Contracted with Over 750,000 Lives
Last Updated March 2010
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
Amanda Massey
Provider Relations
Phone 469-2294348
Fax 469-229-4592
amandam@ameriplanusa.com
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
www.beechstreet.com
Customer Service
25500 Commercenter Drive
Lake Forest, CA. 92630
Phone 800-877-1444
Provider Referrals
Phone 800-877-1444
Fax 949-672-1116
(Please send HCFA or UB and EOB)
Network.Operations@viant.com
Facility Data Management
Network.Operations@viant.com
Phone 800-877-1444
Fax 949-672-1133
CPT Reimbursement Questions
Fee.Schedule@viant.com
Phone 800-877-1444
Fax 949-672-1130
ONLINE SERVICE
Claim Status Inquiry
www.BeechStreet.com
Select “providers” Section and choose “claim status inquiry”
Benefit Office Information & Claim Submission Address
www.BeechStreet.com
Select “providers” section and choose “benefits & eligibility”
Payor Listing
www.BeechStreet.com
Select “providers” section and choose “payor listing”
Other Online Features for Providers
www.BeechStreet.com
Select “providers” section and choose form the options on the left
Bridgeway
www.bridgewayhs.com
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
Phone 480-285-7626
Fax 866-687-0514
ajamison@centene.com
Monica Cervantes
Provider Relations
mcervantes@centene.com
Cathy Farnham
Provider Relations
cfarnham@centene.com
Phone 866-475-3129
Fax 866-638-6124
CorVel Corporation
www.corvel.com
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
debora_skoglund@corvel.com
Leslie Olmsted
PPO/IME Developer
Phone 287-8722 ext: 206
Fax 602-222-6649
Attn: PPO Department
leslie_olmsted@corvel.com
EverCare of Arizona
EverCare Select
EverCare Medicare
3141 N. Third Ave.
Suite 100
Phoenix, AZ. 85013
Phone 602-331-5100
800-377-2055
www.evercareonline.com
www.unitedhealthcareonline.com
Claims Status & Member Eligibility
For Medicare phone 800-393-0993
For Select 800-293-3740
Grievance & Appeals:
Phone 602-331-5100
Sophia Gomez
Provider Relations
Phone 602-745-7996
Fax 602-745-7950
Sophia_y_gomez@uhc.com
Fortified Provider Network, Inc.
8096 N. 85th Way
Suite 103
Scottsdale, AZ. 85258
Amy Reagan
Manager, Operations
Phone 480-607-0222 Ext. 123
amyr@fortifiedprovider.com
www.fortifiedprovider.com
Melissa Peters
ASPA Provider Rep.
Phone 480-607-0222 Ext. 103
Fax 480-607-2199
mpeters@fortifiedprovider.com
Galaxy Health Network
www.galaxyhealth.net
Mailing/Custom Service/Claims
P.O. Box 201429
Arlington, TX 76006
Phone 817-633-5822
Fax 817-633-5729
Judi Hale
ASPA Provider Rep
Phone 800-975-3322, ext 1101
Fax 817-633-5729
Referrals
Phone 817-633-5822, ext 3503
Fax 817-633-5729
Great West Healthcare
www.mygreatwest.com
(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
elizabeth.parks@gwl.com
Caron McGhee
Provider Relations
Direct Line 480-624-5155
Fax 480-348-2380
Caron.McGhee@gwl.com
Claim Issues
Phone 888-663-8081
HealthCare Connect
www.healthcareconnect.org
320 E. McDowell Road
Suite 320
Phoenix, AZ. 85004
Eric Dugar
Community Relations Liaison
Phone 602-288-7562
Fax 602-288-7565
ericd@healthcareconnect.org
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
www.healthchoiceaz.com
(no Mental Health, Anesthesia, Pt’s, NP’s, PA’s)
410 N. 44th Street
Suite 900
Phoenix, AZ 85008
Phone 480-968-6866
800-322-8670
Fax 480-784-2933
Steve Bigman
Network Services Rep.
Phone Direct 480-350-2203
Fax 480-760-4720
sbigman@iasishealthcare.com
Heatlh Net
www.healthnet.com
(Maricopa County Only)
1230 W. Washington Street
Suite 401
Tempe, AZ. 85281
Sue Randol
Provider Relations
Phone 602-794-1505
Fax 877-641-1935gina.m.ericson@healthnet.com
Customer Service/Claims
Phone 800-289-2818
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
sdebroux@humana.com
Bonnie Osterman
Provider Relations – West Valley
Phone 480-515-6464
Fax 480-515-6464
bosterman@humana.com
Claims Customer Service
Phone 800-457-4708
Grievance & Appeals
Phone 800-448-6262
Intergrated Health Plan, Inc.
www.ihplan.com
4020 Park Street
Suite 103
St. Petersburg, FL. 33709
Phone 888-640-8707
Renee Anderson
Provider Relations
Phone 888-640-8707 ext. 341
Fax 737-345-7681
delegatedgroupupdates@ihplan.com
Maricopa Health Plan
www.mhpaz.com
2502 E. University Drive
Suite 125
Phoenix, AZ. 85034
Jennifer Claver
Provider Relations
Phone 602-344-8387
jclaver@uph.org
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
www.multiplan.com
1100 Winter Street.
Waltham, MA 02451
Customer Service
Phone 800-297-7427
Claims Issues contact Provider Relations
Phone 800-546-3887
Between 8:30am – 7:00pm EST, Monday through Frinday
or via email
PR@multiplan.com
Pinal/Gila Long Term Care
P.O. Box 2140
Florence, AZ. 85232
Gerardo Huerta
Provider Service Coordinator
Phone 520-866-4419
Fax 520-866-4450
gerardo.huerta@pinalcountyaz.gov
Prime Health Services, Inc.
www.prime-health.net
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
www.scanhealthplan.com
1313 E. Osborn Road
Suite 150
Phoenix, AZ. 85014
Phone (Main) 602-778-3300
866-563-7321
Donna Warner
ASPA Provider Rep
Phone 602-778-3353
Fax 602-778-3351
dwarner@scanhealthplan.com
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
Three Rivers Provider Network
910 Hale Place
Suite 101
Chula Vista, CA 91914
Phone 619-600-4801
Fax 619-600-4848
Cande Quintana
Provider Rep
Phone 619-600-4802
Fax 619-600-4813
cquintna@trpnppo.com
USA Managed Care Organization
www.usamco.com
916 S. Capitol of Texas Hwy.
Austin, TX. 78746
Phone 800-872-0820 , ext 4889
Fax 512-306-7021
ipa@usamco.com
