15. Click Menu on top left, select Administrative Guides and Manuals, then Community Plan Care Provider Manuals, select state. Call us if you have questions about which provider manual you should use. you go to the doctors, hospital or any other health care provider. This manual applies to all EmblemHealth plans and is an extension of your Provider Agreement. The Gateway Dental Reference Guide is designed to provide you and your office staff with information about United Concordia’s policies and procedures used to administer dental benefits for Gateway Health Plan ® Advantage information in their Community Plan manual. United Concordia and Gateway realize that the success of our partnership is dependent upon communication and educational processes. General Prior Authorization Requirements 2. You will also get an ACCESS or EBT card. The purpose of this manual is to guide Gateway Health participating providers who wish to electronically submit authorization request forms. Environmental Lead Testing19. Covered services will be available to you while you wait to receive your new card. The purpose of this manual is to provide Gateway Health participating providers with a guide to the Secure Messaging application within Gateway Health’s Provider Portal. Pre-requisite This functionality is available for Gateway Health Participating providers with access to NaviNet. TTY users call 711 or 1-800-654-5984. Your plan should be as specific as possible by answering all of the following questions. 16. 13.As of March 2016, Gateway’s plan for CHC is to use a “blended model” for SC. 14. They intend on delegating SC requirements by state and enforcing quality standards from Gateway. Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan (MMP) Provider Manual (PDF) How To. 17. 12.Gateway Health has expressed interest in using AAA learning and development centers for training staff for Community HealthChoices (CHC.) 4) Specific Plan Next decide specifically what you are going to do differently everyday to achieve your goal. B. Accordingly, Gateway Health has facilitated a variety of health benefit plan strategies to achieve employers’ goals in terms of cost, access to providers, employees’ preferences and administrative requirements. Easily find information in this manual using Health Details: the participation status of a provider with the applicable payor, plan or Gateway before referring a patient.Primary Care Physicians . Time Frames for Notice of Decisions ... 801 Gateway Blvd., Suite 100 South San Francisco, CA 94080. It includes detailed information about your administrative responsibilities, and contractual and regulatory obligations. 13. Prior Authorizat 1. Provider Manual - Gateway Health. How? Go to the Provider Manual web page to view individual topics. As an example, let’s use these questions to take a look at how we could plan a small step towards losing weight: a. Providers will be able to access the upgraded application beginning 08/01/2016. The manuals include all-provider and provider-specific pages. • physicians, health care professionals, facilities and A different Community Plan manual: go to UHCprovider.com. It also details best practices for interacting with our plans and helping our members navigate their health care. Each Gateway Health Client Employer has different goals and needs. If your Gateway Health member card is lost or stolen, call Member Services at 1-800-392-1147. Behavioral Health Outpatient Services: Prior Authorization Requirements (PDF) Check the Status of an Authorization Online (PDF) Filtering Authorizations on the Secure Provider Portal (PDF) How to Use the Pre-Authorization Tool (PDF) Primary Care Physicians (PCPs) are those physicians who accept the responsibility of providing and/or coordinating the health care needs of any Gateway member who chooses that physician. 18. Pre-requisite This functionality is available for Gateway Health Participating providers with access to NaviNet. Download the Comprehensive Provider Manual. Call member Services at 1-800-392-1147 before referring a patient.Primary Care Physicians new card access to NaviNet referring gateway health plan provider manual Care! Regulatory obligations extension of your Provider Agreement, CA 94080 receive your card. How to HealthChoices ( CHC. Notice of Decisions Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan ( MMP ) manual... 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