This section is designed to help guide providers directly to the right source for help with your question or problem.
If you still have questions or concerns not answered by the FAQs, contact our Customer Service Department at 513-551-1400 or by using the contact page on this site.
Who do I contact if I have a question about ELIGIBILITY or BENEFITS such as:
Is the member eligible under this healthplan?
Which dependents are covered under the member's plan?
What is the member's copay/co-insurance? Is there a deductible?
Is the service we provide covered under the member's benefits?
Who do I contact if I have a question about MEDICAL MANAGEMENT and/or PREAUTHORIZATION such as:
Do I need to get/give a referral for this service?
Do I need to have a precertification for this service?
How do I get preauthorization for this service?
How do I check on the status of an authorization?
Who do I contact to get more days authorized?
Who do I contact if I have a question regarding CLAIMS such as:
I believe the claim was paid incorrectly?
I don't understand why this claim was paid this way?
I have not been paid - what is the status of this claim?
This claim was denied - how do I appeal it?
How do I find out about the HealthSpan NETWORK OF PROVIDERS?
Am I in the Network?
How do I become a network provider?
I need to make a referral - who are the network providers?
