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