: P.O. 48 0 obj hb``c``ja```01G30323Zq@ [s8cz^TV`8A X/@` u <<786CC871D6E58841AFFFF22908309F57>]/Prev 447040/XRefStm 2739>> xPpurb & If you have any questions about your benefits or claims, were happy to help. endobj 21 0 obj 58 0 obj endstream xPpurb & xPpurb & endstream You can accommodate anything, and you build it into the process. <>/Subtype/Form/Type/XObject>>stream With wellness programs, on-demand tools, resources and caring support, Meritain Health puts easy-to-use health care at your fingertips. endstream xPpurb & endobj 0000244168 00000 n <>/Subtype/Form/Type/XObject>>stream 0000091570 00000 n 0000070600 00000 n <>/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>> endobj ,L"\H4~Zzyv4vet{&+8*BYOl+:;C ks#6i}$9wNB;I@~d hop^F. endstream endobj <>/Subtype/Form/Type/XObject>>stream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 233.16 371.76 372.6 393.96]/Subtype/Widget/T(Address)/TU(Address)/Type/Annot>> xPpurb & endstream endobj endstream 0000000016 00000 n endobj 174 0 obj <> endobj All rights reserved. For 24-hour access to your patients health information,log in to your account. 0000244435 00000 n endstream 139 0 obj <> endobj x endstream 0000071642 00000 n Meritain Health builds connections and solutions that drive down <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream 81 0 obj endobj endstream <>/Subtype/Form/Type/XObject>>stream 0y\Eo^M dT<4 _i ihU;qrxR4RN7gjbLnIiW/{VPnhhu. For the fastest service, dial the toll-free number on the back of your ID card. endobj endstream 158 0 obj H23U0t.=s#0agf$LR@PBPBLDA k <>/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>> 0000002923 00000 n 0000222118 00000 n xPpurb & 27 0 obj 4 0 obj 10 0 obj 155 0 obj xPpurb & %%EOF <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 278.04 506.76 302.88 528.96]/Subtype/Widget/T(Sex_2)/TU(Sex)/Type/Annot>> H23U0t.=s#0agf!R@PBLX n xPpurb & 1-866-221-4988. <>/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>> 153 0 obj <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream H23U0t.=s#0agf$LR@PBPBLDA k 0000244743 00000 n endobj 0000001388 00000 n 0000001225 00000 n endobj 0000075777 00000 n 35 0 obj H23U0t.=s#0agf!R@PBLX n 0000018717 00000 n . 0000015983 00000 n C Protect yourself and your community.Telehealth for Cold and Flu - Meritain Healthwww.meritain.com/telehealth-for-cold-and-flu/FeedbackMeritainhttps://www.meritain.com/about-us-self-fundedProvider services - Meritain HealthWebIf you have questions about claims or benefits, were happy to help. <>/Subtype/Form/Type/XObject>>stream !@;P`C&Nu:cHe,S Ms WqY+oApg]DLz948=j\#.$,^`#s%/"8@GIL3K endobj LWp|vMpf ouC;w$[II'r$j*RHV)[r-E_D9X[/'g 0000030202 00000 n To reach us by phone, dial the toll-free number on the back of the patient . <>/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>> endobj 0000030531 00000 n If you're a Client or Broker, please contact your Meritain Health Manager. endstream 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. To reach us by phone, dial the toll-free number on the back of the patients ID card. x endstream 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. For privacy purposes, the member's spouse and adult dependents, covered by the plan, must each establish logins to access their individual information. If you havent created an account, click Register at the top right of this page and follow the prompts. x3P0 t.C=3C=3=3 6P(JJ grs You can locate the number on the back of your ID Card. 2 0 obj 146 0 obj endobj 37 0 obj Contact Allstate Health Solutions with questions around your policy, claims or more. endobj 52 0 obj x3P0 t.C=63E\i\ g3s 105 0 obj 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>> <>/Subtype/Form/Type/XObject>>stream 130 0 obj If you have questions about claims or benefits, were happy to help. 5 0 obj xPpurb & <>/Subtype/Form/Type/XObject>>stream xPpurb & 56 0 obj xPpurb & 0000030713 00000 n 0000002739 00000 n endobj 42 0 obj endstream endobj <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream endobj <>/Subtype/Form/Type/XObject>>stream endobj endobj startxref xPpurb & 109 0 obj endstream 0000030938 00000 n 90 0 obj <>/Subtype/Form/Type/XObject>>stream xPpuVru 40 0 obj<>stream Select Dental and DVH (Dental Only) ** Network by Aetna. 0000262626 00000 n endobj endobj endobj endstream <>/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>> 129 0 obj H23U0t.=s#0ag 99 0 obj For more information, please call Meridian Member Services at 888-437-0606 (Michigan) or 866-606-3700 (Illinois). 32 0 obj <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream 49 0 obj 75 0 obj <>/Subtype/Form/Type/XObject>>stream At Meritain Health, we create unrivaled connections. endstream Access information quickly For 24-hour access to your patient's health information, log in to your 0000071557 00000 n 0000002362 00000 n Copyright 2023 Meritain Health. endobj <>/Subtype/Form/Type/XObject>>stream For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. Our navigation partnerships and holistic approach to plan design helps support member health journeys. <>/Subtype/Form/Type/XObject>>stream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 43.2 575.64 183.6 597.84]/Subtype/Widget/T(City)/TU(City)/Type/Annot>> xPpurb & endobj <>/Subtype/Form/Type/XObject>>stream endobj Were adding new tools and resources all the time. endobj H23U0t.=s#0ag 77 0 obj Aetna Provider Phone Number List (California) Aetna Medicare Advantage Plans and. All other Plans (California) 888-632-3862. endstream endobj startxref <>/Subtype/Form/Type/XObject>>stream 45 0 obj endobj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream 86 0 obj STATUS AND BENEFIT INFORMATION: 1.800.925.2272 Send to: Meritain Health P.O. endstream If the patient is the employee, go directly to the area below the shaded box. x 50 0 obj 59 0 obj endobj <>/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>> <>/Subtype/Form/Type/XObject>>stream 1 Health and . <>/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>> endstream 0000071023 00000 n Aetna Open Choice PPO Network. Do you need a referral to see a specialist? 135 0 obj 0000030860 00000 n <>/Subtype/Form/Type/XObject>>stream 96 0 obj endobj 0000222146 00000 n endstream To reach us by phone, dial the toll-free number on the back of the patient's ID card. endobj Please forward this completed form to the privacy officer of the employer or to: Meritain Health x 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. xPpurb & 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. startxref If you're a Member or Provider please call 888-509-6420. 1 Health and Welfare IBEW Local 1 Health & Welfare Fund 133 0 obj endobj x IMPORTANT: Please have your doctor or supplier of medical services complete the reverse of this form or attach a fully itemized bill. %R endstream 148 0 obj endobj x3P0 t.C=63E\i\ g3s x xPpurb & <>/Subtype/Form/Type/XObject>>stream 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. 22 0 obj For ALL claims, this area must be filled in completely. endobj endobj endobj endobj 137 0 obj You might occasionally. xref x3P0 t.C=C=33=aP gos H23U0t.=s#0agf!R Section 1. and helpful tips for boosting good healthfor you, and your family. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 77.52 599.04 341.16 621.24]/Subtype/Widget/T(Home Address)/TU(Home Address)/Type/Annot>> Learn how to partner with us. 141 0 obj endobj 11 0 obj 84 0 obj 98 0 obj 0000002916 00000 n 0000047567 00000 n xPpurb & 0000243461 00000 n 40 0 obj <>/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>> <>/Subtype/Form/Type/XObject>>stream 0000005765 00000 n You can get answers to what you need, around the clock. This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. endobj endobj <>/Subtype/Form/Type/XObject>>stream 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>> endobj endobj 0000075478 00000 n To reach us by phone, dial the toll-free number on the back of the patient's ID card. endobj It is believed to be accurate at the time of posting and is subject to change. 106 0 obj endobj 0000195598 00000 n 71 0 obj <>/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>> 93 0 obj After logging in to your Meritain Health account, click on the Submit a Claim link at the top of the page. 0000222040 00000 n the cost of care for our plan sponsors and members. %PDF-1.7 endobj 0000047941 00000 n 0000195637 00000 n <>/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>> endobj We are your Advocates for Healthier Living, and were here to connect you and your family to the care you need, right when you need it. 24 0 obj <>/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>> endstream Submission of these forms to the Meritain Health Appeals Department without a formal written appeal from the provider will not be reviewed. endstream 160 0 obj 0000220357 00000 n Enter a name to find & verify an email >>> Rocketreach finds email, phone & social media for 450M+ professionals. All rights reserved. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 491.689 575.64 579.6 597.84]/Subtype/Widget/T(Home Telephone)/TU(Home Telephone \( \))/Type/Annot>> V>j>Or`DVGlM|v]%Yv+)mv>m{=umfofn]{H+T(T014p0fcO&qtkO^);nu|2@]T Gdd,LO~|4 ^'A{ @21xqW 1`6U endobj 0000007254 00000 n 0000078102 00000 n 0000221498 00000 n For 24-hour automated phone benefits and claims information, call us at 1.800. % 4. H23U0t.=s#0ag endstream xPpurb & 72 0 obj 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. <>/Subtype/Form/Type/XObject>>stream 18 0 obj endobj <>/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>> Whether you're building an employee benefits program, researching your member benefits or offering support to your patients, we're ready to help you do more with your health plan. endobj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 92.28 459.96 579.6 482.04]/Subtype/Widget/T(Spouses Employer)/TU(Spouses Employer)/Type/Annot>> endobj xPpurb & Mail completed Meritain Health form to: P.O. endobj 119 0 obj endobj x3P0 t.C=3C=3=3 6P(JJ grs 113 0 obj 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. 142 0 obj 66 0 obj 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 endobj <>/Subtype/Form/Type/XObject>>stream endstream endstream endobj xPpurb & H23U0t.=s#0ag 0000075278 00000 n [ 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 ] The form linked below should be completed by a member who needs togrant access to their PHIto another individual in connection with an appeal. Copyright 2023 Meritain Health. <> <>/Subtype/Form/Type/XObject>>stream As a member, you can log into your member portal for a more personalized experience. <>/Subtype/Form/Type/XObject>>stream x3P0 t.C=63E\i\ g3s 38 0 obj <<3E4E844C759D00498F9F96196CE1CA18>]>> 0000047241 00000 n Signature of member or members guardian. 67 0 obj endstream 0000075005 00000 n 128 0 obj Claims Processing and Payment: When you see patients who are Meritain Health members, please submit claims to Meritain Health for processing. 0000269194 00000 n <>/Subtype/Form/Type/XObject>>stream 33 0 obj endobj endobj endobj 102 0 obj 29 0 obj 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.
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