Embed Size (px)
Citation preview
Website/Customer Service Center
06/2018
1926 Northlake Pkwy, Suite 100 ٠ Tucker, GA 30084 ٠ 770-455-0040 ٠ 888-635-0459 ٠ www.ActivHealthCare.com
2
Website –Home page
3
Website –CA’s Corner
4
Website –CA’s Corner
5
Website –CA’s Corner
6
Website –CA’s Corner
7
Website –CA’s Corner
8
Website –CA’s Corner
9
Website –CA’s Corner
10
Website –CA’s Corner
AHCØ1 Payor Name from ID Card
Payor Address from ID Card
Payor City, State, Zip
Network Name
John Chiropractic Center
4455 Highway 84
Tucker, GA 30084-7069
1932992610
John Chiropractic Center
4455 Highway 84
Tucker, GA 30084-7069
14322895876
14322895876
Insured’s Information
Patient’s Information
Doctor’s NPI Number
Service Address & NPI # Address/NPI number for who checks are
payable to
11
Service Provider
TIN
If Mailing Paper Claims, Send Claims To:
Coventry Health Care of GA Claims
ActivHealthCare1926 Northlake Pkwy,
Suite 100Tucker, GA 30084
12
All Claims for Networks
(Alliant, Beech Street, First Health, etc)
ActivHealthCare1926 Northlake Pkwy,
Suite 100Tucker, GA 30084
Note: See Network Affiliate sheet. This applies to the networks that are to be submitted through Activ.
If Filing EDI through Office Ally, Address Claims using this format:
Coventry Health Care of GA Claims
AHCØ1 Coventry25133P.O. Box 7711London, KY 40742-7711
13
All Claims for Networks
(Alliant, MHP, First Health, etc)
AHCØ1 “Name of Payor”“Insurance co. payer ID”AddressCity, State, Zip
14
Website –Network Resources
Benefit Verification – Tax ID #
• Payors may require your tax ID number when verifying benefits. If so, give them the ActivHealthCare tax ID number to obtain correct in-network benefits.
58-2068734
15
• Do not use Activ’s tax ID # when submitting claims.
• Unauthorized use of the ActivHealthCare tax ID number is illegal.
• Activ will put the ActivHealthCare tax ID number on claims for in-network providers when you submit the claim to us.
Website-Network Affiliates
16
Claims for these networks must be submitted through Activ.
17
Website –EDI Enrollment forms
18
Website –Forms
19
Website –Feedback
20
Website –Customer Service Center
21
Website –Customer Service Center
User ID: Your TIN Password: Your TIN(will prompt you to change after your first log in)
22
Website –Customer Service Center
23
Website –Customer Service Center
24
Website –Customer Service Center
A list of your open claims will display.
25
Website –Customer Service Center
26
Website –Customer Service Center
Contact Information
We are here to help you and your doctors with any questions or problems.
27
ActivHealthCare1926 Northlake Pkwy, suite 100
Tucker, GA 30084Phone: 770-455-0040
General Fax: 770-455-6188Treatment Plan Fax: 678-990-0025
Credential Fax: 678-990-1124
Questions
28
29
I attest that I have completed the AHC Staff Training and understand the
presented Content.
Date Training Completed: ______________________________________
Staff/Contractor Name (Printed): ________________________________
Staff/Contractor Signature: _____________________________________
Provider Name(s): ____________________________________________
After completing the training, please print and sign this page and fax to
(770) 455-6188.
