INTRODUCTION - PDF document

1 INTRODUCTION Provider Relations SIHO
INTRODUCTION Provider Relations SIHO INSURANCE SERVICES  Provider - sponsored health plan  Founded in 1987, by a fortune 100 employer, local hospitals and local physicians  Created to provide a solution to rise healthcare costs for local

2 businesses  110,000 + members
businesses  110,000 + members  Not - for - profit  Providing health care benefits to organizations of all sizes 2 SIHO OBJECTIVES 3 SIHO will be the premier healthcare delivery system administration company, known and respected f

3 or its high quality people, innovative
or its high quality people, innovative products and outstanding services. VISION Our mission is to continually improve our products and services to meet and exceed our customer‘s needs and expectations, allowing us to prosper as a business and provide a

4 value return for our stakeholders. MI
value return for our stakeholders. MISSION BENEFITS OF SIHO 4  Claims Administration  Pre - Certification  Full Service Medical Management  Member Services  Employer Services  Benefit Consulting  National Pharmacy Net

5 work  Comprehensive Provider Networ
work  Comprehensive Provider Network  Not For Profit  Provider Owned SIHO PROVIDER WEBSITE  Link image of website 5 SIHO PROVIDER LOG IN 6 WEBSITE HOMEPAGE 7 CLAIMS SEARCH 8 9 Claims Search Demo. Screen ADDITIONAL OPTION

6 S/RESOURCES 10  Call into SIHO an
S/RESOURCES 10  Call into SIHO and utilize the Interactive Voice Response. Phone Number: 800.553.6027  The new IVR allows providers to check claim status 24 hours a day, 7 days a week.  Providers have the option to opt out and speak with

7 representative during regular business h
representative during regular business hours or leave a voice message after hours.  Request precertification/authorizations on - line. The request will be reviewed and a response released within 24 hrs. CREDENTIALING / RE - CREDENTIALING 11 Informa

8 tion to include when adding a new provid
tion to include when adding a new provider to your practice:  Provider Name, title, and date of birth  CAQH Provider ID number  Tax Identification number  Group NPI number  Practice demographics  Remittance address Chang

9 es to your practice  Adding or rem
es to your practice  Adding or removing a provider  Practice address changes  Remittance address changes HELPFUL HINTS 12  Member Services Department can assist members as well as providers with questions regarding eligibility, benefits a

10 nd claim status. Phone: 800.443.2980 Qu
nd claim status. Phone: 800.443.2980 Questions may be emailed to memberservices@siho.org  Claim submissions: Rendering provider’s NPI must be listed in 24j & name in box 31; Vendor name must be in box 33 and group NPI listed in 33a  Electronic

11 Claim Submission ensures timely claim pa
Claim Submission ensures timely claim payment. SIHO utilizes a Universal Payer ID: 77153 – TK Software phone: 888.372.2808  Provider Relations Specialists assist with credentialing/re - credentialing, practice changes, claims research, web portal in

12 quiries, fee schedule requests, provide
quiries, fee schedule requests, provider issues and education. CONTACT INFORMATION 13 PROVIDER SERVICES Jana Griner Email: Jana.Griner@siho.org Phone: (812) 378 - 7018 Melanie Brock Email: Melanie.Brock@siho.org (812) 314.2500 ext.

13 1107 Latisha Meyer Email: Latisha
1107 Latisha Meyer Email: Latisha.Meyer@siho.org 812.314.2500 ext. 1187 MEMBER SERVICES: 1 - 800 - 443 - 2980 MEDICAL MANAGEMENT: 1 - 800 - 553 - 6027 Provider Relations: Email: Provider.Services@siho.org Fax number 812.37