2009 Medicaid Contacts

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2009 Medicaid Contacts Powered By Docstoc
					MEDICAID PLAN CONTACT GRID
Collaborative effort by the Harris County Medical Society and the participating Medicaid plans
                                                                                                                                                                      United
                                                          Amerigroup           Community              Evercare               Molina               Texas
Health Plan                         TMHP                                                                                                                            Healthcare-
                                                            Texas             Health Choice           of Texas              Healthcare           Children's
Program/Srvcs                                                                                                                                                         Texas

Info current as of :              10/22/2009               11/4/2009            10/20/2009           10/22/2009            10/20/2009           10/26/2009          10/23/2009

                                                                        www.community
                                                     www.amerigroup     healthchoice.org
                           www.TMHP.com or           corp.com/providers or 713.295.2294                                                       832-828-1004
Eligibility                AIS 800-925-9126          or 1.800.454.3730 or 888.760.2600 1.888.887.9003                   866.449.6849          Option #1          1.800.213.5846

                                                                        www.community
                                                     www.amerigroup     healthchoice.org
                                                     corp.com/providers or 713.295.2294                                                       832-828-1004
Benefits                   www.TMHP.com              or 1.800.454.3730 or 888.760.2600 1.888.887.9003                   866.449.6849          Option #5          1.800.213.5846


                                                                                                                                              Emdeon;
                                                                                                                                              RealMed;
                                                                                               Emdeon;                                        http://www.texa
                           www.TMHP.com;             Availity; Emdeon;       Availity; Emdeon; RealMed;        Availity; Emdeon;              schildrenshealt
                           Availity; Emdeon;         MedAvant;               SSI; RealMed;     www.unitedhealt SSI; Practice                  hplan.org/provi Availity; Emdeon;
Physician Portal           RealMed                   RealMed                 Relay             hcareonline.com Insight; Zirmed                ders/login.htm RealMed


                                                                             In-network           National or local
                                                                             facilities and       Labs go to
                                                                             contracted           http://evercarehe
                                                                             laboratories. See    althplans.com/ph                            In-network
                                                     National and local      Web site.            ysician_facility_di                         facilities and
                                                     vendors (see            National and         rectory.jsp;jsessi    http://www.molina     contracted         National or local
                                                     referral directory      local labs go to     onid=KILJFBIEP        healthcare.com/m      laboratories:      labs go to Web
                                                     on-line at              http://www.comm      KLA?State=TX&         edicaid/providers/t   see Web site       site
                                                     www.amerigroup          unityhealthchoice    LookupZip=7700        x/manual/pro_dir.h    www.texaschild     www.unitedhealth
                                                     corp.com or call        .org/en/providers/   4&FromPage=nu         tml or call UM at     renshealthplan.    care-texas.com or
Laboratory                 N/A                       1.800.454.3700)         net_prov_dir.htm     ll#A                  866-449-6849          org or directory   directory




                                                                                                                                                                          Page 1 of 4
                                                                                                                                           United
                                             Amerigroup         Community            Evercare           Molina          Texas
Health Plan                 TMHP                                                                                                         Healthcare-
                                               Texas           Health Choice         of Texas          Healthcare      Children's
Program/Srvcs                                                                                                                              Texas
                                         National and local
                                         vendors (see
                                         referral directory
                                         on-line at                                              Provider:
                                         www.amerigroup       Vendor Drug      Vendor Drug       800.435.4165       Vendor Drug
                                         corp.com or call     Program          Program           Member:            Program
Pharma               N/A                 1.800.454.3700)      800.435.4165     800.435.4165      800.252.8263       800.435.4165      1.800.435.4165

                                                                                                                                      Thu Hoa:
                                                                                                                                      713.418.6116
                                         Houston:                                                                                     Dana Parrish:
                                         713.218.5100         713.295.2295 PR                                                         713.418.6119
Provider                                 National Call Ctr:   reps assigned by                                                        Cynthia Trevizo:
Representative       www.TMHP.com        1.800.454.3730       territory         1.888.303.6162   866.449.6849       832-828-1008      713.418.6102
                                         Houston:             Mark Kline, VP of
                                         713.218.5100         Network                                               832-828-1008
                                         National Call Ctr:   Management 713-                                       or tool free 1-
Network Relations:   N/A                 1.800.454.3730       295-2394          1.888.303.6162   866.449.6849       800-731-8527      1.866.331.2243

                                                                                                                    832-828-1004
Injectables          N/A                                      N/A              N/A               N/A                Option #6         1.877.728.3927

                                                                                                                    www.texas
                                         www.amerigroup       www.community www.evercare       www.molina           childrenshealth www.unitedhealth
Web site             www.TMHP.com        corp.com             healthchoice.org healthplans.com healthcare.com       plan.com        care-texas.com

                                       Precert/Notification
                                       On-Line
                                       www.amerigroup
                                       corp.com/providers
                                       Phone:
Inpatient                              1.800.454.3730
Certifications                         Fax:                 713.295.2295 or                                         832-828-1004
& Notifications      PCCM-888-302-6167 1.800.964.3627       888.760.2600    1.800.349.0550       866.449.6849       Option #6         1.866.331.2243




                                                                                                                                                Page 2 of 4
                                                                                                                                       United
                                             Amerigroup        Community           Evercare          Molina           Texas
Health Plan                TMHP                                                                                                      Healthcare-
                                               Texas          Health Choice        of Texas         Healthcare       Children's
Program/Srvcs                                                                                                                          Texas
                                         Precert/Notification
                                         On-Line                                                                                  1.866.604.3267
                                         www.amerigroup                                                                           No separate
                                         corp.com/providers                                                                       paper referral is
                                         Phone:                                                                                   necessary when
                                         1.800.454.3730                                                                           referring to a
Referral                                 Fax:                 713.295.2295 or                                      832-828-1004   participating
Authorizations       N/A                 1.800.964.3627       888.760.2600    1.800.349.0550     866.449.6849      Option #6      specialist

Inpatient Clinical                                          713.295.2295 or                                        832-828-1004
Review issues        PCCM-888-302-6167 1.800.600.4441       888.760.2600    1.800.349.0550       866.449.6849      Option #6      1.866.331.2243

                                                            Telephonic and
                                       Helpline:            assigned by                          Advice Line:      832-828-1004
Nurse                PCCM-800-304-5468 1.800.600.4441       territory on-site   1.800.349.0550   888.275.8750      Option 6       713.418.6120

Precertification
Requests-                                                   713.295.2295 or                                        832-828-1004
Authorizations       PCCM-888-302-6167 1.800.454.3730       888.760.2600    1.800.349.0550       866.449.6849      Option #6      1.866.604.3267

                                         713.218.5100       713.295.2295 or
Case Management      PCCM 888-276-0702    Specify product   888.760.2600    1.800.349.0550       866.449.6849      832-828-1270   1.866.331.2243

Disease Mgmt &
Clinical Practice                                           713.295.2303 or www.evercare
Guidelines           N/A                 1.800.600.4441     888.760.2600    healthplans.com 866.449.6849           832-828-1270   1.866.331.2243

Transplant Care                                             713.295.2295 or                      Call UM at 866-
Coordinators         N/A                 1.800.600.4441     888.760.2600    1.800.349.0550       449-6849          832-828-1270   1.866.331.2243

                                                            see Web site
                                                            directory for
Imaging -                                                   locations; no
High Tech            PA thru             MedSolutions       authorizations                       Call UM at 866-   832-828-1004
CT MRI               www.TMHP.com        1.888.693.3211     needed              1.800.349.0550   449-6849          Option #6      1.866.331.2243




                                                                                                                                            Page 3 of 4
                                                                                                                                       United
                                              Amerigroup         Community            Evercare       Molina           Texas
Health Plan                  TMHP                                                                                                    Healthcare-
                                                Texas           Health Choice         of Texas      Healthcare       Children's
Program/Srvcs                                                                                                                          Texas
                                          National and local
                                          vendors (see
                                          referral directory   713.295.2295 or
DME                                       on-line at           888.760.2600;
Examples: Wheelchairs,                    www.amerigroup       authorization
crutches, walkers, hosp                   corp.com or call     needed for over                   Call UM at 866-   832-828-1004
beds, CPAP, nebulizers www.TMHP.com       1.800.454.3700)      $250.00         1.800.349.0550    449-6849          Option #6      1.866.331.2243

                                          National and local
                                          vendors (see
                                          referral directory
                                          on-line at
                                          www.amerigroup
                                          corp.com or call     713.295.2295 or                   Call UM at 866-   832-828-1004
Home Health            www.TMHP.com       1.800.454.3700)      888.760.2600    1.800.349.0550    449-6849          Option #6      1.866.331.2243

                                                               Vendor Drug
                                                               Program                           Call UM at 866-
Mail Order Drugs       N/A                                     800.435.4165     N/A              449-6849          N/A            1.800.435.4165

                                                           Joe Bedford MD
                                                           713.295.2359 or
                                                           Roosevelt       Glenda                                  Angelo
                       Ira Bell MD        Milton Thomas MD Alcorn MD       Coleman MD                              Giardino MD
Medical Director       512-506-7008       713.218.5100     713.295.2209    713.778.8687          866.449.6849      832.828.1216   713.418.6120

                                                          Joe Bedford MD
                                                          713.295.2295 or
                                                          Roosevelt                                                Angelo
Unresolved, Urgent                       Milton Thomas MD Alcorn MD                              Call UM at 866-   Giardino MD
Patient Care issues:   PCCM-888-276-0702 713.218.5100     713.295.2295    1.800.349.0550         449-6849          832.828.1216   1.866.331.2243




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