Mclaren health plan claims address. For additional contact information: Quick Contact Guide; .
Mclaren health plan claims address Note: You must be an established patient Evidence of Coverage says “we,” “us,” or “our,” it means McLaren Health Plan, Inc. Tim Vargas. Paper claims must be Claims Information McLaren Health Plan accepts both paper and electronically billed (EDI) claims. Health (3 days ago) McLaren Health Plan Appeals and Grievance forms. We may send you reminders about going to the doctor, getting needed care or services or to make you aware of any health It lists health care provider names, addresses, telephone numbers, specialties and board certifications. When you register, you’ll be able to see your claims history, choose a primary care physician, look at your explanation of benefits and more. McLaren Health Plan may deny the request for an expedited appeal and move the appeal to the 30 day timeframe. It's not the same as Medicaid in general, but rather an expansion of Medicaid under the Affordable Care Act (ACA) aimed at providing health care coverage to low-income adults between the ages of 19 and 64 who earn up to 138% of the federal poverty level. 03/25 McLaren Health Plan. Claims Information McLaren Health Plan accepts both paper and electronically billed (EDI) claims. Providing health coverage to Indiana families since 1994 UB-04 Claim Form Paper claims MDwise/McLaren Health Plans P. Service Codes Requiring Preauthorization. Jessica Cromer. Box 1511 Flint, MI 48501-1511 Handwritten claims will not be accepted. Forms & Documents. Provider Preauthorization Form; Fraud, Waste and Abuse; Laboratory Information; Our Plans; McLaren Health Plan Appeals and Grievance forms. If billing paper claims, follow PIN Provider Address Zip Phone Hospital Site Hours Availability Gender ALLEGAN COUNTY FAMILY - GENERAL PRACTICE 1025391 HALLEY, DAVID MD 345 NAOMI ST PLAINWELL (269) 552-0100 M-F 9:00-5:0049080 M You may qualify for financial assistance through McLaren Health Care. com 2020-10-15 ESH . ARENAC COUNTY. The address where paper claims are to be sent: McLaren Health Plan P. For pharmacists only, for questions regarding billing issues, claims processing and assistance with claim edits, call: 1-888-274-9689. President/CEO MDwise. This is an important legal document. Skip to content. Medical If you must submit a paper claim, all paper claims are to be mailed to: McLaren Health Plan P. Call Customer Service at 888-327- McLaren Health Plan Community – Individuals On/Off Exchange. W elcome to McLaren Health Plan (MHP)! The following chart shows UM Health-Sparrow's participation, by hospital, with each of the insurance plans that are listed. 50-mile limit one-way. Because you matter to us. You may get a text from time to time from McLaren Health Plan. For additional contact information: Quick Contact Guide; Address: 535 Diehl Road, Suite 100, Naperville, IL 60563 McLaren Health Care and/or its related entity • McLaren Health Advantage (PPO) - 3833A • McLaren Advantage (Medicare HMO) - 3833R • You are expected to submit your MHP claims electronically if you are able. Notification: Effective April 1, 2025, McLaren Health Plan is updating the CONNECT portal for Members and Providers. One of the first things you’ll want to do is to sign in or register on the member portal, McLaren CONNECT. McLaren Health Plan (MHP) offers a variety of products and benefits designed to meet the health care needs of each member. We’ve streamlined complex coverage options and packaged them with easy-to-understand benefits so you can look forward to Claims Payment Page 24 Website Page 25 Page 1 (888) 327-0671 • MclarenHealthPlan. Box 1511 Flint, MI48501-1511 View health record for [NAME] dropdown: If multiple health records appear, choose the appropriate patient record. Department. McLaren Health Plan Community (Individuals and Family Plans) Thank you for choosing McLaren Health Plan Community. Date: From: Phone Number: Fax Number: Number of Pages Faxed: Email address: • Please Claims must first be statused via the McLaren CONNECT Provider Portal Provider Claims Status Fax Form Fax: 833-540-8648 Email: MHPCustomerService@mclaren. Box 1575 . • McLaren Health Plan (K7) • Meridian Health Plan of Michigan (Health Plan of Michigan) (J2) • Priority Health (JZ) After your Medicaid case is opened, Michigan ENROLLS* will contact you about your Health Plan choices. 3. STERLING AREA HEALTH CENTER 725 E STATE ST STERLING, MI 48659-9548 (989) 654-2491 M-F SATURDAY SUNDAY 3:00 PM CLOSED About McLaren Health Plan Government programs - Individual, Medicare and Medicaid products Contracted with top health care systems in Michigan Based in Flint, MI Medicare service area includes 61 counties in Michigan More than 85,000 providers and growing Subsidiary of McLaren Health Care Corporation, the third largest USPS Mail to the address provided by McLaren Health Plan. View member PMP information. Submit claims within the filing period specified by your health plan. Claim Adjustment Form Claims Status Fax Form Genetic Testing Pre-authorization Requirements Healthy Behavior Support – Healthy Michigan Plan Claims must first be statused via the McLaren CONNECT Provider Portal Provider Claims Status Fax Form Fax: 833-540-8648 Email: MHPCustomerService@mclaren. Paper Claim Submissions . If you have any questions about your dental coverage, please call Delta Dental at (866) 558-0280. org Welcome Welcome to McLaren Health Plan! We are dedicated to partnering with providers such as you who Department Address Administrative McLaren Health Plan G-3245 Beecher Road Flint, MI 48532 Claims McLaren Health Plan P. 04/25 Notification: Effective April 1, 2025, McLaren Health Plan is updating the CONNECT portal for Members and Providers. Our Payer ID for electronic claims are: McLaren Medicaid / Healthy Michigan Plan – 3833C McLaren Community - Commercial HMO/POS – 38338 McLaren Health Advantage – 3833A McLaren Medicare Supplemental – 3833S McLaren DirectCare -3833T At this time you will need to contact McLaren Health Plan at 888-327-0671 to request. com Laboratory For Medicaid and Commercial HMO - Required lab vendor is Joint Venture Hospital Lab (JVHL) (800) 445-4979. McLaren Health Plan will review this and respond back. When you join a Health Plan, the Health Plan will send you a plan handbook and a health plan card. Send this completed Provider Claim Adjustment Request form along with supporting documentation to: McLaren Health Plan Attention: Customer Service . McLaren Health Care and/or its related entity Appeals and Grievance - McLaren Health Plan. The address where paper claims are to be sent McLaren Health Plan P. Submit a claim to MHP with procedure code 96160, in addition to the services rendered, and you If you have any questions, please contact McLaren Health Plan at (888) 327-0671, TTY:711. Gar Atchison. Box 1511 Flint, Mi 48501-1511. Electronic Claim Submissions About McLaren Health Plan 4 Service Area 5-8 Product Overview 9-10 Provider Manual 11 claims are: • McLaren Medicaid/Healthy Michigan - 3883C • McLaren Health Plan Community (Commercial HMO) - 38338 • McLaren Health Advantage (PPO) - 3833A McLaren Healthy Michigan Plan covers dental services for Healthy Michigan Plan members. MDwise is the right health plan for you and your family. Genetic Testing Preauthorization Requirements Joint Venture Hospital Laboratory (JVHL) Companion Guide Health Care Claim: 837 Page 1 of 17 This document may be copied only for JVHL internal use and for use by our Trading Partners in conducting business with JVHL. If billing paper claims, follow the CMS requirements for using the CMS 1500 and UB-92 claim forms and mail to: McLaren Health Plan P. org MHPCC20190105 . Need help? 1-888-327-0671 (TTY: 711) McLaren Health Plan. If you are a non-contracted provider, you will be able to register after you submit your first claim. President/CEO Compliance Program and Resources Price Transparency Website Privacy Policies © 2024 All rights reserved. esolutionsinc. Home. Cotiviti is a leading solutions and analytics company that provides payment accuracy services, including reviewing inpatient claims, to more than 100 commercial, Medicaid, and Medicare health plans and maintains a database of over 1. The HMO was started to serve Michigan’s Medicaid population and has added group, individual and Medicare products along with a Third Party Administrator 38338 e mclaren health plan commercial all claim office addresses 3833c e mclaren health plan medicaid all claim office addresses 06111 e oxford health plan all claim office addresses sx158 e paramount health po box 928 claims office toledo oh 43697 Contact McLaren Medicare. to 8 p. ; Take your Health Plan card and mihealth card with you when you visit the doctor, pharmacy, hospital or other medical provider. If billing paper claims, follow the CMS requirements for using the CMS 1500 and UB-92 claim forms and mail to: McLaren HealthPlan P. If you are unable to view the EOP this only means the claim or line of business has not been loaded into our McLaren Health Care and its subsidiaries offer convenient online bill pay options along with direct mail and in person. When you register, you’ll be able to see your claims history, choose a primary care physician, look at your explanation of benefits and more. Box 1511 Flint, MI 48501-1511 Or Fax to: (877) 502-1567 For questions regarding the Provider Claims Adjustment Process, call Customer Service at (888) 327-0671. Box 1511 Flint, MI 48501-1511 There is no copayment for preventive care, maternity services or family planning services. Please keep it in a safe place. Fundraising Opt-Out; Regarding The McLaren St. Box 1511 Flint, MI 48501-1511 Billing & Claims; Provider Resources. NOTE: The address where paper claims are to be sent McLaren Health Plan P. Box 1575 Flint, MI 48501. For EDI claims, McLaren Health Advantage uses Contact Customer Service if you have any questions regarding these items or need help, such as: Members and Providers can use McLaren CONNECT (member or provider portal) to submit You can find the form below or you can obtain a copy by calling Customer Service at (888) 327-0671. The Centers for 2. Once a claim is pulled you will be able to view the claims detail, and also have the option to view and print the EOP. To ensure appropriate adjudication of secondary claims, primary insurance payments must be reported at the line level, not at the claim level. Medicaid and Healthy Michigan Plan (HMP) provider copay obligations. to 7 p. Your Doctor First. If billing paper claims, follow the CMS requirements for using the CMS 1500 and UB-92 claim mclaren health plan commercial all claim office addresses: 3833c e: mclaren health plan medicaid all claim office addresses: 3833s: e mclaren medicare supplemental: all claim office addresses The address where paper claims are to be sent: McLaren Health Plan P. Date: From: Phone Number: Fax Number: Number of Pages Faxed: Email address: The following must be included in all claims: •Billing Provider Name and Address number includes service location address and expanded zip plus 4 – (Field 1) •Tax Identification Number (TIN) – (Field 5) Paper Claims MDwise/McLaren Health Plans P. is rated 3. 1-March 31: Seven days a About McLaren Health Care menu About McLaren Health Care. We are also committed to helping you understand our financial and billing Notification: Effective April 1, 2025, McLaren Health Plan is updating the CONNECT portal for Members and Providers. As your health care provider, McLaren is committed to offering you the best care possible. $0 copay for up to 20 one-way non-emergency trips per year to plan approved health-related locations. PO Box 1511 Flint, MI 48501-1511 United States. CT, Monday through Friday. If, after informally attempting to resolve the dispute through verbal contact or a Provider Claims Adjustment, a provider continues to disagree with an administrative Mailing address: Email to: MHPAppeals@mclar en. In addition to claim payment, claim submissions are used for quality measurement, including Pay for Performance (P4P) and provider incentive payments. Find a provider with McLaren Health Plan. McLaren Health Plan Medicaid / Healthy Michigan Plan – 3833C McLaren Health Plan Community ‐ Commercial HMO/POS – 8338 McLaren Health Advantage – 3833A McLaren Medicare Supplement – 3833S If you must submit a paper claim, all paper claims are to be mailed to: McLaren Health Plan P. Main Menu About Our Plans; Health McLaren Health Plan Medicare Plans in Michigan| Medicare| View Plans 2025. Thank you for choosing McLaren Health Plan. We are working on getting the gaps and care on our portal. (TTY McLaren Health Plan Medicare Preauthorization Form Phone: (888) 327-0671 Medicaid and Healthy Michigan (810) 600-7959 HMO Commercial/ Community, POS Commercial/ Community, and Health Advantage (810) 600-7966 McLaren Medicare (833) 358-2404 . The name of your Primary Care Physician (PCP) is on the card. . McLaren Medicare View Plans 2025 (Section Name) menu McLaren Medicare. Meridian Health Plan of Michigan, Inc. Can I send a question to McLaren Health Plan? Yes on the . MDwise/McLaren Health Plans . President/CEO McLaren Medical Group. 2 Claims Information McLaren Health Plan Community accepts both paper and electronically billed (EDI) claims. Address: 535 Diehl Road, Suite 100, Naperville, IL 60563. McLaren Health Care and/or its related entity Welcome to McLaren Health Plan Healthy Michigan, your new Health Partner! Make sure you use your McLaren Health Plan Healthy Michigan ID card when you need medical care. When it says “plan” or “our plan,” it means McLaren Medicare Inspire Plus . Help is available from 8 a. President/CEO McLaren Macomb. 5 million providers. Luke's Transition; Research & Clinical Trials; The Doctor Is In For Hoosier Healthwise and Healthy Indiana Plan, MDwise customer service is available at 800-356-1204. Meals after discharge: The Healthy Michigan Plan is a type of Medicaid program specific to the state of Michigan. Member Portal; InstaMed; Mail Payment To: McLaren Health Plan Community PO Box 771983 Detroit, MI 48277-1983. Quick Links. Appeals (810) 600-7984. Box 1511 Flint, Mi For EDI Claims, McLaren Health Plan Community utilizes ENS/OptumInsight clearing houses. ) Please contact our Member Services number at 833-358-2404 for additional information. Common reasons include: • Valid NPI is missing or incorrect • Unable to identify the provider (Use your NPI McLaren Health Plan Service Area - Maps McLaren Health Plan – Medicaid 2019 Approved Service Areas MHP20141021 Rev. Copayments can be as high as $75 per hospital stay. Make Payment Online: You can now make your premium payment by credit/debit card or e-check. there is an option to ask your question. President/CEO McLaren Health Management Group. Direct Member Reimbursements should be submitted to address on the form. McLaren Health Plan . If you would like to know which local health department is close to you, or you need to know which Children’s Multispecialty Clinic is in your area, please call us at 888-327‑0671 (TTY: 711). McLaren Medicare has affordable, all-in-one Medicare plans with an extensive network of doctors and hospitals to serve you. MHP receives EDI claims from our clearinghouse, ENS Optum Insight. Tracey Franovich. Medical Claims . As a McLaren Health Plan member, you get outstanding service and plans that fit your needs. page under . O. McLaren Medicare Contact Us. Binesh Patel, MD. 13 [MHPPR20241201] tel: 888-327-0671 | fax: 833-540-8648 | McLarenHealthPlan. Box 1511 Flint, MI 48501-1511 Information on how to contact McLaren Health Care. If you do not currently utilize ENS/OptumInsight for electronic submission of claims, contact them at: m McLaren Health Plan’s transaction or payer ID numbers are McLaren Community HMO: 38338 McLaren Medicaid: 3833C McLaren Health Advantage: 3833A Effective April 1, 2025, McLaren Health Plan is updating the CONNECT portal for Members and Providers. org . The written notice will tell you McLaren Health Plan’s decision and the benefit and medical necessity information that was used in MHP can accept and process electronic secondary claims. ET, 7 a. 5 out of 5 among health insurance plans in the National Committee for Quality Assurance (NCQA)’s Medicaid Health Insurance Plan Ratings for 2019-2020. Main Menu Claims Payment Information; Find a Provider; Communications; Covered Services; Address, phone, office hours and website (if applicable) To view claims, you can search by member ID (please see box below), date of birth and begin/end date, or by claim number. McLaren Health Plan: Your Choice for Michigan Health Insurance | McLaren Health Plan | Providers | Provider Resources View member claims information. HRA Submission Completed HRAs should be submitted as follows: Fax: (517) 763-0200 Send this completed Provider Claim Adjustment Request form along with McLaren Health Advantage Attention: Customer Service P. ; Your Provider will use your Health Plan Email: HAFlexSpending@mclaren. As a member, you can schedule a virtual care visit, find a clinic near you and view your benefits. Buxton, PhD. 835 . "Yes" means services are covered at in-network benefit levels for that UM Health-Sparrow facility. For questions about your filing period, please call the number on the back of your insurance card. To this end, our mission is to partner with providers who offer high-quality, accessible and cost-effective health services throughout our service area. If billing paper Provider Address City and Zip Phone. Fax: 810-600-7984 Medicaid / MIChild. Request access to Member Health Profile. President/CEO McLaren Lapeer Region. Prior Authorization For prescribers only, for questions regarding prior authorization, or to initiate prior authorization requests, call: 1-800-788-2949. EDI Enrollment Instructions: • Electronic Remittance Advice (ERA) 835 and Electronic Funds Transfer (EFT) is only available through the Optum Electronic Payment and Statement (EPS) system and EFT is required to receive the ERA. With McLaren Connect, you can access your McLaren Health Plan information in one convenient location. Hospital-based clinic billing does not affect patients with commercial health insurance plans - only affects those patients with Medicare, Medicaid, or other governmental plans. Award Winning Care; Community Health Needs Assessment and Implementation Plans; Contact Us; History; McLaren Health Care Executive Team; Video Vault; Our Foundations. Contact MDwise Provider Relations online. McLaren Health Plan: Your Choice for Michigan Health Insurance | McLaren Health Plan | Members | Forms & Documents •Use only the physical address for the service facility location field. Your dental coverage is through Delta Dental. Follow the CMS requirements for paper claims using the CMS 1500 form and mail to: McLaren Health Advantage P. Delta Dental’s Healthy Michigan Plan network serves both Medicaid and Healthy Michigan Plan members with dental coverage through Health Alliance Plan (HAP CareSource), McLaren, Meridian Health Plan, Priority Health or Upper Peninsula Health Plan (UPHP). Submit requests for prior authorization. 1500 Health Insurance Claim Form File Guide the Agreement between you and McLaren Health Plan, the provision in this manual will control unless o Office address or phone number o Office services o Call coverage . Submit requests for care management disease management programs. Before 1/1/25 Access the DentaQuest provider portal Effective April 1, 2025, McLaren Health Plan is updating the CONNECT portal for Members and Providers. Effective April 1, 2025, McLaren Health Plan is updating the CONNECT portal for Members and Providers. Credentialing McLaren Health Plan Medicaid covers dental services for adults 21 and older. Payer ID: 38338 www. Phone: 833-358-2404 (TTY: 711) April 1-Sept. Box 1511 Flint, MI 48501‐1511 Contact McLaren Health Plan by fax. Box 1511 . HIP State Plan Basic could cost more than paying the HIP State Plan Plus monthly POWER Account contribution. Barton P. Provider Relations Phone: (888) 327-0671 Fax: (810) 600-7879. On April 1, 2025, all users must re-register and create a new account to access the portal. If you have any questions about your dental coverage, please call Delta Dental at 866-558-0280. HIP Maternity Plan HIP Maternity Plan is for people who are pregnant and gives them more benefits! Claims Information McLaren Health Plan Community accepts both paper and electronically billed (EDI) claims. Main Menu About Our Plans; Health & McLaren Health Plan G-3245 Beecher Road • Flint, Michigan • 48532 tel 888-327-0671 (TTY: 711) • fax 833-540-8648 McLarenHealthPlan. Box 1511 Flint, MI 48501-1511 For EDI Claims, McLaren Health Plan utilizes ENS/OptumInsight clearing houses. It is your responsibility to see your PCP within 60 days of becoming a McLaren Health Plan Healthy Michigan member. org Rev. Make a Direct Deposit: You can do a direct deposit via the Electronic Funds Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of McLaren Medicare Inspire Plus (HMO) This document gives you the details about your Medicare health care and prescription drug coverage from January 1 – December 31, 2025. Last Updated: included a new claim submission address, as well as new electronic payer IDs for Hoosier Healthwise •Paper claims: MDwise/McLaren Health Plans P. Additional information. 4. MDwise Claim Contact Information. 15 Effective April 1, 2025, McLaren Health Plan is updating the CONNECT portal for Members and Providers. • The claim includes additional information when required by McLaren Health Plan Non-Clean Claims When McLaren Health Plan is unable to process a submitted claim, notification will be provided identifying the reason for rejection. NEW FAX NUMBER – Effective 4/01/2019. Health (2 days ago) Mailing address. P. Dental Provider Portal. MDwise was rated 3. m. Box 1511 Flint, Michigan 48501-1511. McLaren offers several payment options based on financial information. Box 1575 Flint, MI 48501 •Electronic submission: Hoosier Healthwise EDI/Payer ID: 3519M Healthy Indiana Plan EDI/Payer ID: 3135M Please note: Paper claims must be on red/white form with MDwise has developed a comprehensive quick contact guide that includes contact information for Hoosier Healthwise and Healthy Indiana Plan. Electronic Claim Submissions . 30: Monday-Friday, 8 a. Oct. You will receive a written notice from McLaren Health Plan within 3 calendar days of the appeal meeting. Flint, MI 48501 . Box 1575 Flint, MI 48501 Electronic claims Hoosier Healthwise EDI/Payer ID: 3519M 3 MDwise Claim Contact Information Medical Claims Paper Claim Submissions MDwise/McLaren Health Plans . Please ask to see our Patient Financial Services Counselors if you have: No health insurance; No secondary insurance; Been denied by Medicaid; An insurance company which requires a large co-pay or deductible Notification: Effective April 1, 2025, McLaren Health Plan is updating the CONNECT portal for Members and Providers. Search for and select your provider’s name that will review the renewal request. in these two circumstances please use the number and addresses listed below. McLaren Health Plan Provider Directory Your PCP and McLaren Health Plan will work together to make sure that you are able to continue care with all of your doctors. If McLaren Health Plan (MHP) has been operating as a Michigan-based licensed Health Maintenance Organization (HMO) since 1998 and currently delivers health care benefits to 260,000 members. Clearinghouse: Optum Financial McLaren Medicaid/McLaren HMP Lakeland Care Network. McLaren Health Advantage accepts both paper and electronic claims. org Please complete form and fax to McLaren Health Plan (MHP) and we will fax back a status response. • enshealth. • Please ensure your address is correct or up to date with McLaren Health Plan. UPG payment - Call 313-745-8100 or 1-866-978-6333 or mail payment to: McLaren Health Plan; McLaren Medical Group; Research & Clinical Trials It is called the National Committee for Quality Assurance (NCQA). Flint, MI McLaren Health Plan Community (Individuals and Family Plans) Thank you for choosing McLaren Health Plan Community. Physicians, employers and agents can access their portals here too! McLaren Health Plan encourages providers to first contact Customer Service when a dispute occurs. org MAIL CLAIM FORM TO: McLaren Health Advantage FSA Unit PO Box 1511 Flint, MI 48501-1511 -0671 Fax: (810) 600-7942 Please PRINT Clearly Employee Name ID or Social Security Number Group/Employer Address Street City State Zip Contact Number ( ) Please check if this is a new address Instructions In fact, McLaren Health Plan was recently awarded the opportunity to be the only health plan offered to Medicaid beneficiaries in every county in the lower peninsula! Everyone deserves quality, affordable health care. Login to myMDwise. 12/2018 Crawford Livingston Emmet Charlevoix Cheboygan Presque Isle Antrim Ostego Montmorency Alpena Leelanau Benzie Effective April 1, 2025, McLaren Health Plan is updating the CONNECT portal for Members and Providers. 5 out of 5 in NCQA's Medicaid Health Insurance Plan Ratings 2023-2024. • The letter will include instructions for submitting the medical records, the list of claims to be reviewed, and the number of days you have in which to submit documentation. Please submit a separate claim form for each patient and pharmacy from which you purchase medications. tsvddz cxdm mbfdj mgtqg ktxedoxt cno iodtv svkcl knd fsog udofb lvw nlg qeq aybd