Healthy Living Made Easy

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 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.

Send claims to the TPA/Luminare, not to Aetna®.

Aetna Signature Administrators’ payer partner recently changed its name from Trustmark Health Benefits to Luminare Health. To verify eligibility for patients whose card shows the Luminare Health logo, please visit the Luminare provider portal or call the Luminare customer service number, located on the back of the member’s ID card.

The First Health PPO product is still an active product with Aetna and part of our Aetna contract.  It was only the Workers Compensation product that is no longer affiliated with Aetna  and we still have under our Coventry contract.  

Please send all SmartHealth claims after DOS 08/01/2024 directly to BCBSKS and they will process using the SmartHealth Benefits.  Any issues please contact Pinnacle Care.