Contracted with Over 750,000 Lives
Last Updated October 2008
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
USAallthewayJA@msn.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
Research & Resolution
Phone 800-877-1444
Fax 949-672-1116
(Please send HCFA or UB and EOB)
Physician Data Management
Network.Operations@viant.com
Phone 800-877-1444
Fax 949-672-1133
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
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
Estevan Rodriguez
Provider Relations
(Yuma, Maricopa-Phoenix/Central Valley “east of SR-51” and Scottsdale)
Phone 602-745-7985
etevan_I_rodriguez@uhc.com
Cathy Farnham
Provider Relations
(Pima, Coconino, Maricopa-East Valley -Tempe, Chandler, Mesa, Ahwatukee, Gilbert and Queen Creek)
Phone 602-745-7904
cfarnham@uhc.com
Tiffany Surleta
Provider Relations
(Navajo, Apache, Maricopa – Phoenix “west of 43rd Ave” all west valley cities, Wickenburg)
Phone 602-745-7911
Tiffany_I_surleta@uhc.com
Amy Osborn
Provider Relations
(Mohave, LaPaz, Maricopa-Central Phoenix “43 Ave – SR 51”)
Phone 602-745-7974
amy_j_osborn@uhc.com
Kari Coxson
Network Operations Manager
Phone 602-745-7980
Kari_e_coxson@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
Rebecca Chesley
Claims Issues
Phone 480-607-0222 Ext. 102
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
(CLOSED PANELS)
(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)
(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
gina.m.ericson@healthnet.com
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
sdebroux@humana.com
Bonnie Osterman
Provider Relations – West Valley
Phone 480-515-6464
Fax 480-515-6464
bosterman@humana.com
Eve Balbo
Provider Relations – Phoenix/Scottsdale
Phone 480-515-6461
ebalbo@humana.com
Nancy Hooper
Provider Relations – East Valley
Phone 480-515-6463
nhooper@humana.com
Claims Customer Service
Phone 800-558-4444
Intergrated Health Plan, Inc.
www.ihplan.com
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
Lcasler1@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
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
service@multipan.com
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
Kiven.Formo@c.pinal.az.us
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
Gene Dameron
VP, Network Management Services
Phone 602-778-3315
gdameron@scanhealthplan.com
Gary Goforth
Network Management Rep.
Phone 602-778-3355
Fax 602-778-3351
ggoforth@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
Sierra Health & Life
www.sierrahealthandlife.com
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
www.sierrahealthandlife.com
Lorena Acosta
Contractual Issues, Network Contracts Coordinator
Phone 702-242-7068
Fax 702-242-9124
juriclo@sierrahealth.com
Amanda Day
Contractual Issues,
Network Contract Coordinator
Phone 702-240-8793
Fax 720-242-91254
aday@sierrahealth.com
Herbert
halquisada@sierrahealth.com
Three Rivers Provider Network
1620 Fifth Ave.
Suite 900
San Diego, CA. 92101
Phone 800-966-8776
Fax 619-230-0503
Member Services
Claims Issues
Fax to Appeals Dept.
Fax 619-230-1500
USA Managed Care Organization
www.usamco.com
916 S. Capitol of Texas Hwy.
Austin, TX. 78746
Krista Wenske
IPA supervisor
Phone 800-872-0820 Ext 4109
Fax 512-306-7021
WENSKEK@usamco.com
United Healthcare
(Lake Havasu City only)
(Not accepting new ASPA providers-closed panels)
3141 N. 3rd Avenue
Phoenix, AZ. 85013
Stephanie Villareal
Phone 602-664-5240
Stephanie_a_villareal@uhc.com
