Our provider call center wait times continue to be longer than normal. We know this causes challenges for you and your patients, and we’re making changes so we can respond faster.
While we wait for these solutions to have full impact, we’d like to remind you that you might be able to find what you need in prism or our Provider Manual.
- Find member benefits quickly and easily in prism. Click on Member Inquiry and search by a member’s contract number or date of birth. You’ll find information about general eligibility, plan benefits, specialist visit coverage, physical therapy and other rehabilitation visit counts, and much more.
- Need to know if prior authorization is required? The Authorization Quick Reference List in our Provider Manual can help.
- Submit claim disputes in prism. Click on Claims and search by claim number or contract number with date of service. Select “Contact us about this claim.” Select from the two options: Question About My Claim or Appeals. For detailed instructions, visit our Provider Manual. This process will generate an inquiry number you may follow in prism under Appeals or General Requests. You also may obtain full claim status in prism and may request a copy of EOBs under General Requests. The provider call center will follow the same process already available to you in prism.
We’ll keep you updated in our provider news about our improvement efforts. Thank you for your partnership.