wellmed claims mailing address
Email: WebsiteContactUs@wellmed.net EDI 278N: Hospital Admission Notification. 73 0 obj 0000009876 00000 n Please contact our Patient Advocate team today. EDI Clearinghouse Options. The question arises How can I eSign the wellmed provider appeal form I received right from my Gmail without any third-party platforms? 49 0 obj Paper Submission to United Healthcare In case of claims paper submission to United Healthcare, you will need UHC claims mailing address. Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. Start automating your signature workflows today. View claims status Easily find the app in the Play Market and install it for eSigning your wellmed provider appeal form. xref The sigNow extension was developed to help busy people like you to minimize the burden of signing legal forms. hbbd``b`$ @$f"@+`J@E$AzU,8qb``$@ j2 Need Help Logging in? Interested in learning more about WellMed? Open the doc and select the page that needs to be signed. View and submit authorizations and referrals For instance, browser extensions make it possible to keep all the tools you need a click away. Box 400066 ; San Antonio, TX 78229 . Call: 1-888-781-WELL (9355) Explains rules and state, line of business and CMS-specific regulations regarding 837P EDI transactions. Please do not call the Customer Service number listed throughout this website. To continue your current session, click "Stay on this page" below. Find Plans In Your Area. Get help making the right decision when shopping for coverage. We are happy to help. Find Caregiver Resources (Opens in new window). at eprg.wellmed.net Call 800-550-7691 Submitting claim reconsiderations to WellMed For these plans, submit claim reconsideration requests to the same claims address. Utilize Risk Adjustment Processing System (RAPS) tools Representatives are available Monday through Friday, 8:00am to 5:00pm CST. Claims: 61101 Encounters: 61102 Advanced claims editing All EDI submissions to Humana pass through Availity. P.O. [[state-end]], Your session is about to expire. Wellcare wants to ensure that claims are handled as efficiently as possible. EDI Connectivity. EDI 270/271: Eligibility and Benefit Inquiry and Response. endobj hb```, cb Call: 1-888-781-WELL (9355) Copyright 2013 WellMed. eProvider Resource Gateway "ePRG", where patient management tools are a click away. Appeals or disputes. hWOFo~yq:EJr@@zWal{lx8 *^ZaLX$S1)2IILtFaqJXIQZ#3pJL}/M1ywjzi5ueO[']-]VkCFT``?H,tfQ5 Look through the document several times and make sure that all fields are completed with the correct information. 2023 United HealthCare Services, Inc. All rights reserved. Get access to a GDPR and HIPAA compliant platform for maximum simplicity. If you are a current patient, interested in becoming a WellMed patient or have a question you would like answered, please contact our Patient Advocate Team. Providers can help facilitate timely claim payment by having an understanding of our processes and requirements. All you have to do is download it or send it via email. Untitled - provider name, address and telephone number Name, address and phone number of the billing facility or service supplier 2 Untitled - pay-to-name, address INQUIRY FORM Explains rules and state, line of business and CMS-specific regulations regarding 837I EDI transactions. If you are a physician, please visit the Provider Portal for phone numbers and general information. To call or email the HSConnect Help Desk: 1-866-952-7596| HSConnecthelp@hsconnectonline.com To register for HSConnect visit: https://bravohealth . C-HS MARKETS . hb```f``Z ,@QY \B `N78c``0` )~rQb@,g:"#If s75T``;5Cr `1000p(9 d`4hb! Mail: Claims Department Amerigroup Iowa, Inc. 4800 Westown Parkway, Suite 200 West Des Moines, IA 50266 Fax: 1-844-400-3463 . Claims and reimbursement for Dual Special Needs Plans (DSNPs): UnitedHealthcare Dual Complete Choice Premier (H2228-041), UnitedHealthcare Dual Complete (H4514-013) and AARP Medicare Plans from UnitedHealthcare, UnitedHealthcare Insurance Company or an affiliate (UnitedHealthcare), [[state-start:AL,AS,AK,AZ,AR,CA,CO,CT,DE,FL,GA,GU,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,NE,MP,NV,NH,NJ,NM,NY,NC,ND,OH,OK,PA,PR,RI,SC,SD,TN,TX,UT,VT,VI,VA,WA,DC,WV,WI,WY,null]]. Speed up your businesss document workflow by creating the professional online forms and legally-binding electronic signatures. Box 400066 ; San Antonio, TX 78229 . Follow our step-by-step guide on how to do paperwork without the paper. There are three variants; a typed, drawn or uploaded signature. 0000001429 00000 n Despite iPhones being very popular among mobile users, the market share of Android gadgets is much bigger. Please contact our Patient Advocate team today. hbbd``b`s ] LR Re"AA b8"WM@B d?`t2H4$3012 20,3 Due to the fact that many businesses have already gone paperless, the majority of are sent through email. startxref Optimum Healthcare (WellMed clinic locations only) Original Medicare UnitedHealthcare WellCare Email: Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. Please contact our Patient Advocate team today. Texas . Representatives are available Monday through Friday, 8:00am to 5:00pm CST. We help supply the tools to make a difference. Representatives are available Monday through Friday, 8:00 am to 5:00 pm CST. <<1283B0ACEBB5B2110A00B0933B5DFE7F>]/Prev 373885>> 0000005057 00000 n With signNow, you can eSign as many files daily as you need at an affordable price. Before submitting an EDI file using Payer ID UHNDC, you must successfully complete specific EDI testing. startxref endobj WellMed Medical Group (part of UnitedHealth Group) is a physician-owned healthcare network of doctors, specialists, and professionals based in Texas that focuses on health care for Medicare-eligible patients. Get access to thousands of forms. Go to the Member Site to Sign In or Register for an account. 0000030168 00000 n <> We are happy to help. https://www.wellmedhealthcare.com/about-us/careers/, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. 0000003775 00000 n Some doctors offices may accept other health insurance plans. Some insurance plans offer a level of coverage that could result in out-of-pocket costs. 0 Medicare Information Center brought to you by WellMed Located inside Cross Roads Seniors Center 1301 E. Fern Ave. Suite C1 McAllen, Texas 78501 Interested in learning more about WellMed? 2023 airSlate Inc. All rights reserved. CUSTOMER SERVICE & GENERAL INQUIRIES . Download your copy, save it to the cloud, print it, or share it right from the editor. Learn more about how Medicare works, Access EDI Provider disputes You have the right to request an appeal of a claim decision. %%EOF Select the area where you want to insert your eSignature and then draw it in the popup window. 0000033577 00000 n Submission through UHC provider portal The whole procedure can last a few moments. All rights reserved. Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. Welcome to the newly redesigned WellMed Provider Portal, The signNow extension provides you with a selection of features (merging PDFs, including several signers, etc.) Plans vary by doctors office, service area and county. Call the number on the back of your member ID card. To find it, go to the AppStore and type signNow in the search field. Phone: Call toll-free: 1-800-721-0627. 0 EDI Quick Tips for Claims. 0000006009 00000 n Decide on what kind of eSignature to create. Copyright 2023 Wellcare Health Plans, Inc. Clinical Laboratory Improvement Amendments (CLIA), Health Outcomes Survey (HOS) for Medicare Members, Behavioral Health Toolkit for All Providers, Including Primary Care Physicians. 2023 WellMed Medical Management Inc. . . 0000010612 00000 n Refer to NDC Claim Submission or call UnitedHealthcare EDI Support at 800-842-1109 for more information. Other Veterans Affairs / Community Care Network (CCN) Call: 1-888-781-WELL (9355) Email: WebsiteContactUs@wellmed.net Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. Create your eSignature, and apply it to the page. P.O. WellMed Claims . We are happy to help. We are happy to help. signNow makes eSigning easier and more convenient since it offers users numerous additional features like Invite to Sign, Merge Documents, Add Fields, and many others. 1-800-964-3627 Email us mpsweb@amerigroupcorp.com Contact your local Amerigroup health plan and Provider Relations representatives Bexar service area: 1-800-589-5274 Dallas and Tarrant service areas: Central, Northeast and West rural service areas: 1-800-839-6275 El Paso service area: 1-877-405-9871 Harris and Jefferson service areas: View claims status Submit referrals to Disease Management Utilize Risk Adjustment Processing System (RAPS) tools Link to health plan formularies. With the collaboration between signNow and Chrome, easily find its extension in the Web Store and use it to eSign wellmed provider appeal form right in your browser. %PDF-1.7 % Get information to understand your Medicare plan options. 2023 WellMed Medical Management Inc. All Rights Reserved. 0000026981 00000 n Paper Submission: Professional vendors must submit on a CMS 1500 Ambulatory surgery centers with appropriate modifier SG or TC Hospital and Facility vendors must submit on a CMS 1450 Paper Claim Submission Address: Optum Medical Network Claims PO Box 46770 Las Vegas, NV 89114 In the News! The answer is simple - use the signNow Chrome extension. <>stream C-HS MARKETS . The way to make an electronic signature for a PDF online, The way to make an electronic signature for a PDF in Google Chrome, The best way to create an e-signature for signing PDFs in Gmail, How to generate an electronic signature from your smartphone, The way to generate an e-signature for a PDF on iOS, How to generate an electronic signature for a PDF file on Android, If you believe that this page should be taken down, please follow our DMCA take down process, You have been successfully registeredinsignNow. Become a Patient Name * help you select the plan that may best meet your needs. Call: 1-888-781-WELL (9355) Email: WebsiteContactUs@wellmed.net. Get plan information, forms and documents you may need now or in the future. There are three variants; a typed, drawn or uploaded signature. Please contact our Patient Advocate team today. 73 0 obj endstream Need Help Registering? Create an account using your email or sign in via Google or Facebook. EDI 276/277: Claim Status Inquiry and Response. Providers can help facilitate timely claim payment by having an understanding of our processes and requirements. Interested in learning more about WellMed? For more information, call 1-800-341-6141. Wellcare uses cookies. Select the document you want to sign and click. 0000001302 00000 n UT. signNow combines ease of use, affordability and security in one online tool, all without forcing extra software on you. 0000033204 00000 n endstream endobj 2024 0 obj <>/Metadata 129 0 R/OCProperties<>/OCGs[2040 0 R 2041 0 R]>>/Outlines 158 0 R/PageLayout/SinglePage/Pages 2013 0 R/StructTreeRoot 247 0 R/Type/Catalog>> endobj 2025 0 obj <>/ExtGState<>/Font<>/Properties<>/XObject<>>>/Rotate 0/StructParents 0/Type/Page>> endobj 2026 0 obj <>stream Call UnitedHealthcare at: Printing and scanning is no longer the best way to manage documents. 1et?5AiJcEp"@(84=E,/m Texas . 101 0 obj Please contact our Patient Advocate team today. This plan has been saved to your profile. members address using the eligibility search function on the website listed on the members health care ID card. Reimbursement Policies If you have questions, please contact your physician advocate, provider relations . Contact your clearinghouse to begin the testing process. Therefore, signNow offers a separate application for mobiles working on Android. 9 a.m. - 5 p.m. Once youve finished putting your signature on your wellmed appeal timely filing limit, decide what you wish to do after that - download it or share the doc with other parties involved. TTY users, call: 711. EDI Companion Guides. A process known as advanced claims editing (ACE) applies coding rules to a medical claim submitted through the Availity gateway via EDI before the claim enters Humana's claim payment system. 0000021758 00000 n You may verify the Use a wellmed appeal form template to make your document workflow more streamlined. AARP Medicare Supplement Insurance Plans, insured by UnitedHealthcare Insurance Company, or UnitedHealthcare Insurance Company of America, or United Healthcare Insurance Company of New York. Call: 1-888-781-WELL (9355) Need to upload a document? Verify patient eligibility, effective date of coverage and benefits 2039 0 obj <>/Filter/FlateDecode/ID[<72CC28110A53BB45B3AE504C9EE1C7C9><54651E69B47C3340BBB01C9C2DD21162>]/Index[2023 31]/Info 2022 0 R/Length 84/Prev 578691/Root 2024 0 R/Size 2054/Type/XRef/W[1 2 1]>>stream Need help finding the right plan? That goes for agreements and contracts, tax forms and almost any other document that requires a signature. Representatives are available Monday through Friday, 8:00am to 5:00pm CST. 0000004909 00000 n Amerigroup's Medicare Advantage HMO plans help you save money with no or low plan premiums. If you have Original Medicare or Medicare Advantage, or are about to turn 65,find a doctorand make an appointment. All you need is smooth internet connection and a device to work on. OptumInsight Connectivity Solutions, UnitedHealthcare's managed gateway, is also available to help you begin submitting and receiving electronic transactions. You will receive a decision in writing within 60 calendar days from the date we receive your appeal. We know how stressing filling out forms could be. 2023 WellMed Medical Management Inc. All Rights Reserved. Representatives are available Monday through Friday, 8:00am to 5:00pm CST. Representatives are available Monday through Friday, 8:00am to 5:00pm CST. ~QW& E7h c>;A 0xwL@!K\]-2 Sign in to myuhc.com. 0000013213 00000 n Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. Talk to a licensed agent: 855-216-6615 (TTY: 711) Mon-Fri, 8 a.m. to 8 p.m. Follow the step-by-step instructions below to eSign your wellmed appeal mailing address pdf: Select the document you want to sign and click Upload. Representatives are available Monday through Friday, 8:00am to 5:00pm CST. 84130-0602. If you are interested in learning more about Welmed and our Disposable Product Suite, please complete the Inquiry Form below and your information will be forwarded to the appropriate resource for a timely response. ATTENTION: We no longer support Internet Explorer (IE) or certain versions of other browsers. IPA / Independent Entity (if applicable) Claims Mailing Address . You make a difference in your patient's healthcare. 50 0 obj Salt Lake City. EDI provides a faster and cleaner method for delivering time-dependent data, saving you time compared to filing paper claims. Please contact your insurance provider prior to your WellMed appointment to review your insurance coverage. Medicare Advantage HMO Plans with Amerigroup. 41 33 The field "Medical Claims" will provide you with the correct claims address to mail in the claim. Claims Options: TrackIt Quick Start Guide open_in_new TrackIt serves as your daily to-do list. If you own an iOS device like an iPhone or iPad, easily create electronic signatures for signing a wellmed provider appeal form in PDF format. Call UnitedHealthcare at: 0000013868 00000 n 2023 WellMed Medical Management Inc. All Rights Reserved. 0000012637 00000 n coverage options and when to enroll. Let's upgrade your browser to make sure you all functionality works as intended. Call: 888-781-WELL (9355) appeals process for formal appeals or disputes. 2053 0 obj <>stream home page in. tXuy($ C$J %PDF-1.5 % Search for the document you need to eSign on your device and upload it. If you would like to speak with someone about any of our practice options, please share your info at this link: Contact Request(Opens in new window). Let UnitedHealthcare, Make an appointment with a licensed insurance agent/producer in your area, [[state-start:null,AL,AS,AK,AZ,AR,CA,CO,CT,DE,FL,GA,GU,HI,ID,IL,IN,IA,KS,KY,LA,ME,MD,MA,MI,MN,MS,MO,MT,MP,NE,NV,NH,NJ,NM,NC,ND,OH,OK,OR,PA,PR,RI,SC,SD,TN,TX,UT,VT,VI,WA,VA,DC,WV,WI,WY]]. endobj Electronic data interchange (EDI) is the computer-to-computer exchange of business documents in a structured format. Get the most up-to-date claims status and payment information, and the ability to submit your claim reconsideration requests all in one easy-to-use tool without mailing or faxing. PQaE0Cbi{73,) 3@cI^f2h6h8AqW3Xop!#~ pKKKsIqRAjeiR;wn~F^m.A/"`\s0!!!H0.` Sp-P) X`1g; i> e c&wLf20210f\pO'z@Uw1F+4#g H10TfNUo*FE N 0000007018 00000 n Begin eSigning wellmed appeal timely filing limit with our tool and join the numerous satisfied clients whove already experienced the benefits of in-mail signing. endstream endobj startxref If you wish to share the wellmed appeal timely filing limit with other people, you can easily send it by electronic mail. 0000003369 00000 n UT. Methods to Submit Claims to UHC 1. 0 IPA / Independent Entity (if applicable) Claims Mailing Address . Please contact our Patient Advocate team today. Call: 1-888-781-WELL (9355) Email: WebsiteContactUs@wellmed.net Online: By completing the form to the right and submitting, you consent WellMed to contact you to provide the requested information. 9 a.m. 5 p.m. PO Box 30607 Salt Lake City, UT 84130-0607 Enrollment forms: Use the address provided on the paper application you received in the mail. Box 400066 San Antonio, TX 78229 Who do I contact for more information? You will automatically go back to the Use its powerful functionality with a simple-to-use intuitive interface to fill out Wellmed appeal address online, e-sign them, and quickly share them without jumping tabs. Now you can quickly and effectively: %%EOF Contact. PROVIDERS ONLY If you are a Provider and require assistance, you may contact UnitedHealthcare plans by following the link below to the UHC Provider website. for a better signing experience. <> Claims Claims Wellcare wants to ensure that claims are handled as efficiently as possible. 0000000956 00000 n Representatives are available Monday through Friday, 8:00am to 5:00pm CST. Error:Please enter a valid email address. 7 a.m. 11 p.m. Go digital and save time with signNow, the best solution for electronic signatures. The links below lead to authorization and referral information, electronic claims submission, claims edits, educational presentations and more. Select the area you want to sign and click. After its signed its up to you on how to export your wellmed appeal timely filing limit: download it to your mobile device, upload it to the cloud or send it to another party via email. Please refer to your provider manual for additional details including where to send Claim Reconsideration request. 2023 0 obj <> endobj Already a member? Are you looking for a one-size-fits-all solution to eSign wellmed provider appeal form? You can submit a claim reconsideration request and we'll review the claim decision. Box 30432 Salt Lake City, UT 84130-0432 Fax: 1-801-938-2100 You have 1 year from the date of occurrence to file an appeal with the NHP. 3. if(typeof loadStateSpecificContent == 'function') loadStateSpecificContent('_krf1rtqt'); %%EOF Add the PDF you want to work with using your camera or cloud storage by clicking on the. 7 a.m. - 11 p.m. After that, your wellmed appeal timely filing limit is ready. 0000000016 00000 n CLAIM.MD | Payer Information | WellMed Payer Information WellMed Payer ID: WELM2 This insurance is also known as: WMMI Wellcare WellMed Medical Management, Inc. WELLMED NETWORKS, INC. UHC Medicare Advantage Other ID's: TH023 Need to submit transactions to this insurance carrier? Or sign into your member account to get information about your plan(s). Email: WebsiteContactUs@wellmed.net Applies only to 837P claims. Please submit EAP claims to the Behavioral Health claims submission address on the consumer ID card. 0000004384 00000 n 2. Find the extension in the Web Store and push, Click on the link to the document you want to eSign and select. Welcome to the newly redesigned WellMed Provider Portal, eProvider Resource Gateway "ePRG", where patient management tools are a click away. A plan has been removed from your profile. 0000002296 00000 n Click, Direct deposit enrollment veterans benefits administration form, 29 0309 direct deposit enrollmentchange form, Certifying body for your health occupation 1998 form, Va application for familly memberpdffillercom 2011 form, Provide only diagnoses that pertain to ms vba va form, Sign Kentucky Application for University Free, Sign Kentucky Application for University Secure, Sign Kentucky Application for University Fast, Sign Kentucky Application for University Simple, Sign Kentucky Application for University Easy, Sign Kentucky Application for University Safe, How To Sign Kentucky Application for University, How Do I Sign Kentucky Application for University, Help Me With Sign Kentucky Application for University, How To Sign Alaska Nanny Contract Template, How Can I Sign Kentucky Application for University, Can I Sign Kentucky Application for University, How Do I Sign Alaska Nanny Contract Template, Help Me With Sign Alaska Nanny Contract Template, Sign Arizona Nanny Contract Template Online. Use the following address to send UnitedHealthcare correspondence through the mail if you have a Medicare Supplement Insuranceplan. Ventura County Health Care Plan. Claims and payments. UnitedHealthcare Customer Service advocates are available to assist you with password resets, enhancement requests and technical issues with the website. Electronic Submission to United Healthcare In case of electronic submission, you will need UHC payer ID i.e. MyHealthLightNow Texting Terms and Conditions, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. If you are a Provider and require assistance, you may contact UnitedHealthcare plans by following the link below to the UHC Provider website. 41 0 obj Use professional pre-built templates to fill in and sign documents online faster. Shop Plans. And because of its cross-platform nature, signNow can be used on any device, desktop or mobile, regardless of the operating system. If you would like to learn more about Clinical Rotation opportunities please visit us at the following link: https://www.wellmedhealthcare.com/about-us/careers/(Opens in new window). hb```b``f`e`Qdf@ a+>Oss=(J4 kUpSY\_jAl.qnY4jQH@::@A!0mllM\\. See more here. endobj Contact Us; Contact Us. Technical issues? WellMed Claims . If you are interested in a career or externship with WellMed, visit the Careers page for more information. By continuing to use our site, you agree to our Privacy Policy and Terms of Use. Learn about the Medicare Advantage plans, Medicare Supplement Insurance plans. Email: WebsiteContactUs@wellmed.net MyHealthLightNow Texting Terms and Conditions, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin. 0000005482 00000 n Because of its cross-platform nature, signNow is compatible with any device and any operating system. 0000012074 00000 n jC%k9nh_Vnu_]{I>~p|>70-]= 9Ww~tf m\kY*u&lc ?LDe0S`A3-6OGcf7$kw(}q8&u/L+ m^]U&"GgM1 &<=(j^TY(rFd&{{)Y5RO8|r vs$qr @&mp^j?{v_aHUBi)zz=zw+7elI5O=.e1/J?,+xtDrNM6)fVyQ. Find Caregiver Resources (Opens in new window). endobj Go to Member Site to Sign In or Register for an account, Plan through your employer? 84130-0755. Call: 888-781-WELL (9355) Email: WebsiteContactUs@wellmed.net Enrollment forms: Use the address provided on the paper application you received in the mail. Get information to understand your Medicare plan options. Contact the WellMed HelpDesk at 877-435-7576. Humana's priority during the coronavirus disease 2019 (COVID-19) outbreak is to support the safety and well-being of the patients and communities we serve. Google Chromes browser has gained its worldwide popularity due to its number of useful features, extensions and integrations. 30755. Submit referrals to Disease Management Please contact our Patient Advocate team today. Let UnitedHealthcare <>/Filter/FlateDecode/ID[<75DAB2220A8A4147B184C4DB1F685C63>]/Index[49 53]/Info 48 0 R/Length 109/Prev 370043/Root 50 0 R/Size 102/Type/XRef/W[1 2 1]>>stream Customer ID Card (Back) . 0000008118 00000 n Ready to enroll? Use the following address to send UnitedHealthcare correspondence or enrollment forms through the mail if you have a Medicare Advantage, Medicare prescription drug or Medicare Special Needsplan. 87726. Connect with UnitedHealthcare by calling the number on your member ID card, 8 a.m.8 p.m., 7 days a week. The field "Medical Claims" will provide you with the correct claims address to mail in the claim. Start completing the fillable fields and carefully type in required information. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our 3rd party partners) and for other business use. Get connected to a strong web connection and start executing forms with a legally-binding eSignature in minutes. Link to health plan formularies. From time to time, Wellcare Health Plans reviews its reimbursement policies to maintain close alignment with industry standards and coding updates released by health care industry sources like the Centers for Medicare and Medicaid Services (CMS), and nationally recognized health and medical societies. EDI 278I: Prior Authorization and Notification Inquiry. <. Providers are routed by their TaxID. signNow has paid close attention to iOS users and developed an application just for them. 0000011608 00000 n 0000007129 00000 n ET. 0000017231 00000 n MyHealthLightNow Texting Terms and Conditions, Language Assistance / Non-Discrimination Notice, Asistencia de Idiomas / Aviso de no Discriminacin, UnitedHealthcare Employee Retirement System Group PPO, UnitedHealthcare Teacher Retirement System Group PPO, Humana (Select WellMed clinic locations only), Optimum Healthcare (WellMed clinic locations only). Customer ID Card (Back) . Use our eSignature tool and leave behind the old days with security, efficiency and affordability. Draw your signature or initials, place it in the corresponding field and save the changes. ET, Monday - Friday Optum EAP. Doctors helping patients live longer for more than 25 years. 0000014583 00000 n Relay Health (Professional claims CPID: 2795 or 3839 Institutional claims CPID: 1556 or 1978) MailPaperClaimsto: Cig na-Hea lthSpring PO Box 981706 El Paso, TX 79998
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