Print or download data in whichever format you prefer (835, CSV, XLS, or PDF). Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you. About. Phone Number *. (888) 525-1730 Email Provider Services For general inquiries & questions, contact us via email Providerservices@sonderhealthplans.com Fax Provider Services Provider Services's fax center is open from 8 am to 7 pm. Answer 4. Take a look around to learn more. Password. For details on the claims filing process and your responsibilities, please refer to our Sonder Health Plans Provider Manual, section, Sonder Health Plans, Inc. Answer 5. Division Director, Member and Provider Services. I'm a Broker. Need help registering for the PeakTPA Provider Portal, tips for navigating the site, or need to reset your password? For those services that do require prior authorization, such as elective inpatient procedures, please see our Prior Authorization Request Form for completion and submission per instructions on the form. Simply enter the virtual card number into your card terminal and youre done. PeakTPA submits risk adjustment data to CMS based on claims and encounters received, follow-up and correction of errors, and submission of return files to PDAC. We submit coordination of benefits data to the Electronic Correspondence Referral System and assist with the annual MSP Survey. Discover what works best for your business: Choose how your data & payments are delivered. You can manage all your payment information in our easy-to-use provider portal. Popular Questions. Other website users will need to contact Allied directly at 800-288-2078 for forgotten account numbers. PeakTPA is a service of CareVention HealthCare. a) HCFA-1500 (standard form used by Providers) b) UB-04 or UB-92 (standard form used by Hospitals) 8. . Faxing this PCP Referral Form indicates to SHP that the Specialist has conducted the required follow-up with the PCP and that the PCP has reviewed the required information and has agreed with the Specialists proposed plan of care. At Peak One Administration, our mission is to deliver user-friendly employee benefits administration solutions and the highest levels of productivity-enhancing features while out-performing in customer service and attention. With 330 payers instead of just one, we have an ever-growing network to help you get your money fast. Question 4. Customer Service; Flexible Spending Account; Forms & Resource Center; Employers; Producers; Providers; . Zip Code *. Weve partnered with Mastercard to provide secure, card-based payments. Secure Download includes a CSV file with virtual card numbers and EOP PDFs. We use cookies to provide the most relevant user experience to our website visitors, including reliable website functionality and access to the most relevant products and services, as well as for content including social media features and web traffic analysis. For claims submissions*: EDI Payer ID: 27034. (413) 241-6321 IMPORTANT NUMBERS/ADDRESSES: Authorization Phone Number: Authorization Fax Number: Eligibility TTY Claims Inquiry Serenity Care PACE Center: Claim Address: Peak PACE Solutions PO Box 30760 Tampa, FL 33630 Fax: (314) 961-3456 EDI Payer ID 27034 (413) 241-6321 (413) 747-3979 (413) 241-6321 (413) 734-5440 (413) 241-8967 (413) 241-6321 Providers may use the following link to access the AHRQ CPGs: Filing a claim shouldnt be stressful. Sales Support. 233(g)-(n). With ACH, you get paid weeks faster than by mailed check. A TPA for employee health benefits is "a person or organization that performs administrative services, such as claims processing, adjudication or record-keeping, typically on behalf of an employer that self-insured health benefits," according to an article recently published by Zane Benefits. Our expertise in health plan management, particularly in PACE, means you can focus on delivering high-quality care to your participants. Question 1. Every member of Sonder is unique and therefore needs care tailored to them. Use the following button below to access the Medicare interactive chart for detailed information on coverage and coding requirements. Please make sure to confirm Member eligibility and to submit your claims/encounter data into SHP as required to comply with prevailing Medicare and documentation standards. About Author Lawerence Harrell Editor in Chief PCPs may use any referral documentation type, such as their own internal referral forms, or script for initial referrals to a Specialty Provider; however, if PCP is referring to a Specialist for services that are NOT listed under our Service Specific Referral Not Required List, a PCP Referral Form must be completed and faxed to 1(888) 217-4320 to notify SHP of the referral. Our extensive expertise in TPA means your organization can focus on providing care, instead of the technicalities of a health plan. Streamline Your Complete Healthcare Data Workflow. All of our services are now on one site! Fax 719.365.5004 Contact PACE Organization of Rhode Island by filling the form and we will get back to you as soon as possible. For a downloadable version instead of the interactive webpage, click here. PeakTPA provides complete claims adjudication, processing and payment for your PACE program. Monday to Friday, October 1st March 31st PeakTPA posts Medicare and Medicaid Revenue and payments by participant and payer for distribution of the monthly Accounts Receivable Aging Report. Heres how the Sonder Team and our network of providers are working to support our members and continue to keep them save during these trying times. Forget about wasted time from fixing errors. Affiliated with: Teaching hospital of: Box 30760 Tampa, FL 33630-3760 For claims status, please call: 866-386-4447 Electronic claims payer ID: 27034 We Want to Hear from You! English. Peak TPA. For Sparrow Health System inquiries, please . Enter a valid 10-digit number. Box 30760 Tampa, FL 33630-3760. Responsible for operational oversight and management of numerous . Employee Search Employee ID: Last Name: Employee Only Employee & Dependents Jan 2011 - Mar 20165 years 3 months. Our extensive expertise in TPA means your organization can focus on providing care, instead of the technicalities of a health plan. We encourage feedback from all our stake-holders. Clean data and expedited payments means spending less time on the phone with payers and more on patient care. Copyright 2022 - Sonder Health Plans, Inc. |, Service Specific Referral Not Required List. Only numbers are allowed. Our extensive experience with TPA allows organizations to focus on providing care instead of the technicalities of a health plan. you may have. Peak performs back-office functions for PACE organizations, including acting as a Third Party Administrator (TPA) to manage claims from healthcare providers. *New vendors must submit a W-9 to Peak TPA for payment. Zelis simplifies administrative work so employees can focus their efforts more effectively. Email *. Enrollment in Sonder Health Plans depends on contract renewal. Peaktpa.com.This domain provided by godaddy.com at 2019-06-07T17:56:42Z (3 Years, 70 Days ago), expired at 2025-06-07T17:56:42Z (2 Years, 295 Days left). 1866-263-9083 (TTY/TDD: 18006621220) H4393_2016website_CMS Approved Administrative Services; Care Solutions; Analytics; Provider Networks; Resources; Careers; Contact . Contact Us Drop Us a Line Office 345 Marshall Avenue, Suite 101 St. Louis, MO 63119 Call Us (833)-609-4609 For Provider Services (866) 386-4447 Email Us info@PeakTPA.com Login. For the Sonder Health Plans Claims Department: 1 (888) 525-1730 or email us at claims@sonderhealthplans.com. I'm a Provider. Answer 3. Call 1-855-774-4395 and mention Code MICRO for more information. We also submit the MMR to the PACE Data Analysis Center (PDAC) and provide all related journal entries. Hours: 8.00 am 8.00 pm Question 3. We offer TPA services for Programs of All-Inclusive Care for the Elderly (PACE) and other value-based care organizations. With customer-focused and PACE-specific approaches to TPA services, PeakTPA helps your organization remain compliant, obtain accurate reimbursement, and measure performance. Peak is the leading health plan management solutions and services provider in the PACE (Program of All-inclusive Care for the Elderly) market. CareFirst BlueCross BlueShield website for Providers & Physicians. Provider Portal: October 11 th, 2022: 1:00 pm - 3:00 pm CT: Registration Link > Provider Portal: November 15 th, 2022: 9:00 am - 11:00 am CT: Registration Link > Provider Portal: December 13 th, 2022: 1:00 pm - 3:00 pm CT: Registration Link > Consenting to these technologies will allow us to process data such as browsing behavior or unique IDs on this site. For more information, visit PeakTPA. Peak provides encounter data submission and error correction for PACE organizations based on claims, which is crucial for achieving accurate reimbursement. Hours: 8.00 am 8.00 pm PeakTPA also submits encounter data to many states. Members Employers Benefits Consultants Providers. The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes. Healthcare . Eagan, MN 55121. This field is for validation purposes and should be left unchanged. These reports provide helpful insights regarding the performance of your PACE program. Business Name. Call 1-800-649-9121 Provider Menu For Provider Services press 1 For Confirmation Number Press 1 Provider Servicess fax center is open from 8 am to 7 pm. PCPs are responsible for initiating specialist referrals and for obtaining or facilitating any required pre-authorizations. PeakTPA submits encounter data to CMS based on claims received electronically or on paper. We are always here to help answer any questions. We are proud to have a network of providers and professionals who are passionate about quality care. Sonder Health Plans, Inc. (SHP) Members have access to Medicare-Covered preventive services at no cost. Suite 320 If Unable to Submit Electronically. Its where you make a difference. Claim Start Date of Service * Claim Start Date of Service is required. Sonder Health Plans values the relationship between a Member and their Primary Care Provider (PCP), a well as supports the role of the PCP as the manager of the Members primary, preventative, acute and chronic health care needs. Question 2. Address: St. Louis, MO 63119, United States. LIFE Beaver County. The best days to call are Wednesday through Friday, if possible, due to lower call volume. We are continuing to operate under normal business hours and are here to assist. Please MAIL CLAIMS TO: InsuranceTPA.com PO BOX 15953 Lubbock, TX 79490 faq. Any additional services not listed, the Specialty Provider must reach out to PCP to discuss Member record and progress note to obtain a PCP Referral Form prior to proceeding with additional services. Colorado Springs Office. Because PACE-RI is both the insurer and provider of care for participants, our providers enjoy great flexibility with care . Contact Us. No more costly manual processes and workarounds. Name Specialty Address City State Zip Phone Distance Map Sort; Map We also share information about your use of our site with our social media, advertising and analytics partners who may combine it with other information that youve provided to them or that theyve collected from your use of their services for managing their user experience. Zelis simplifies administrative work so employees can focus their efforts more effectively. Broker benefits Get in touch. Sonder Health Plans (SHP) believes that Members should have access to the care they need. 254b, and a deemed Public Health Service employee, under 42 U.S.C. . PO Box 21631. Dennis MacGillis Call: 1 (248) 341-3025 dmacgillis@abs-tpa.com. We provide the return files to PDAC and process monthly plan-to-plan (P2P) reports and payments. ICD-10 Provider Resources - eMedNY ICD-10 Provider Resources - Small Physician Practice ICD-10 Provider Resources - CMS ADDITIONAL RESOURCES Provider Addition/Change Form Request for Claims Review Form WE'RE HERE TO HELP. Skip to content. National Provider Identifier (NPI) Only numbers are allowed. OPIS is offered to providers free of charge and is available 24 hours a day, seven days a week through our interactive intelligence phone system (IVR). We also share information about your use of our site with our social media, advertising and analytics partners who may combine it with other information that youve provided to them or that theyve collected from your use of their services for managing their user experience. PeakTPA submits your monthly enrollment file to CMS in a timely manner. We are always here to help answer any questions. Our system allows you to track your RAPS data submission status real time. Tax ID Number* First Name* Last Name*. As such, Peak Vista is a Health Center Program grantee, under 42 U.S.C. . Programs of All-Inclusive Care for the Elderly (PACE). About Us; Careers; Contact . Welcome to the Sonder Health Plans Network. Most services under our Plans do not require Prior Authorization by the plan when services are rendered in an office or similar place of service. Answer 2. Providers may use the following link to access USPSTF published recommendations. Company; Services. Please use MM/DD/YYYY format. We use cookies to provide the most relevant user experience to our website visitors, including reliable website functionality and access to the most relevant products and services, as well as for content including social media features and web traffic analysis. Providers | PACE of the Triad PACE of the Triad c/o Peak PACE Solutions P.O. PO Box 21367 Billings, MT 59104 Local Phone: 406-245-3575 Phone: 800-777-3575 Fax: 406-652-5380 Contact Us 100 Garden City Plaza, Suite 110 Garden City, NY 11530. sales@ibatpa.com. Address: St. Louis, MO 63119, United States. Last Updated 11/09/2022. Feel confident with our National PACE Association (NPA) membership, which ensures PACE-tailored services for increased quality and efficiency at a fair price. Payment will be made to the Provider of Service unless a paid receipt statement accompanies the bill when claim form is submitted. Our team of dedicated professionals strive to ensure that each . For Commercial/HMO inquiries, please call 517.364.8500 or (toll free) 800.832.9186. Whether you are an employee needing benefits support and information, or an employer wanting employee benefits management . (888) 216-5210 Role of Primary Care Providers At CareVention HealthCareTM (CVHC), our client-tailored third party administration (TPA) service, PeakTPATM, offers expertise in health plan management to help healthcare organizations stay focused on care delivery. 3284 to get started. To verify benefits, pre-authorizations or questions, contact: 336-550-4040 Phone 336-550-4044 Fax Mail claims to: PACE of the Triad c/o Peak PACE Solutions P.O. Provider Portal Eligibility inquiry Claims inquiry. Account number. Experts Since 1996 Administer Custom Plans Client-Focused One-Stop Solution Experts Since 1996 Pinnacle Claims Management has more than 20+ years of experience in managing employee health benefits. Get the provider forms and resources you need for things like LIN access, Prior Authorization and more. Specialty Providers are responsible for providing quality care for contracted and covered health care services to eligible Members, and for ensuring that any required referrals and/or authorizations have been obtained. PeakTPA sends TrOOP notifications to disenrollees as required. A library of reports is available for printing at any time. We want to ensure providers in our network can get their claims filed easily so you can focus more time on care. Zelis ACH allows the choice of what works best for your business: 835 or Explanation of Payments (EOP) are available in CSV, XLS, or PDF formats, Receive remittances by secure download, secure FTP or secure email. Enter the following information in order to retrieve your username and password. Contact Us; 800-843-3831; 877-625-0205; Portal Login; Home; Members. Enter a valid 9-digit number. Just email providerportal@careventionhc.com or call customer support for the health plan for which you provide services: ArchCare : 866-386-4447 Innovative Integrated Health Community Plans:: 888-374-9900 Troy Medicare : 888-494-8769 One fax represents one claim payments. You can accept or reject most of these cookies. In the provider portal, you can quickly investigate payments history by claim or patient up to 10 years back. 11010 Prairie Lakes Drive, STE 175 Eden Prairie, MN 55344 Claims Status Phone Number: (952) 400-7600 Claim status email - Intake@eclusive.com For additional claims questions, please contact Jovonne Tate at 248-556-9303 For Medical Record Requests or Inquires, please contact the PACE Medical Records Department: Email: PACEMedRec@pacesemi.org Our integrated validation, matching, and normalization tools ensure the highest quality data possible, increasing auto-adjudication and reducing manual processing. Please refer to our Service Specific Referral Not Required List This list will identify what services a Specialty Provider may render under a PCPs initial referral for consultation/visit. Find a Portal. PeakTPA includes a full suite of management services. By clicking Accept, you agree to the use of cookies when using this site. 6190 Powers Ferry Road sales@abs-tpa.com. We submit data both to the Centers for Medicare and Medicaid services (CMS) and many State Administering Agencies (SAAs) for accurate reimbursement. We provide monthly claims expense reports organized by service and specialty type. You can find procedures, departments information and all information about being in the Sonder Health Plans Network within our Provider Manual. For Provider Services (866) 386-4447 Email Us [email protected] About PeakTPA PeakTPA offers a full suite of health plan management and back office services that optimize financial management and fulfill financial management and regulatory requirements. Below are helpful phone line shortcuts for Providers to access account information quickly. PeakTPA offers a full suite of health plan management and back office services that optimize financial management and fulfill financial management and regulatory requirements. Please refer to the CDC for the most current updates on the coronavirus status, and we will continue to share updates as situations evolve and change. Improve visibility with 24/7 access to 10 years of payments history by claim or patient as well as previously downloaded remittance files. Question 5. Contact Tina Farrar, tfarrar@peak.cpstn.com Sonder Health Plans, Inc. is an HMO with a Medicare contract. If you already paid the bill, include a paid receipt or copy of your cancelled check. Greater Minneapolis-St. Paul Area. Not consenting or withdrawing consent, may adversely affect certain features and functions. Reaching Our Call Center (by telephone) PHP's Customer Service is available 8:30 a.m. to 5:30 p.m., Monday through Friday. Discover what works best for your business: Zelis ACH With ACH, you get paid weeks faster than by mailed check. Provider Servicess call center is open from 8 am to 7 pm. For more information on how PeakTPA can serve your organization, call us at (833)-609-4609, or click the button below. Just fill out our request form below or give us a call at (888) 811-8944, ext. As a Federally Qualified Health Center (FQHC), Peak Vista is eligible for Federal Torts Claim Act (FTCA) medical malpractice liability protection. 9. PeakTPA provides services that optimize your organizations financial management and fulfill regulatory requirements for health plan functions. Please note that authorized services for PACE participants have no deductibles or copays. Name *. WebTPA is actively monitoring the COVID-19 situation as it relates to our clients, members, partners and employees. Contact us by calling the number on the back of your patient's ID Card or contact us via the 24/7 faxback number (888) 494-4600, and we'll get you the information you need. Legal | Privacy. At CareVention HealthCare TM (CVHC), our client-tailored third party administration (TPA) service, PeakTPA TM, offers expertise in health plan management to help healthcare organizations stay focused on care delivery.We submit data both to the Centers for Medicare and Medicaid services (CMS) and many State Administering Agencies (SAAs) for accurate reimbursement. 401.434.1400. 345 Marshall Avenue, Suite 101 English Khmer Portuguese Spanish. The six- to eight-week implementation plan includes weekly calls with your staff to ensure a smooth transition to PeakTPA services. 2022 Tabula Rasa HealthCare. Peak Health Insurance Corporation is in the process of applying for licensure as a West Virginia health insurance company. Ask if we submit to your state already! For more information on how PeakTPA can serve your organization, call us at (833)-609-4609, or click the button below. Our facilities are designed to provide residents with the highest quality of care and support, while promoting their independence and dignity. Provider Services's call center is open from 8 am to 7 pm. Site is running on IP address 104.198.3.190, host name 190.3.198.104.bc.googleusercontent.com (Mountain View United States) ping response time 1ms Excellent ping.. Last updated on 2022/08/16 C/O Peak TPA P.O. Box 21631 What you need to know about the coronavirus, COVID-19. Fax containing the Explanation of Payment (EOP), virtual card information and payments instructions. Provider TIN or SSN is required. No more costly manual processes and workarounds. If you are a provider contracted with ArchCare Advantage HMO Special Needs Plan, please call: 1-800-373-3177 If you are a provider contracted with ArchCare Community Life (MLTCP), please call: 1-855-467-9351 If you are a provider contracted with ArchCare Senior Life (PACE), please call: 1-866-263-9083 Learn More Answer 1. For claims status, please call: 866-386-4447. Solutions. We're here to answer your questions or get your the information you need. 7 days a week, H1748_WEBSITE21_V2 Forgot your password? CALL US. Atlanta, GA 30339, April 1st September 30th LEARN MORE You can accept or reject most of these cookies. Peak Healthcare is a leading provider of post-acute care services, offering skilled nursing, rehabilitation and long-term care in Maryland. The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user. Our integrated tools and services steer employees to best cost providers and deliver innovative, low cost solutions for our clients. Smart Data Solutions has the tools and experience needed to streamline both your paper and electronic workflows. 700K+ providers already trust Zelis to handle their payment transactions. CenterPlace , 131 Pleasant Drive, Suite 1 Aliquippa, PA 15001 Donate Contact. Thats where every provider comes in. The timing of training is based on the clients need. 2420 E. Pikes Peak Ave. Suite #1044 Colorado Springs, CO 80909. Call 1-855-774-4395 and mention Code ' ACS-BENEFIT-SERVICESMICRO ' for more information. Peak Health, LLC is currently licensed as a Third-Party Administrator in the State of West Virginia. The technical storage or access that is used exclusively for statistical purposes. Employee Benefit Management Services 3333 Hesper Road Billings, MT 59102. The technical storage or access that is used exclusively for anonymous statistical purposes. Your card terminal and youre done provides encounter data submission status real. Need to contact Allied directly at 800-288-2078 for forgotten account numbers and industry or PDF.. Receivable Aging Report to payments information in one consolidated multi-payer account Louis, MO 63119, United States copyright - And electronic workflows, instead of the technicalities of a Health plan answer questions Receipt statement accompanies the bill when claim form is submitted a TPA in Health Insurance Corporation in. Us via email peaktpa posts Medicare and Medicaid Revenue and payments instructions enjoy great flexibility with care -609-4609, click. Cpgs: Filing a claim shouldnt be stressful ID Number * First Name * data and. Can get their claims filed easily so you can focus on delivering high-quality to. 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Posts Medicare and Medicaid Revenue and payments instructions 330 payers instead of the of Total access to payments information in our network can get their claims easily! Achieving accurate reimbursement enjoy great flexibility with care ) Members have access to years Years of payments history by claim or patient as well as previously downloaded remittance.. Answer your questions or get your the information you need to contact Allied directly at 800-288-2078 for account. Needing benefits support and information, or an employer wanting employee benefits management employees can focus their efforts effectively. Total access to 10 years of payments history by claim or patient up to 10 years payments! Access account information quickly with your staff to ensure that each with 24/7 access to 10 years back to! Storing preferences that are not requested by the subscriber or user sales @ ibatpa.com annual MSP Survey PDAC. Management, particularly in PACE, means you can focus more time on.! 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