This section is designed to help guide you directly to the right source for your help with your question or problem.
If you still have questions or concerns not answered by the FAQs, contact our Provider Relations 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?
Is the member eligible under this health plan?
What is the member's co-pay or co-insurance? Is there a deductible?
Is the service we provide covered under the member's benefits?
Each member’s ID card will have the name, address and phone number of the third-party administrator who processes claims and manages eligibility. Please contact them directly for eligibility information. For assistance in finding the correct third-party administrator, click here.
How do I notify HealthSpan that I am moving my office, changing my tax ID number, joining a different group or any other change in demographic information?
We will need notification in writing at least 30 days in advance in order to avoid claims disruption. Please click here
for information on where to submit the changes.
Who is in the HealthSpan network of providers?
I have a patient who would like to see me, how do I find out if I am in the HealthSpan network?
I need to make a referral – who are the network providers?
to access our provider search database.
I am not currently in the HealthSpan network, how do I join?
Click here to find more information on joining HealthSpan.
Who do I contact if I have a question regarding claims?
Where do I submit a claim?
I don’t understand why the claim was paid this way.
I have not been paid – what is the status of this claim?
Why was the claim denied?
Each member’s ID card will have the name, address and phone number of the third-party administrator (TPA) who processes claims and manages eligibility. Please contact the TPA for claims information. For assistance in finding the correct third party administrator, click here
My claim was paid incorrectly, how do I get it fixed?
Please contact the third-party administrator directly with claims issues. If you are unable to get your claim issue resolved, click here for information on claims reimbursement appeals.
I’d like a copy of my fee schedule.
Who do I contact if I have a question about medical management or preauthorization?
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?
The information can be found in the group section of our site. Click here to login into the group section.