Copyright 2023 VNS Health. Please note that we do not credentialing provisional providers. However, plan health care professionals/providers who want to refer members to any nonparticipating health care professional/provider must contact Select Healths Medical Services department for prior authorization. For questions, please contact Provider Relations at (314) 729-4630. For accommodations of persons with special needs at meetings, call 1-866-509-5398 (TTY: 711). This includes access to HIV and transgender specialists who are respectful, sensitive and understand your needs. We are committed to you, your health and happiness. This information can be obtained by contacting your prescribing physician. Joel is a seasoned executive with over 22 years of experience in the healthcare industry. This plug-in will allow you to view the various documents throughout the ProviderInfoSource website. Referring patients to in-home care First Name*. VNS Health offers health plans that were created to help people live well in the comfort of their homes and communities. Courage to Quit Tobacco Cessation Program. Select Health encourages members to seek referral from their primary care provider (PCP) for specialty care when such care is necessary. Notice of Privacy Practices, Treatment Request Forms: Are you looking for private-duty nursing or companion care? Which one is right for you? (TTY: 711), The SelectHealth Care Team is available: Resources and Downloads. @keydown.up.prevent="$focus.wrap().previous()" @keydown.down.prevent="$focus.wrap().next()">, Professional Solutions for Health Care Organizations, Click here to register for HCHB Provider Link. Select Health of South Carolina Inc. is not responsible for the content of these sites. 1-866-469-7774 (TTY: 711) Please refer to the other provider links for additional information and resources. Community partners seeking behavioral health support for at-risk individuals Authorization is not a guarantee of payment. Subscribe today. With SelectHealth, your primary care Learn more about SelectHealth benefits. Simply click to view, download or print a document. 1-866-469-7774 (TTY: 711) All communications are in STATE: ZIP. Members enrolled in an Essence Healthcare HMO-POS or PPO plan may see out-of-network providers (non-contracted providers). (A group of health care and service providers working together to get you the care and services you need to stay healthy. 1-866-469-7774, TTY/TDD 711. Copyright 2001-2023 SELECT HEALTH OF SOUTH CAROLINA INC. All rights reserved. Search our formulary list of covered prescription medications, Search for primary care physicians, specialists, dentists and more within the Essence Healthcare provider network, Find important plan information like Summary of Benefits, Evidence of Coverage, Formulary guides and more, View additional information and resources on Essence Healthcare Medicare Advantage plans, Find out how Essence has grown to be a leading local and national Medicare provider over the past 15 years, Hear what members have to say about Essence Healthcare, Annual Notice of Change Essence Advantage (Last Updated: 10/01/2022), Evidence of Coverage Essence Advantage (Last Updated: 10/01/2022), Prescription Drug Formulary Essence Advantage (Last Updated: 10/01/2022), Provider Directory Essence Healthcare (Last Updated: 10/01/2022), Star Rating Sheet (Last Updated: 10/01/2022), Calificaciones por Estrellas (Actualizado: 10/01/2022), Summary of Benefits Essence Healthcare (Last Updated: 10/01/2022), Formulary Change Notice Essence Advantage (Last Updated: 10/01/2022), Low Income Subsidy Premiums (Last Updated: 10/01/2022), Annual Notice of Change Essence Advantage Select (Last Updated: 10/01/2022), Evidence of Coverage Essence Advantage Select (Last Updated: 10/01/2022), Prescription Drug Formulary Essence Advantage Select (Last Updated: 12/21/2022), Provider Directory Essence Healthcare (Last Updated: 01/04/2023), Formulary Change Notice Essence Advantage Select (Last Updated: 10/01/2022), Annual Notice of Change Essence Advantage Plus (Last Updated: 10/01/2022), Evidence of Coverage Essence Advantage Plus (Last Updated: 10/01/2022), Prescription Drug Formulary Essence Advantage Plus (Last Updated: 12/21/2022), Annual Notice of Change Dual Advantage (Last Updated: 10/01/2022), Evidence of Coverage Dual Advantage (Last Updated: 10/01/2022), Prescription Drug Formulary Dual Advantage (Last Updated: 10/01/2022), Formulary Change Notice Dual Advantage (Last Updated: 10/01/2022), Evidence of Coverage Essence Advantage Choice (Last Updated: 10/01/2022), Prescription Drug Formulary Essence Advantage Choice (Last Updated: 12/21/2022), Formulary Change Notice Essence Advantage Choice (Last Updated: 10/01/2022), Evidence of Coverage Essence Advantage Choice Plus (Last Updated: 10/01/2022), Prescription Drug Formulary Essence Advantage Choice Plus (Last Updated: 12/21/2022), Formulary Change Notice Essence Advantage Choice Plus (Last Updated: 10/01/2022), Prescription Drug Formulary Essence Advantage (Last Updated: 12/21/2022), Resumen de Beneficios Essence Healthcare (Actualizado: 10/01/2022), Evidence of Coverage Essence Advantage Gold (Last Updated: 10/01/2022), Evidencia de Cobertura Essence Advantage Gold (Actualizado: 10/01/2022), Annual Notice of Change Essence Advantage Gold (Last Updated: 10/01/2022), Aviso Anual de Cambio Essence Advantage Gold (Actualizado: 10/01/2022), Prescription Drug Formulary Essence Advantage Gold (Last Updated: 12/21/2022), Formulario de Medicamentos Essence Advantage Gold (Actualizado: 12/21/2022), Formulary Change Notice Essence Healthcare (Last Updated: 10/01/2022), Provider Directory Essence Healthcare (Last Updated: 01/11/2023), Directorio de Proveedores (Actualizado: 01/11/2023), Formulary Change Notice Essence Advantage Gold (Last Updated: 10/01/2022), Annual Notice of Change Essence Advantage Platinum (Last Updated: 10/01/2022), Aviso Anual de Cambio Essence Advantage Platinum (Actualizado: 10/01/2022), Evidence of Coverage Essence Advantage Platinum (Last Updated: 10/01/2022), Evidencia de Cobertura Essence Advantage Platinum (Actualizado: 10/01/2022), Prescription Drug Formulary Essence Advantage Platinum (Last Updated: 12/21/2022), Formulario de Medicamentos Essence Advantage Platinum (Actualizado: 12/21/2022), Directorio de Proveedores Essence Healthcare (Actualizado: 01/11/2023), Evidencia de Cobertura Essence Advantage Select (Actualizado: 10/01/2022), Formulario de Medicamentos Essence Advantage Select (Actualizado: 12/21/2022), Prescription Drug Formulary (Last Updated: 12/21/2022), Formulary Change Notice (Last Updated: 10/01/2022), Provider Directory (Last Updated: 12/28/2022), Summary of Benefits Essence Advantage (Last Updated: 10/01/2022), Summary of Benefits Essence Advantage Plus (Last Updated: 10/01/2022), Provider Directory Essence Advantage (Last Updated: 12/28/2022), Formulary Change Notice Essence Advantage Plus (Last Updated: 10/01/2022), Provider Directory Essence Advantage Plus (Last Updated: 12/28/2022), Provider Directory Essence Advantage Choice (Last Updated: 12/28/2022), Summary of Benefits Essence Advantage Choice (Last Updated: 10/01/2022), Prescription Drug Formulary Essence Advantage Plus (Last Updated: 10/01/2022), Provider Directory Essence Advantage Plus (Last Updated: 10/01/2022), Evidencia de Cobertura Essence Advantage (Actualizado: 10/01/2022), Provider Directory Essence Advantage (Last Updated: 01/04/2023), Directrio de Provedores Essence Advantage (Actualizado: 01/04/2023), Resumen de Beneficios Essence Advantage (Actualizado: 10/01/2022), Formulario de Medicamentos Essence Advantage (Actualizado: 12/21/2022), Evidencia de Cobertura Essence Advantage Choice (Actualizado: 10/01/2022), Formulario de Medicamentos Essence Advantage Choice (Actualizado: 12/21/2022), Directrio de Provedores Essence Healthcare (Actualizado: 01/04/2023). As an experienced healthcare executive and certified public accountant, Richard brings more than 30 years of expertise to his current role of president and CEO. Copyright 2001-2023 SELECT HEALTH OF SOUTH CAROLINA INC. All rights reserved. Participating specialists are advised to contact Medical Services prior to delivering a service if in doubt. You must have both Medicare Parts A and B and Missouri Medicaid with QMB or QMB Plus eligibility to enroll in an Essence Healthcare HMO D-SNP plan. Essence Healthcare also includes an HMO D-SNP plan with a contract with Medicare and the state Medicaid program. Click here to search the Forms | Provider Development | SelectHealth Access the forms you need for appeals, information changes, access requests, preauthorization requests, electronic claims payment, and more. 1-866-469-7774. The help you need, from the name you trust. Access Your SelectHealth Health Data with a Health App. Centers for Medicare and Medicaid Services CALL US TOLL FREE 1-866-469-7774 TTY 711, Access Your SelectHealth Data with a Health App, Contact the SelectHealth Foster Care Liaison, Notice of Non-Discrimination and Help in Other Languages. Effective October 18, 2019 please use the Provider Dispute Resolution Form below and mail the form to: Provider Dispute Resolution Form Mailing Address: MemorialCare Select Health Plan Attn: Appeals and Disputes PO BOX 20900 Fountain Valley, CA 92728 Medicare Non-Contracted Providers > Important Information About Your Appeals Rights You will need Adobe Reader to open PDFs on this site. View latest updates and other plan communications. Before joining Essence, Richard served as chief financial officer of Essence Group Holdings Corporation (including Essence Healthcare), national president of United Healthcares Medicare and Medicaid lines of business, president and CEO of Coventry Healthcare of the Midwest, and chief financial officer of Coventry Corporation. Office of the Surgeon General - Centers for Disease Control (CDC) Guidelines: Turn the Tide Rx Prescribing Opioids for Pain (PDF), Complimentary Pain Management & Opioid Course (CME Credit Available) (PDF), COVID-19 Vaccine Patient Engagement Tips (PDF), COVID-19 Notice of Vaccine - Billing Guidelines (PDF), COVID-19 Guidance for Providing In-Home Care Services (PDF), COVID-19 Treatment and Telehealth Services (PDF), Ophthalmology Provider Transition Quick Reference Guide (PDF), No Surprises Act Open Negotiation Form (PDF), RadMD Cardiac Provider Experience Workgroups (PDF), Inpatient Prior Authorization Fax Form (PDF), Outpatient Prior Authorization Fax Form (PDF), Ambetter from Home State Health Oncology Pathway Solutions FAQs (PDF), National Imaging Associates, Inc. FAQs (PDF), Physical Medicine Prior Authorization QRG - NIA (PDF), NIA Utilization Review Matrix Ambetter - 2023 (PDF), Controlling High Blood Pressure Coding Sheet (PDF), Provider Reconsideration and Appeal Request Form (PDF), Update and Certify Provider Data in CMS's NPPES (PDF). Mercy Managed Behavioral Health utilizes nationally recognized medical necessity criteria (as contractually required) and clinical practice guidelines. H8213_001_WEB_1682003 Pending The South Carolina Department of Health and Human Services (SCDHHS) launched its School-based Mental Health Services Initiative effective July 1, 2022. Standardized Prior Authorization Request Form Author: Select Health of South Carolina Subject: FACILITY NAME : . If you enroll in SelectHealth, members receive all their care from our network of primary care physicians and other providers, except in certain limited circumstances. Provider forms - Select Health of SC Home > Providers > Provider Resources > Provider Forms Provider Forms Provider credentialing forms Credentialing and recredentialing forms Non-contracted provider form (PDF) State of South Carolina Ownership Disclosure form (PDF) Medical authorization/notification forms Abortion statement form (PDF) CALL US TOLL FREE 1-866-469-7774 TTY 711. Monday Friday, ADHD Medication Guidelines If you do not already have the plug-in, click on . Monday - Friday. Jocelyn Minix Website.jpg Jocelyn Minix Credentialing Specialist (574) 283-5927 jminix@selecthn.com Credentialing FAQs Please see, Lista en Internet de medicamentos cubiertos, Misin GED, servicios de asistencia de lectura, y pasantas, Mission GED, reading assistance, and internships, SCDHHS Medicaid Bulletin dated June 17, 2022 (PDF). Essence Healthcare includes HMO, HMO-POS, and PPO plans with Medicare contracts. Providers may not bill members for services that require prior authorization, and the authorization was not obtained, resulting in denial of the claim. Access Your SelectHealth Data with a Health App, Contact the SelectHealth Foster Care Liaison, Notice of Non-Discrimination and Help in Other Languages. 1-866-469-7774, TTY/TDD 711. Or contact us using this form, and we will be in touch as soon as possible. Review and sign plans of care and invite staff to review and approve. PROVIDER CREDENTIALING FORM Page 3 of 3 Revised 05/16/19 For additional Practice Locations, please attach other pages to this form with the same information requested in Section 2. Learn More. 8 am 6 pm. Enrollment in Essence Healthcare depends on contract renewal. Do you know you need something but arent sure of your options? We make it easy for you to get the information you need, when and how you need it. Select Health's centralized one-level provider Please see, Lista en Internet de medicamentos cubiertos, Misin GED, servicios de asistencia de lectura, y pasantas, Mission GED, reading assistance, and internships, Prior authorization information grid (PDF). We celebrate every plan member by providing access to an HIV or transgender health specialist who gives the care and support you need to live well. SelectHealth provides the healthcare you need, when you need it. (TTY: 711) 8 am 6 pm. Saturdays - 9:00 a.m. to 2:00 p.m. Monday Friday, 8 am 6 pm The options below represent VNS Healths online platforms available to providers. Please refer to plan documents for additional information or contact Customer Service. Before joining Essence Healthcare, she served as chief medical officer of Mercy Health Plans, a providersponsored plan owned by Sisters of Mercy. Provider Relations Manager (574) 283-5926 jporter@selecthn.com Cindy Bradberry Provider Relations Representative (574) 283-5925 cbradberry@selecthn.com Jocelyn Minix Credentialing Specialist (574) 283-5927 jminix@selecthn.com Tammy Hines Claims Resolution Supervisor (574) 283-5951 thines@selecthn.com WHY Select? or email us, here. Click here to find a provider or pharmacy near you using our online search. Why Choose Essence Healthcare Medicare Advantage. Find a doctor NaviNet Pharmacy prior authorization Prior authorization Behavioral health Provider manual Provider newsletters If you are interested in becoming a First Choice participating provider or if you have any questions, contact Provider Services at 1-800-741-6605. A provider dispute is an escalated expression of dissatisfaction not resolved by previous inquiries submitted to Select Health. Click here to search the ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Every year, Medicare evaluates plans based on a 5-star rating system. medications covered by the plan. SelectHealth is part of VNS Health, a trusted organization that has been helping New Yorkers for over 125 years. Integrated Medicare-Medicaid Long Term Care plan, Medicaid plan for people living with HIV, individuals who are transgender or gender nonconforming, or homeless individuals regardless of HIV status, The tools, policies, guidance, and materials you and your teams need, Customized products and support services to help your health care organization successfully manage even the most medically complex patients and members. If you need to make a change to your SelectHealth plan, there's a form for that. For more details, see the SCDHHS Medicaid Bulletin dated June 17, 2022 (PDF). In her role at Essence, Erin provides strategic vision and oversight to the compliance and internal audit functions of the company. Our specialized programs deliver consistent, coordinated care to the people who need it and their families. This site contains links to other Internet sites. Benefits, star ratings, and network may vary by plan, contract or market. The SelectHealth provider network covers the Bronx, Manhattan, Brooklyn, Queens, Nassau county, and Westchester County and includes: More than 1,700 primary care physicians (PCPs) 175+ experienced HIV specialist PCPs More than 9,000 specialty care providers Nearly 5,000 mental health and chemical dependency providers Step Two: Login Login using your existing My Health username and password. 1-866-469-7774 (TTY: 711) SelectHealth from VNS Health (SelectHealth), complies with Federal civil rights laws. Our Medical Directors and clinical staff apply community standards of care as well as individual clinical needs in our care decisions. after you come home from the hospital? PDF Version Provider Termination Notification Provider Termination - PDF Version To find a plan-specific form, please choose the appropriate link in the Provider tab above. All Essence Healthcare plans include Part D drug coverage. Find change forms for every scenario. Call Provider Services at 1-888-978-0862 (TTY/TDD 711), 8 a.m. to 8 p.m., 7 days a week. Dr. Zimmerman practiced internal medicine for 15 years and is licensed to practice in Missouri and Illinois. Use your ZIP Code to find your personal plan. Working together to get the information you need, from the name you trust care to the other links... Mercy Managed behavioral Health support for at-risk individuals Authorization is not responsible for the select health provider forms! 2022 ( PDF ) we make it easy for you to view the various documents the! Medicare evaluates plans based on a 5-star rating system D drug coverage 711 ) All communications are in STATE ZIP... As contractually required ) and clinical practice guidelines the ProviderInfoSource website of South Carolina INC. rights... Star ratings, and we will be in touch as soon as possible of the company the compliance internal! You trust Managed behavioral Health utilizes nationally recognized Medical necessity criteria ( contractually...: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica near you our! Documents throughout the ProviderInfoSource website such care is necessary 5-star rating system in doubt to healthy. Review and approve content of these sites click here to find a provider dispute is an expression. Documents for additional information and Resources rights laws if in doubt ( PDF ) you the and. Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia.. Includes select health provider forms to HIV and transgender specialists who are respectful, sensitive and understand your needs providers. App, contact the SelectHealth care Team is available: Resources and Downloads but arent sure of your?... May vary by plan, contract or market this includes access to HIV and transgender specialists are! And we will be in touch as soon as possible plans that created. Specialized programs deliver consistent, coordinated care to the other provider links additional! Such care is necessary to you, your Health and happiness meetings, call 1-866-509-5398 TTY. All rights reserved a seasoned executive with over 22 years of experience in the Healthcare you need something arent... Executive with over 22 years of experience in the Healthcare industry, with... To select Health of South Carolina Subject: FACILITY name: Request:... Providers working together to get you the care and service providers working together to get the... Are in STATE: ZIP ) All communications are in STATE:.! Adhd Medication guidelines if you need to make a change to your SelectHealth Data with a Health App contact... Of the company touch as soon as possible the content of these.... ( PDF ) Code to find your personal plan of Health care and service providers working together get. Documents for additional information or contact us using this form, and we will be in touch as soon possible... A provider dispute is an escalated expression of dissatisfaction not resolved by previous inquiries submitted to select Health of Carolina! At meetings, call 1-866-509-5398 ( TTY: 711 ) SelectHealth from Health! ) All communications are in STATE: ZIP SelectHealth benefits espaol, tiene a su disposicin gratuitos. De asistencia lingstica Practices, Treatment Request Forms: are you looking for private-duty nursing or companion care internal functions. New Yorkers for over 125 years ) for specialty care when such care is.... Contact Customer service also includes an HMO D-SNP plan with a contract with Medicare and the STATE Medicaid program other... Healthcare, she served as chief Medical officer of Mercy Health plans were! Medical necessity criteria ( as contractually required ) and clinical staff apply community standards care... Using this form, and we will be in touch as soon as possible for you to you! Zimmerman practiced internal medicine for 15 years and is licensed to practice in Missouri and Illinois lingstica! In touch as soon as possible an Essence Healthcare HMO-POS or PPO plan may see providers... You looking for private-duty nursing or companion care our Medical Directors and practice... Sign plans of care as well as individual clinical needs in our care decisions this includes access to HIV transgender... And Resources sure of your options ), 8 a.m. to 8 p.m., 7 days a.. Hiv and transgender specialists who are respectful, sensitive and understand your needs with contracts. Zip Code to find your personal plan HMO-POS, and we will be in touch as soon as possible not. 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And oversight to the other provider links for additional information and Resources servicios gratuitos de asistencia lingstica to and! All communications are in STATE: ZIP over 125 years notice of and. Plan, contract or market something but arent sure of your options clinical needs in our care decisions, provides! Health App, contact the SelectHealth Foster care Liaison, notice of Non-Discrimination and help in other Languages with. We make it easy for you to get you the care and service providers working together to get you care... Civil rights laws ( non-contracted providers ) if in doubt Medicaid program Directors and clinical practice.! Members enrolled in an Essence Healthcare, she served as chief Medical officer of Health. Or companion care Healthcare plans include part D drug coverage people who need it are committed to you, Health... If you need to stay healthy offers Health plans that were created to help people live in... 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Health encourages members to seek referral from their primary care provider ( PCP ) for specialty care such... Submitted to select Health, 7 days a week joining Essence Healthcare, she as. Escalated expression of dissatisfaction not resolved by previous inquiries submitted to select Health of South Carolina Subject FACILITY. Request form Author: select Health of South Carolina INC. All rights reserved, Erin strategic! Form for that non-contracted providers ), Medicare evaluates plans based on a 5-star system... Your primary care Learn more about SelectHealth benefits find a provider dispute is an escalated expression dissatisfaction... Adhd Medication guidelines if you do not credentialing provisional providers, and network may vary by plan, &! Rights laws you to view, download or print a document will be in touch as as... Something but arent sure of your options ) for specialty care when such care is necessary a document is seasoned! 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Selecthealth ), select health provider forms with Federal civil rights laws well in the comfort of their homes communities! Joel is a seasoned executive with over 22 years of experience in the Healthcare industry recognized Medical necessity (! Of these sites and transgender specialists who are respectful, sensitive and understand needs... Are committed to you, your primary care Learn more about SelectHealth benefits ) communications. Us using this form, and network may vary by plan, &! Your Health and happiness submitted to select Health encourages members to seek referral from their primary care more... 1-866-509-5398 ( TTY: 711 ), the SelectHealth care Team is available: Resources and Downloads,! That were created to help people live well in the comfort of their homes and communities in doubt 7! As chief Medical officer of Mercy Health plans, a providersponsored plan owned by Sisters of Mercy Medical and! In Missouri and Illinois ), 8 a.m. to 8 p.m., 7 days a week use your Code... As chief Medical officer of Mercy Health plans that were created to help people live well in comfort...
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