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Unified Health Plan (UHP) uses the Providrs Care Network. We have a direct contract with Providers Care so all our our providers in the Pinnacle Care are in network with this plan.
For all Providers Inquires call 1-800-259-8330 or email ProviderRelations@ProvidrsCare.net.
The PCN logo will display in the member card.
Electronic Claims Submission:
Payer ID# 48100
Paper Claims Mail to:
UHP
238 N. Waco
Wichita, Kansas 67208
GEHA (Government Employees Health Association, Inc.) is a not-for-profit provider of medical and dental plans for federal employees based in Lee’s Summit, Missouri.
They use the United HealthCare Options PPO network.
They have a new Provider Advocate Program. Contact Holly Hoette at 833-424-2477 ext. 4294
or email her at holli.hoette@GEHA.com.
Allwell is Centene Corporation's Medicare Advantage product in Kansas. Together, Allwell and Sunflower Health Plan exist to help members get the care they need to feel their best.
Ambetter from Sunflower Health Plan is Centene Corporation's Health Insurance Marketplace product. Ambetter exists to improve the health of its beneficiaries through focused, compassionate and coordinator care.
Please click here for provider information and a phone directory for SmartHealth.
Patients enrolled in Wow Health may access your services through Multiplan's ValuePoint network as we are an in-network provider for Value Point.
Wow members will have an ID card featuring the ValuePoint by Multiplan logo.
844-969-4325
www.mywowhealth.com
Cigna believes virtual care has the potential to help providers attract and retain patients, reduce access barriers, and contribute to their ability to provide the right care at the right time. Their policy ensures you can continue to receive ongoing reimbursement for virtual care provided to your patients with Cigna commercial medical coverage.
Billing and reimbursement requirements:
For services included in our Virtual Care Reimbursement Policy, a number of general requirements must be met for Cigna to consider reimbursement for a virtual care visit. When all requirements are met, covered services are currently reimbursed at 100% of face-to-face rates (i.e., parity).
Reimbursement requirements:
Services must be on the list of eligible codes contained within in our Virtual Care Reimbursement Policy.
Claims must be submitted on a CMS-1500 form or electronic equivalent.
Modifier 95, GT, or GQ must be appended to the virtual care code(s).
Claims should be billed POS 02.
Except for the noted phone-only codes, services must be interactive and use both audio and video internet-based technologies (i.e., synchronous communication).4
Store and forward communications (e.g., email or fax communications) are not reimbursable.
For a complete list of billing requirements, please review the Virtual Care Reimbursement Policy.
On December 29, 2022 the consolidated appropriations act of 2023 enacted a new one-time requirement whcih went into effect on 06/27/2023 for any Drug Enforcement Administration (DEA) registered practitioner to complete eight hours of training on the treatment and management of patients with opioid or other substance use disorders. If you have not met this specific eight hour training yet, the deadline to do so is the date of the practitioners next scheduled DEA registration submission.
AMA offers the activites to fulfill the eight hour requirement and one CME hour equals to one hour of required training.
Substance Use Disorders and Addiction Education to Meet New DEA Requirements | AMA Ed Hub (mcas.ms)
On Jan. 1, 2024, UHC will be providing plans and benefits for FedEx employees nationwide.* This means FedEx employees will have access to the following: • UnitedHealthcare products • Surest (Your Choice) plans • Level2 (Type II diabetes plan) • Optum behavioral health • Optum pharmacy solutions Remember, since you’re in network with UnitedHealthcare, you’re automatically in network with Surest and Level 2 plans.
Surest is a UnitedHealthcare company that administers a health plan without a deductible or coinsurance. Members have access to the nationwide UnitedHealthcare and Optum® Behavioral Health networks and can check costs and care options in advance. A small number of members have the Surest Flex plan, which includes the feature of flexible coverage. For a fixed list of plannable tests, procedures or treatments, the member must activate coverage at least 3 business days in advance of the service, or the member may not have coverage for the service. Visit the Surest Provider Guideopen_in_new to learn about flexible coverages.
Pinnacle Care Inc.
Girard Express Care and SEK Urgent Care both offers patients quick and professional care with convenient weekend hours when your primary care physician is not available. Located at 307 N. Hospital Drive Girard, Kansas 66743 and SEK Urgent Care Clinic is located at 302 E. Centennial Drive Pittsburg Kansas and open during the week and weekends.