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By developing a multi-specialty network of credentialed providers located throughout the state of Arizona, more than 750,000 beneficiaries of the following ASPA contracted payors use IPA members for their health care services: Ameriplan USA 5700 Democracy Drive Planto, TX. 75034 Joel Andrews, Provider Relations Phone 480-228-2249
Banner Health Plans (Not accepting new ASPA providers-closed panels) Karen McAlister, Provider Relations karen.mcallister@bannerhealth.com 445 W. 5th Place Mesa, AZ. 85201 Phone 480-827-7077
Beech Strreet/CappCare Customer Service 25500 Commercenter Drive Lake Forest, CA. 92630 Phone 800-877-1444 Provider Referrals Phone 800-877-1444 Research & Resolution Phone 800-877-1444 Fax 949-672-1116 (Please send HCFA or UB and EOB) Physician Data Management Phone 800-877-1444 Fax 949-672-1133 Facility Data Management Phone 800-877-1444 Fax 949-672-1133 CPT Reimbursement Questions Phone 800-877-1444 Fax 949-672-1130 ONLINE SERVICE Claim Status Inquiry Select “providers” Section and choose “claim status inquiry” Benefit Office Information & Claim Submission Address Select “providers” section and choose “benefits & eligibility” Payor Listing Select “providers” section and choose “payor listing” Other Online Features for Providers Select “providers” section and choose form the options on the left
Bridgeway 1501 W. Fountainhead Parkway Suite 201 Tempe, AZ. 85282 Phone 866-475-3129 Claims address Bridgeway Claims P.O. Box 3040 Farmington, MO. 63640-3814 Anne Jamison Provider Relations Monica Cervantes Provider Relations Cathy Farnham Provider Relations Phone 866-475-3129 Fax 866-638-6124
CorVel Corporation 3550 N. Central Ave. Suite 915 Phoenix, AZ 85012 Phone 602-287-8722 800-230-888 1st point of contact: Deborah J. Skoglund NDB Specialists Phone 602-287-8722 ext 205 Fax 602-222-6649 Attn: PPO Department Leslie Olmsted PPO/IME Developer Phone 287-8722 ext: 206 Fax 602-222-6649 Attn: PPO Department
EverCare of Arizona EverCare Select EverCare Medicare 3141 N. Third Ave. Suite 100 Phoenix, AZ. 85013 Phone 602-331-5100 800-377-2055 www.unitedhealthcareonline.com Claims Status & Member Eligibility For Medicare phone 800-393-0993 For Select 800-293-3740 Estevan Rodriguez Provider Relations (Yuma, Maricopa-Phoenix/Central Valley “east of SR-51” and Scottsdale) Phone 602-745-7985 Cathy Farnham Provider Relations (Pima, Coconino, Maricopa-East Valley -Tempe, Chandler, Mesa, Ahwatukee, Gilbert and Queen Creek) Phone 602-745-7904 Tiffany Surleta Provider Relations (Navajo, Apache, Maricopa – Phoenix “west of 43rd Ave” all west valley cities, Wickenburg) Phone 602-745-7911 Amy Osborn Provider Relations (Mohave, LaPaz, Maricopa-Central Phoenix “43 Ave – SR 51”) Phone 602-745-7974 Kari Coxson Network Operations Manager Phone 602-745-7980
Fortified Provider Network, Inc. 8096 N. 85th Way Suite 103 Scottsdale, AZ. 85258 Amy Reagan Manager, Operations Phone 480-607-0222 Ext. 123 Rebecca Chesley Claims Issues Phone 480-607-0222 Ext. 102
Great West Healthcare (rural areas is PPO and OPEN ACCESS in all other areas with in Pima & Maricopa County) 6909 E. Greenway Parkway Suite 180 Scottsdale, AZ. 85254 Liz Parks 2nd Contract Manager Phone 480-624-5158 Direct Phone 408-624-5158 Fax 480-348-2380 303-801-5798 Caron McGhee Provider Relations Direct Line 480-624-5155 Fax 480-348-2380 Claim Issues Phone 888-663-8081
HealthCare Connect 320 E. McDowell Road Suite 320 Phoenix, AZ. 85004 Eric Dugar Community Relations Liaison Phone 602-288-7562 Fax 602-288-7565 Enrollment & Eligibility Dept. Phone 602-288-7564 (opt. 2) Submit all encounter & referral data to: HealthCare Connect 320 E. McDowell Road Suite 320 Phoenix, AZ. 85004
Health Choice (no Mental Health, Anesthesia, Pt’s, NP’s, PA’s) 1600 W. Broadway Suite 260 Tempe, AZ. 85282 Phone 480-968-6866 800-322-8670 Fax 480-784-2933 Steve Bigman Network Services Rep. Phone Direct 480-350-2203 Fax 480-303-4433 Freda Benavides Network Services Rep. Phone Direct 480-350-2221 Fax 480-303-4433 fbenavides@iasishealthcare.com Derrick Harris Network Services Rep Phone Direct 480-350-2218 Fax 480-303-4433
Heatlh Net (Maricopa County Only) (Not accepting new ASPA providers – closed panels) 1230 W. Washington Street Suite 401 Tempe, AZ. 85281 Gina Erickson Provider Relations Phone 602-794-1509 Fax 800-858-3958 Customer Service/Claims Phone 800-289-2819
Human Choice Care 333 Main Street Regency Bldg. 5th Floor Green Bay, WI. 54301 Main Fax 800-626-1686 Phone 800-626-2741 Shari Debroux Network Operations Supervisor Phone 800-626-2741 Bonnie Osterman Provider Relations – West Valley Phone 480-515-6464 Fax 480-515-6464 Eve Balbo Provider Relations – Phoenix/Scottsdale Phone 480-515-6461 Nancy Hooper Provider Relations – East Valley Phone 480-515-6463 Claims Customer Service Phone 800-558-4444
Intergrated Health Plan, Inc. 4020 Park Street Suite 103 St. Petersburg, FL. 33709 Phone 888-640-8707 Laurie Casler Director, Provider Relations Phone 888-640-8707 ext. 309 Fax 737-345-7680
Maricopa Health Plan 2502 E. University Drive Suite 125 Phoenix, AZ. 85034 Jennifer Claver Provider Relations Phone 602-344-8387 Claims Submission P.O. Box 37169 Phoenix, AZ. 85069 Grievance & Appeals Submission 2701 E. Elvira Tucson, AZ. 85756 Phone 800-582-8686 Clinical Services Phone 602-344-8777 866-466-8777 Prior Authorization Phone 866-210-0512 Pharmacy Phone 602-344-8777 866-466-8777 Hospital Notification Phone 602-344-8777 866-466-8777 Dept. Fax 602-344-8372 Utilization Management Phone 602-344-8777 866-466-8777 Claims Customer Service Phone 800-582-8686 Opt. 6 Kim Bolton Claims Manager Phone 520-874-5200 Member Services Phone 800-582-8686 opt 2 For Member Services Eligibility Silvia Parra Member Services Manager Phone 520-874-5200 Sonia Ross Appeals Manager Phone 520-874-5518
MultiPlan/PHCS 115 Fifth Ave. New York, NY. 10003 Customer Service Phone 800-546-3887 Claims Issues contact Provider Relations Phone 800-546-3887 Between 8:30am – 7:00pm EST, Monday through Frinday or via email
PacifiCare HMO Provider Assistance (Providers only) Phone 800-283-7525 Customer Service (Members) Phone 800-347-8600 HMO Claims Submission: PacifiCare of Arizona, Inc. Attn: Claims Dept. P.O. Box 52078 Phoenix, AZ. 85072-2078 PPO Provider Assistance (Providers only) Phone 866-863-9776 Customer Service (Members) Phone 866-316-9776 PPO Claims Submission: PacifiCare PPO Attn: Claims Dept. P.O. Box 6099 Cypress, CA. 90630
Pinal/Gila Long Term Care P.O. Box 2140 Florence, AZ. 85232 Kiven Formo Provider Service Coordinator Phone 520-866-6728 Fax 520-866-6708
Prime Health Services, Inc. 7110 Crossroads Blvd. Suite 100 Brentwood, TN. 37027 Phone (Main) 866-348-3887 Phone (Local) 615-329-4098 Fax 615-329-4751 Brenda Benda Customer Service Manager customerservice@prime-health.net
SCAN 1313 E. Osborn Road Suite 150 Phoenix, AZ. 85014 Phone (Main) 602-778-3300 866-563-7321 Gene Dameron VP, Network Management Services Phone 602-778-3315 Gary Goforth Network Management Rep. Phone 602-778-3355 Fax 602-778-3351 Member Services Phone 888-540-7226 Case Management Phone 602-778-3300 866-563-7321 Claims Inquiry Phone 877-235-7226 Network Management Services Phone 602-778-3300 866-406-0937 Medical Management Phone 602-778-3326 Prior Authorization Phone 866-046-0955 Grievance and Appeals Phone 866-046-0994 Transportation Phone 866-848-9428 American Medial Alert Corporation Phone 310-877-7145 SCAN ON-Call Phone 877-582-7226 877 LTC-SCAN Pharmacy Questions- ESI/SCAN Customer Reps (SCAN Pharmacy Group #AN9A) Phone 866-553-4125
Sierra Health & Life Member Services Eligibility Benefits Claims Status Prior Authorization Status Phone 877-559-4512 Utilization Management Prior Authorization Submissions Phone 800-288-2264 Fax 800-282-8845 Online Eligibility Claim Status Prior Authorization Submissions Status Lorena Acosta Contractual Issues, Network Contracts Coordinator Phone 702-242-7068 Fax 702-242-9124 Amanda Day Contractual Issues, Network Contract Coordinator Phone 702-240-8793 Fax 720-242-91254 Herbert
Schaller Anderson Network www.schallerandersonhealth.com 4645 E. Cotton Center Blvd. Bldg. 1, Suite 200 Phoenix, AZ. 85040 Phone 602-659-1783 Fax 602-414-7160 Gina Goodman Senior Contract Specialist Phone 602-659-1118 Fax 602-414-7131 Gina.goodman@schalleranderson.com Tony Flanagan Provider Services Healthcare Phone 602-659-1708 Tony.flanagan@schalleranderson.com Pamela Laguna Provider Relations Phone 602-659-1785 Fax 602-414-7162 Pamela.laguna@schalleranderson.com Member Services Claims Eligibility Prior Authorization General Information Phone 888-99-1459
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