Box 31364 Job Description The Compliance Lead is responsible for evaluating and determining the appropriate action on activities related to Health Plan reporting, audit preparation, health plan audit results and corrective action plans, benefit analysis and system design, manage special projects and auto-adjudication applications as it applies to auditing and claims compliance. With a reputation built on quality, flexibility and responsiveness, Heritage provides superior vision plans at competitive prices. Answering phones, and assisting with claims status, assisting providers and members with claims documentation, logging and maintaining claim information. Box 31364 Salt Lake City, UT 84130-0760, Dual Complete (HMO D-SNP) Does Heritage Vision Plans accept all types of providers? With an important distinction. Claims Status. In addition, our Urgent Care is now open daily 6am - 8pm. Mental health. Contacts --Contact Business. These breakthrough innovators are making significant contributions in the areas of technology, research, or new approaches to healthcare systems. westprteam@uhc.com, Network Management Provide a description of the damage, and if possible, have your policy number handy. We accept over 85 different health plans, including HMO, PPO, POS, EPO, Private and Medicare plans. 39115 TRADE CENTER DR PALMDALE, CA 93551 Get Directions (661) 480-2000 . Milwaukee (NE, NW & SE WI) This site is compatible with: Heritage Vision Plans makes vision benefits easy for everyone: for benefits managers and, most importantly, for employees using the benefits. Bakersfield Family Medical Center provides excellence in health care to our patients in professional settings that promote wellness and preventive medicine in Kern County. With offices throughout the greater Orange County area, chances are board-certified primary care physician and board certified specialists you need are in your own neighborhood. All HPN participating providers and staff are dedicated to improving the healthcare journey and experience of all patients. CHS serves as our population health management services organization (PHMSO), meaning that they support our participating practices with key resources needed to achieve success in value-based care. Reston, VA 20191, Network Management 8510 Balboa Boulevard Suite 285 Our commitment to complete patient care includes developing new and better ways of delivering healthcare. Easy for you, clear for employees. This is why you will find easy access to your doctor, minimal waiting time for referrals, and staff members that genuinely care for your well-being. Request . Ste 5300 125 South 84th St. As a Heritage Vision Plans provider, you always have a provider service representative available to answer questions and address your needs. Mission Heritage Medical Group is home to a team of board-certified primary care physicians and specialists serving the South Orange County communities. West Des Moines, IA 50266, Health plan Support Prior uthorization: 800-310-6826 P.O. P.O. 35 Casa Street, Suite 170, San Luis Obispo, CA 93401 (805) 540-5035 Get Directions 325 Posada Lane, Templeton, CA 93465 (805) 239-0644 Get Directions These IPA physicians are affiliated with BFMC/CCPN for the coordination of care rendered to members who have selected CCPN as their primary medical group. Claims. Indianapolis, IN 46278, Northwest IN - Lake, Porter & Laporte Counties Our claims center is staffed with specialists who. 12018 Sunrise Valley Drive 312-453-7055, Network Management We aim to deliver quality, affordable healthcare to the communities we serve. San Luis Obispo, California 93401. Nebraska_network@uhc.com, Medicare Advantage and Community Plan *. We believe the most important aspect of healthcare is tending to the personal needs of our patients. 888-362-3368, UnitedHealthcare Oxford health plans Please allow 30 days from the date of submission for processing. inquiries@heritagemed.com. Economical. For more than 25 years, we've been fortunate to have an impressive team of health care professionals, administrators, support personnel and dedicated volunteers who work in unison to help us deliver on our promise. Desert Oasis Health Care (DOHC) P.O. These IPA physicians remain affiliated with BFMC although they maintain their own individual offices. Because everyone deserves to hear well and live happy, Heritage has teamed up with Amplifon Hearing Health Care to offer member savings on hearing health services and devices. As a Heritage Vision Plans Provider, you are the public face of the vision care programs we provide, and we value the relationship we have with you. 9700 Health Care Lane, These IPA physicians remain affiliated with BFMC although they maintain their own individual offices. Heritage Vision Plans provides affordable, high-quality vision benefits for companies of all sizes. All paper claims must be mailed to: Lakeside Community Healthcare Attn: Claims Department P. O. providertechsupport@uhc.com How often do you process provider claims? Attn: Claims Processing. Mission Heritage Medical Group 1148.3 miles away Mon - Fri : 8 a.m - 5 p.m Our Approach Serving Mission Viejo, California Mission Heritage Medical Group is home to a team of board-certified primary care physicians and specialists serving the South Orange County communities. Throughout the twenty year history of our medicalgroup, we have diligently invested our resources in the development of programs and services responsive to the healthcare needs of todays patient while adapting to the increasingly diverse needs of tomorrows healthcare agenda. Hearing loss affects 1 in 9 Americans, get the care you deserve. P.O. Submit an inquiry and review the Claims Status Detail page. 866-331-2243, Network Management For Providers: Contact Us If you're a provider who needs to contact us about one of our Blue Cross Blue Shield of Michigan, Blue Care Network or our Medicare products, start here. Salt Lake City, UT 84131-0364, General claim disputes Tampa, Florida 33607, Preferred Care Partners and Preferred Care Network Maitland, FL 32751, South Florida Box 30757 ADOC Medical Group (ADOC) is an independent practice association, a medical group of over 275 private physicians and 600 specialty physicians who are dedicated to providing affordable, quality healthcare for individuals of all ages. To join our Heritage Provider Network, fill out our Provider Enrollment Inquiry Form. Suite 200 Together, we partner with local hospitals, medical experts and business leaders, and we actively support numerous organizations, educational, cultural and recreational events. Medical office locations in Foothill Ranch, San Clemente, Lake Forest, Laguna Niguel and Mission Viejo, CA. How can we help? Bakersfield Family Medical Center provides excellence in health care to our patients in professional settings that promote wellness and preventive medicine in Kern County. Suite 5300 Personal service is one of the reasons our network of providers is so stable with an extremely low turnover rate. We have convenient locations throughout the Coachella Valley, Morongo Basin and Yucca Valley areas. Provider Profile Details: NPI Number Details: Provider Business Mailing Address Details: Provider's Primary Taxonomy Details: Secondary Taxonomy Details: Request a copy of your contract Throughout the twenty year history of our medicalgroup, we have diligently invested our resources in the development of programs and services responsive to the healthcare needs of todays patient while adapting to the increasingly diverse needs of tomorrows healthcare agenda. Our culture has strong ties to supporting the local community through providers preserving their independent practice using our group environment. Medicare Advantage and Community Plan Members who choose physicians of CCPN will see their doctors in their conveniently located private offices and also have access to a whole network of out-of-area specialists. Contact Us: Home Contact Us: Network Support Services. of Special Projects (661) 951-3224 ocampos@heritagemed.com Puerto Rico Network Management 800-291-2634, Medicare Advantage and Community Plan Regal Medical Group (RMG) Atlanta, GA 30374, Health plan support For more than 25 years, we've been fortunate to have an impressive team of health care professionals, administrators, support personnel and dedicated volunteers who work in unison to help us deliver on our promise. This is why you will find easy access to your doctor, minimal waiting time for referrals, and staff members that genuinely care for your well-being. In 1979, Dr. Merkin founded the predecessor to Heritage Provider Network (HPN), which currently serves nearly 700,000 individuals in California, making it one of the largest IPAs in the United States. St. Jude Heritage Medical Group is widely recognized as one of Southern California's finest medical groups. HPNs medical and administrative management organization assesses internal and external statistical data and surveys to monitor compliance with medical policies, procedures and standards. 5900 Parkwood Place, 5th Floor That size works to your advantage, allowing us to be there to coordinate all of your health care, when and where you need us. "We applaud the efforts of those exceptional winners as they are the leaders and innovators we rely on to create a convergence of new technologies and science that will change healthcare outcomes in the next decade. For Medicare members and their plan risk or out-of-area claims and/or direct Medicare member reimbursements, please submit them to: Western Health Advantage Mail Service. We know that getting sick doesn't happen on an 8 - 5 schedule. 866-270-5785, San Diego County One way that we keep your overall health care costs low is by emphasizing preventative care in order to keep you healthy. These IPA physicians are affiliated with BFMC/CCPN for the coordination of care rendered to members who have selected CCPN as their primary medical group. Your dispute must contain the following information: Provider's name. Heritage Provider Network in Lancaster, CA What email should the hiring manager contact you at? Medicare Fee-For-Service beneficiaries and health plan members can expect the highest quality, coordinated care from a primary care or specialist provider participating in HPN. This organization has created or championed new ways of thinking and doing, uniting diverse constituencies to work together. Visit your health plans website or call to ensure your doctor is in Providences network. Suite 2600 HDMG has a long-standing promise to provide residents of the Antelope Valley with the highest quality health care possible. Our goal is to help you make better care decisions for yourself and your family. As of November 1, 2018, WellCare Health Plans, Inc., is directing all the EDI claim submissions sent to the payer IDs shown in the grid below to WellCare's payer ID (14163) regardless of the date of service. We accept both private practice providers and those affiliated with retail locations or corporate chains. All Savers Health Plan They have all personally, and organizationally made those promises to improve health, care, and cost a reality for tens of thousands of New Yorkers most in need, and lighting the way for others to follow," said Mark Wagar, President of Heritage Medical Systems. 888-362-3368, Provider Relations Physician and Hospital Advocate Team Ph: 714.937.6143. CCPN is an Independent Practice Association (IPA) formed in 2006, consisting of a network of contracted physicians located throughout the San Luis Obispo and Tulare counties. Fax: 859-825-6173, Louisville Cincinnati, OH 45241, Northeast Syracuse, NY 13206, NYS Empire Plan Our goal is to help you make better care decisions for yourself and your family. Contact Claims. Dr. Merkin is a visionary and a sought-after healthcare expert who encourages innovation and challenge. Call toll free 800.252.2053 or click here to send us your inquiry. At SMG your health is our priority. Las Vegas, NV 89128, Medicare Advantage and Community Plan Contact information for Heritage Provider Network, media relations, and our medical groups are as follows. 100 Phone: 1 (855) 536-2744 Fax: 1 (866) 929-4530 Claims Questions Immediately call Heritage Insurance toll-free at 1-855-415-7120 to report how, when and where the damage occurred. Cleveland, OH 44114, Dayton and Cincinnati Kingston, NY 12402-5290, Behavioral health If you need help resetting your password, you call us. Heritage Vision Plans is a leading national provider of vision benefits plans with an extensive, nationwide network of eye care providers. Your location: Learn more about our mission, vision and values. 888-650-3462, 6860 West 115th St. northeastprteam@uhc.com, Network Management He is on the Visionary Board of the X-Prize Foundation. (661) 945-9411 Our Lancaster facility offers the convenience of having your Primary Care Physician, Lab, X-Ray, Urgent Care, Pharmacy, a Health Education Department, Infusion Center, and a multitude of subspecialties all under the same roof. Highlighting cutting edge applications of technology and up-and-comers in the healthcare industry. Dublin, OH 43016 877-842-3210, Medicare Advantage and Community Plan hdmg.net 12370 Hesperia Road Ste. Our Lancaster facility offers the convenience of having your Primary Care Physician, Lab, X-Ray, Urgent Care, Pharmacy, a Health Education Department, Infusion Center, and a multitude of subspecialties all under the same roof. Brentwood, TN 37027 Provider Lookup . We also believe that during a visit to your doctor, the focus should be on health and wellness. Preventive health care services include employer-based health education programs, vaccinations and fitness programs. Network Resources. This is why you will find easy access to your doctor, minimal waiting time for referrals, and staff members that genuinely care for your well-being. 5757 Plaza Drive Send your new credentialing application by mail, fax, or email: Mail: PO Box 327 - MS 263 Seattle, WA 98111-0327. Additionally, he is on the Board of Directors at the California NanoSystems Institute at UCLA. Detroit, Eastern, Western and Northern and Upper 888-980-8728 Regal Medical Group works together with your healthcare plan and your PCP to keep things running smoothly. Suite 100 Pioneer Provider Network, A Medical Group, Inc . Box 371330 Reseda, CA 91337 Your dispute can be submitted by a letter or by a provider dispute form. Lakeside Community Healthcare P.O. 877-542-9235, Network Management ", "We are very proud to be the exclusive media partner of Heritage Provider Network for their 2nd year of their Heritage Healthcare Innovation Awards initiative, as they seek to recognize health care innovators who have improved the lives of millions of New Yorkers" said Jill Kaplan, Vice President and Publisher of Crain's New York Business. You should be discussing things like prevention, diagnosis, treatment and healing, not coverage, networks, claims, regulations and billing. With over 31,000 providers nationwide, our members are never far from quality vision care. We have the resources and commitment to always bring the best to meet the new challenges and ever-changing health care needs of the Victor Valley region. Suite 1170 View Verification of Benefits. Consolidated Portal. We'll use your location to find clinics, hospitals and doctors closest to you. With over 50 Primary Care Providers, 300 Specialists and 3 local hospitals in our network, Heritage Sierra Medical Group takes pride in Starting . Learn more about becoming a Premera provider. mn_contracting@uhc.com, 9700 Health Care Lane That's where an IPA, like Regal Medical Group, is able to serve both patients and physicians, by managing the business of managed care so that you don't have to. 24/7 behavioral health and substance use support line. View patient deductibles/out of pocket amounts. Trilogy Health Solutions - Wisconsin Preferred Provider Network . 1485 Heritage Parkway. Lakeside Medical Group is a comprehensive healthcare provider with a network of physicians and services throughout the San Fernando, San Gabriel and Santa Clarita Valleys, as well as parts of Ventura and San Bernardino Counties. An excellent team of specialty physicians who are either board certified or board eligible supports our primary care physicians providing you with a comprehensive healthcare network that is fully committed to your individual needs. 1 East Washington Set your location to find care near you. DOHCs services include access to 6 Immediate and Urgent Care Centers - Bermuda Dunes, Indio, Palm Desert, Palm Springs and Yucca Valley. Cypress, CA 90630, Provider Relations Physician and Hospital Advocate Team We're located at 4550 California Avenue, Suite 100, in Bakersfield. To obtain a provider dispute form, please contact the Appeals Coordinator at (818) 654-3400. As a Heritage provider, your information will be included in our Heritage Provider Directory. Claims Address Nebraska Total Care Attn: Claims PO Box 5060 Farmington, MO 63640-5060. Providence Affiliated Physicians - St. Joseph, St. Jude and Mission have come together as a network of dedicated health care professionals with one central vision - making our community its healthiest. Suite 400 At SMG your health is our priority. Heritage Physician Network (HPN) IPA is an independent physician association organized in 1995 by independent practices in the Houston metropolitan area and has grown to over 800 providers. 400 E. Business Way Mon-Fri 7:30 am - 4 pm ST. Our Services. ADOC Medical Group (ADOC) is an independent practice association, a medical group of over 275 private physicians and 600 specialty physicians who are dedicated to providing affordable, quality healthcare for individuals of all ages. Heritage Victor Valley Medical Group has exceeded our members expectations since its inception in 2003 through personalized care by a staff of skilled professionals, a speedy referral system, and a panel of specialists to serve all your medical needs. https://www.providerexpress.com/content/ope-provexpr/us/en/our-network.html, Optum Physical Health/Alternative Medicine (Acupuncture, Massage Therapy, Chiro, Naturopaths, etc.) Regal Medical Group works together with your healthcare plan and your PCP to keep things running smoothly. Implementing our benefits program is easy, and options are available for employer and employee plans. UnitedHealthcare Community Plan 2717 N 118th Street, Suite 300 Omaha, NE 68164. Our facilities offer superior patient convenience by providing Urgent Care, Pharmacy, Lab, Radiology, Pediatrics and a variety of specialty services at one convenient site. Eye health and wellness is a priority with Heritage Vision Plans, and we believe in giving back to the communities where we live and work. The complete list of 25 finalists can be found at www.crainsnewyork.com/heritage. Find the right contact I need to contact Clear Inputs about TTY users: To reach any number listed here, dial 711. UnitedHealthcare Omaha, NE 68164 Heritage Provider Network Contact List As of April 2015 Group Department Contact Type Contact Name Title Phone Email Claims Main Contact Anthony Cockerill Director, Claims (661) 726-3815 awcockerill@hdmg.net Escalated Contact Octavio Campos Corporate Dir. Heritage members will provide you with their identifying information (Name, Date of Birth or ID Number, and the name of their employer or covered group). You always have a provider service representative available to help either by telephone, email or the contact us form. 3000 Town Center, Suite 1400 Heritage Provider Network is located at 39115 Trade Center Dr in Palmdale and has been in the business of Computer Related . Learn more about our mission, vision and values. Professor of Medicine, New York Medical College; Chief of Medicine, NYC Health + Hospitals/Metropolitan. We have enjoyed our partnership with Heritage Vision Plans over the last several years. 800-638-3302 950 Winter St. Sign up with your email address to receive news and updates. Chicago, IL 60601 If you are a clinic or hospital-based physician or other qualified healthcare provider, use a CMS-1500 (02-12) form for claims for professional services and supplies related to: Anesthesia. When youre ready, call your physicians office or schedule an appointment online. From our approach to prevention and disease management to our hospitalist program and more, your care is coordinated so that you have the best possible outcomes. In addition, the Heritage Physician Network is a group of physicians located throughout Kern County who have joined together to form an Independent Physicians Association (IPA). Kingston, NY 12401 Heritage Healthcare Organizational Leadership Award:Steven Safyer, MD Box 30760 customerservice@regalmed.com. Simple. All Savers Health Plan New York, NY 10119, Health plan support DOHCs services include access to 6 Immediate and Urgent Care Centers - Bermuda Dunes, Indio, Palm Desert, Palm Springs and Yucca Valley. Fax: 504-849-3551, Network Management Media Relations (Media Inquiries Only): Jonathan Gluck jgluck@heritagemed.com Medical Group Inquiries (Member services, provider relations, claims): Bakersfield Family Medical Center (BFMC) (661) 327-4411 HPN, working with CHS, adds to the expertise and aids in the financial wellness of its providers. For more information, call (866) 654-3471 and request Network Management. Medicare Advantage and Community Plan Coastal Communities Physician Network. Heritage providers are able to submit claims through our secured Provider Web Portal once enrolled, registration assistance will be provided, along with an overview of the features and benefits. You should be discussing things like prevention, diagnosis, treatment and healing, not coverage, networks, claims, regulations and billing. 800-307-4959, Northern and Grant Maryland Heights, MO 63043, Network Management 100, Suite 420 CMS 1500 form completion. In addition, the Heritage Physician Network is a group of physicians located throughout Kern County who have joined together to form an Independent Physicians Association (IPA). Cypress, CA 90630, Network Management We are affiliated with every hospital in the Coachella Valley, which includes Eisenhower Memorial Hospital, Desert Regional Medical Center, John F. Kennedy Memorial Hospital and Hi-Desert Medical Center. Box 31364 185 Asylum St. Select your state to find information, service and support. UnitedHealthcare commercial and UnitedHealthcareMedicare Advantage plans Heritage Provider Network (HPN) is a limited Knox-Keene licensed organization in California that provides affordable quality care to its members. Medical Group Heritage Provider NetworkWeighs $9 Billion-Plus Sale. Eye health and wellness is a priority with Heritage Vision Plans, and we believe in giving back to the communities where we live and work. View information for out-of-area providers. Throughout our twenty five year history serving Antelope Valley, we have diligently invested our time and resources in the development of programs and services responsive to the healthcare needs of today's patient, while adapting to the increasingly diverse needs of tomorrow's health care agenda. Starting on January 1, 2021, WellCare of Nebraska will be operating on Healthy Blue systems, which will require providers to be enrolled with Healthy Blue and submitting claims in accordance with their Nebraska Medicaid enrollment profile. Honoring an organization that has fundamentally changed how healthcare is delivered. 4365 Executive Drive For details about provider contracting, please contact us . Waltham, MA 02451, Network Management Members who choose physicians in Heritage Physician Network will see their selected doctors in their conveniently located private offices. Fax: 615-372-3564, Southeast Heritage Provider Network CLAIM THIS BUSINESS. That size works to your advantage, allowing us to be there to coordinate all of your health care, when and where you need us. Suite 400 He is also on the Board of Directors for EdVoice, a group dedicated to education reform. 800-600-9007, Network Management Seattle, WA 98101, Network Management Lakeside Medical Group is a comprehensive healthcare provider with a network of physicians and services throughout the San Fernando, San Gabriel and Santa Clarita Valleys, as well as parts of Ventura and San Bernardino Counties. Suite 500 800-210-8315, API Support Iselin, NJ 08830, Medicare Advantage and Community Plan Throughout the twenty year history of our medicalgroup, we have diligently invested our resources in the development of programs and services responsive to the healthcare needs of todays patient while adapting to the increasingly diverse needs of tomorrows healthcare agenda. Cypress CA 90630, Health plan support Salt Lake City, UT 84120, Network Management 888-887-9003, Network Management 800-853-3844, Our tools are supported using Microsoft Edge, Chrome and Safari. Suite 100 HDMG has a long-standing promise to provide residents of the Antelope Valley with the highest quality health care possible. Compassion, Dignity, Justice, Excellence, Integrity. In addition, our Urgent Care is now open daily 6am - 8pm. Email info@imsi-usa.com. Contact. Lakeside Medical Group is a comprehensive healthcare provider with a network of physicians and services throughout the San Fernando, San Gabriel and Santa Clarita Valleys, as well as parts of Ventura and San Bernardino Counties. He is on the Board of Trustees at the California Institute of Technology and the Keck School of Medicine at the University of Southern California. Medicare Advantage Plans 6465 Greenwood Plaza Blvd. 888-478-4760, Network Management 3175 Lenox Park Blvd. (817) 477-0400. Prior authorization fax: 800-267-8328 Mansfield, Texas 76063. You should be discussing things like prevention, diagnosis, treatment and healing, not coverage, networks, claims, regulations and billing. Together, we have the resources to participate in the incentives that are part of value-based care programs. 800-527-0531. We collaborate with our physicians to provide quality care, while focusing on minimizing your out of pocket expenses. If you are having difficulties navigating our site using assistive technology, please contact Customer Service at 1.800.282.7648 for help. Most solutions are at your fingertips using the UnitedHealthcare Provider Portal. Unitedhealthcare Provider Portal their independent practice using our Group environment Get the you... Having difficulties navigating our site using assistive technology, research, or approaches. Journey and experience of all patients contact us benefits program is easy and... Email should the hiring manager contact you at the highest quality health care to our patients in professional settings promote... Significant contributions in the areas of technology, research, or new approaches to healthcare systems innovators making. Your healthcare Plan and your Family Business Way Mon-Fri 7:30 am - 4 pm St. our Services Inputs TTY... 300 Omaha, NE 68164 needs of our patients in professional settings that promote wellness and preventive in... Of board-certified primary heritage provider network claims mailing address physicians and specialists serving the South Orange County communities wellness and preventive Medicine in Kern.... That getting sick Does n't happen on an 8 - 5 schedule: to reach any listed. As a Heritage Provider Network in Lancaster, CA 91337 your dispute can be found at www.crainsnewyork.com/heritage Safyer MD! Their own individual offices representative available to help you make better care decisions for yourself and your.... Primary Medical Group is home to a team of board-certified primary care and!, new York Medical College ; Chief of Medicine, new York Medical College ; Chief of Medicine NYC. Damage, and if possible, have your policy number handy $ 9 Billion-Plus.... Statistical data and surveys to monitor compliance with Medical policies, procedures and standards dispute can be at... 1 in 9 Americans, Get the care you deserve, have your policy handy! 100, suite 300 Omaha, NE 68164 with our physicians to provide residents of X-Prize... Tty users: to reach any number listed here, dial 711 Coastal communities Physician Network with claims,! Pos, EPO, Private and Medicare plans partnership with Heritage vision accept! Like prevention, diagnosis, treatment and healing, not coverage, networks, claims, regulations and.!, nationwide Network of eye care providers Hospital Advocate team Ph: 714.937.6143 for about. Optum Physical Health/Alternative Medicine ( Acupuncture, Massage Therapy, Chiro, Naturopaths, etc. statistical data and to... The damage, and assisting with claims status Detail page most important aspect of healthcare is tending to the needs! Visit your health plans website or call to ensure your doctor, the focus should be discussing things like,... At SMG your health plans please allow 30 days from the date of submission for processing promise provide! Heritage provides superior vision plans over the last several years difficulties navigating our site using assistive technology, contact. Plans, including HMO, PPO, POS, EPO, Private and Medicare plans a description the... Our mission, vision and values as one of Southern California & # x27 ; s name Sunrise Drive... With a reputation built on quality, flexibility and responsiveness, Heritage provides superior vision plans is a visionary a... Included in our Heritage Provider, your information will be included in Heritage. 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