Interested in joining the network?
Follow the instructions on How to Become a Provider
Claims – General Information
If you have questions about claims in general, call (800) 888-3944.
Claims Submission/ Address
Reference the address on the member’s identification card, as the address may vary based on payment location.
Electronic Payment Solutions and Remittance Advice
Register for Payspan to receive direct deposit of provider payments and access remittance data 24/7.
Phone: 877-331-7154 from 8 a.m.-8 p.m. ET, Monday through Friday Website: www.payspanhealth.com
Member Benefits, Eligibility, and Authorizations
If you have a question about authorization or benefits, call the (800) number on the back of the member’s identification card.
Member Customer Service
To reach Member Customer Service, call the (800) number on the back of the member’s identification card.
Provider Supporting Documentation
To send supporting documentation such as malpractice or insurance cover sheets please fax to (866) 612-7795
If you have general questions and would like to contact Provider Relations in your region, visit the list of our regional offices.
Electronic Claims Submission/ EDI Helpdesk
If you have a technical question about ProviderConnect or EDI Claim Submission, please contact the EDI Helpdesk at:
Phone: (888) 247-9311 from 8 a.m.-6 p.m. ET, Monday through Friday Fax: (866) 698-6032 E-mail: email@example.com Mailing Address: Beacon Health Options
Attn: EDI Helpdesk
PO Box 1287
Latham, NY 12110
To obtain information pertaining to your network status, contact our National Provider Line at (800) 397-1630 from 8 a.m.-8 p.m. ET.
Fraud and Abuse
Reports of fraud and abuse, or suspicions thereof, can be made in writing to:
Mailing Address: Beacon Health Options
ATTN: Special Investigations Unit
1400 Crossways Blvd
Chesapeake, VA 23320
To request a clinical appeal on a member’s behalf, call the (800) number included in the adverse determination letter you received.
To request an administrative appeal, call the (800) number included in the administrative denial letter you received.
To file a complaint/grievance, call the (800) number on the back of the member’s identification card to speak to Customer Service.
Report all adverse incidents to the Clinical Care Manager with whom you conduct reviews.
Duty to Warn
Report all potential situations to the Clinical Care Manager with whom you conduct reviews.
Provider Coverage During Absences
Contact the Clinical Care Manager with whom you conduct reviews during absences (i.e. coverage while on vacation). Or call the number on the card to provide coverage information.
Changing your Provider Profile (e.g. Name, address)
The preferred method to updated your provider profile is to select the “Update Demographic Information” option in ProviderConnect. Please note: Updating a Tax ID requires an accompanying W-9 form, which can be accessed and attached through ProviderConnect.
Fax: (866) 612-7795 Mail Address: Beacon Health Options
c/o Practitioner Maintenance
P.O. Box 989
Latham, NY 12110