endobj <>/DR<>/Font<>>>/F 4/P 4 0 R /Parent 130 0 R /Rect[ 496.92 51.72 579.48 74.28]/Subtype/Widget/Type/Annot>> Box 853921 Richardson, TX 75085-3921 Fax: 1.763.852.5057 , https://www.health-improve.org/meritain-health-claim-mailing-address/, Health (9 days ago) Web(9 days ago) WebMeritain Health Claims Mailing Address Health (9 days ago) Web (1 days ago) WebHealth Claim Form Complete and send to: Meritain Health P.O. trailer If youve already registered, we hope youll visit again. 48 0 obj 25 16 0000070600 00000 n endobj 62 0 obj Contact us at 1.800.925.2272 if you have . endstream Welcome to Meritain Health. endstream endobj 26 0 obj<> endobj 27 0 obj<> endobj 28 0 obj<>/ColorSpace<>/Font<>/ProcSet[/PDF/Text/ImageC]/ExtGState<>>> endobj 29 0 obj<> endobj 30 0 obj<> endobj 31 0 obj<> endobj 32 0 obj[/ICCBased 38 0 R] endobj 33 0 obj<> endobj 34 0 obj<> endobj 35 0 obj<> endobj 36 0 obj<>stream 90 0 obj H23U0t.=s#0ag If you're a Client or Broker, please contact your Meritain Health Manager. 91 0 obj hb``c``ja```01G30323Zq@ [s8cz^TV`8A X/@` u 0000000934 00000 n <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream H23U0t.=s#0agf!R@PBLX n For language services, please call the number on your member ID card and request an operator.Is meritain the same as Aetna?psichologyanswers.com/library/lecture/read/489793-is-meIs meritain part of Aetna?Meritain Health will become part of the Aetna family, part of a $600 million acquisition of Meritains parent company announced Thursday at Aetnas quarterly shareholders meeting. All rights reserved | Email: [emailprotected], Unitedhealthcare medicare advantage claims address, Drexel behavioral health continuing education, Prohealth westwood health and fitness center, Shadow health gastrointestinal subjective. Electronic Claims Address CLAIM STATUS/ PROVIDER RELATIONS APPLICABLE STATE Carpenters' Health & Welfare Trust Fund Meritain Health PO Box 853921 Richardson, TX 75085-3921 (87 Web MD/Emdeon, #41124 or McKesson/Relay Health 1761 (314) 644-4802 ext. 2JSt}Np~}y7i6i~..jnfE6zS\0 u}&p[ @68_=emL&Zqk$AT1KY$C#}Ra|h0{81[Gd8mdmmS4i\&;E 40 0 obj The formal written appeal and these forms would then be sent to the address of the Meritain Health Appeals Department (listed on form) by the provider. endobj 0000263210 00000 n endobj endobj <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 143.52 401.52 153.6 411.48]/Subtype/Widget/T(No go to section 4)/TU(No \(go to section 4)/Type/Annot>> endobj 106 0 obj 0000002362 00000 n 0000071487 00000 n Transition or Continuity of Care (in Spanish). endobj endstream 46 0 obj xPpurb & Please have your tax ID number, provider name and address exactly as it appears on the W-9 you submitted along with your NPI and phone number. 0000018652 00000 n <>/Subtype/Form/Type/XObject>>stream endobj endobj Please note, the claims appeal procedure is explained at length within each groups Summary Plan Description (SPD). Were making access just a click away. xPpurb & endobj To reach us by phone, dial the toll-free number on the back of the patient's ID card. H23U0t.=s#0agf!R@PBLX n <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 237.84 238.2 247.8 248.16]/Subtype/Widget/T(undefined_3)/TU(undefined)/Type/Annot>> xPpurb & 92 0 obj Skip to content. 67 0 obj For 24-hour access to your patients health information,log in to your account. xPpurb & 25 0 obj <> endobj 1 Health and Welfare IBEW Local 1 Health & Welfare Fund To reach us by phone, dial the toll-free number on the back of the patients ID card. endobj 0000020823 00000 n HWnF}G(W{_04A>ye $wfI@b3mltGgI4xmjwKfIah8`g4Bp0z'}$O2%. 0000002739 00000 n x3P0 t.C=3C=3=3 6P(JJ grs Box 853921 Richardson, TX 75085-3921 Fax: 1.763.852.5057 Email: Health-improve.org Category: Health Detail Health Meritain Health Benefit/Claim Customer Service 1 Health 0000002847 00000 n 0000023547 00000 n Aetna Claim Address|Aetna Provider Phone Number Updated (2023) 100 0 obj endstream endobj 238 0 obj <>/Filter/FlateDecode/Index[6 133]/Length 27/Size 139/Type/XRef/W[1 1 1]>>stream You might occasionally. endobj endobj Doctor Lookup. <>/Subtype/Form/Type/XObject>>stream This content is being provided as an informational tool. xPpurb & Box 7796 London, KY 40742 (877) 232 . endobj Electronic Claims Address CLAIM STATUS/ PROVIDER RELATIONS Carpenters' Health & Welfare Trust Fund Meritain Health PO Box 853921 Richardson, TX 75085-3921 . <>/Subtype/Form/Type/XObject>>stream PDF Meritain Health Customer Service - EPC Copyright 2023 Meritain Health. endobj We are your Advocates for Healthier Living, and were here to connect you and your family to the care you need, right when you need it. endobj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 402.96 506.76 534.6 528.96]/Subtype/Widget/T(Childs Name first last initial)/TU(Childs Name \(first, last, initial\))/Type/Annot>> endobj Mail completed Meritain Health form to: P.O. For the fastest service, dial the toll-free number on the back of your ID card. 79 0 obj endstream 87 0 obj endstream 0000124097 00000 n hbbd```b`` "A"BA$0"Y)0 * dP=&m$ N r V>j>Or`DVGlM|v]%Yv+)mv>m{=umfofn]{H+T(T014p0fcO&qtkO^);nu|2@]T Gdd,LO~|4 ^'A{ @21xqW 1`6U xPpurb & endobj endstream For ALL claims, this area must be filled in completely. endstream We're making access just a click away. 56 0 obj For 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. Meritain Health endobj Purpose: why do you want the information released? 81 0 obj x3P0 t.C=30agE\i\ gs endstream endobj <>/Subtype/Form/Type/XObject>>stream 138 0 obj 9fK3J*9zl3$6)6}t+d=u+iTv5G(. h|]1Lf2wO^%L[^'t7o1/ V5?? xPpurb & 0000000016 00000 n 0000002399 00000 n <>/Subtype/Form/Type/XObject>>stream After logging in to your Meritain Health account, click on the Submit a Claim link at the top of the page. %PDF-1.4 % <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 483.12 599.04 512.16 621.24]/Subtype/Widget/T(Birthdate)/TU(Birthdate)/Type/Annot>> 119 0 obj All rights reserved. Meridian Phone Members: 888-437-0606 (TTY 711) Providers: 888-773-2647 (TTY 711) Meridian's regular business hours are Mon - Friday 8am-6:30pm EST. specific needs. 154 0 obj 131 0 obj xPpurb & <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 235.56 541.08 245.64 551.16]/Subtype/Widget/T(Employees Spouse)/TU(Employees Spouse)/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream If you're a Member or Provider please call 888-509-6420. 0000047633 00000 n <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 371.52 575.64 449.16 597.84]/Subtype/Widget/T(Work Telephone)/TU(Work Telephone \( \))/Type/Annot>> endstream 152 0 obj If your ID card is available, please use the number on the back for faster service. <>/N<>>>/AS/Off/BS<>/F 4/MK<>/P 4 0 R /Parent 128 0 R /Rect[ 190.56 198.96 200.64 209.04]/Subtype/Widget/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream endobj <>/Subtype/Form/Type/XObject>>stream 97 0 obj 139 101 endobj H23U0t.=s#0ag For 24-hour access to your personal health information,log in to your account. 145 0 obj 0000018717 00000 n 0000002620 00000 n endobj endobj 17 0 obj Get Meritain Vision Claim Form - US Legal Forms PO Box 853921 endstream If you have questions about claims or benefits, we're happy to help. 0000243461 00000 n <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 376.92 75.6 579.6 95.64]/Subtype/Widget/T(Employees Signature)/TU(Employees Signature)/Type/Annot>> 0000005765 00000 n endstream 0000001225 00000 n xPpurb & <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream endobj "LR <>/Subtype/Form/Type/XObject>>stream endobj <>/Subtype/Form/Type/XObject>>stream The Authorization for Release of Information form is required according to the guidelines set forth in the Health Insurance Portability and Accountability Act (HIPAA), specifically 45 CFR 164.508 of the HIPAA Regulations. <>/Subtype/Form/Type/XObject>>stream x Via Meritain's Provider Relations Team: 866-761-3018 a. ,L"\H4~Zzyv4vet{&+8*BYOl+:;C ks#6i}$9wNB;I@~d hop^F. To reach us by phone, dial the toll-free number on the back of the patients ID card. 72 0 obj 0000195637 00000 n 0000153847 00000 n [ 6 0 R 10 0 R 12 0 R 14 0 R 16 0 R 18 0 R 20 0 R 22 0 R 24 0 R 26 0 R 28 0 R 30 0 R 32 0 R 37 0 R 42 0 R 47 0 R 49 0 R 51 0 R 53 0 R 55 0 R 57 0 R 59 0 R 61 0 R 63 0 R 65 0 R 67 0 R 72 0 R 77 0 R 79 0 R 81 0 R 83 0 R 85 0 R 87 0 R 89 0 R 91 0 R 96 0 R 101 0 R 103 0 R 105 0 R 107 0 R 109 0 R 111 0 R 116 0 R 121 0 R 123 0 R 128 0 R 133 0 R 135 0 R 137 0 R 139 0 R 144 0 R 149 0 R 151 0 R 153 0 R 155 0 R 157 0 R ] You can see the specialist you choose without a referral.. 37 0 obj xPpurb & Section 1. With wellness programs, on-demand tools, resources and caring support, Meritain Health puts easy-to-use health care at your fingertips. If you havent created an account, click Register at the top right of this page and follow the prompts. endstream endobj endobj endobj 0000244628 00000 n If you need help registering or logging in, contact Meritain customer service at 866.761.3018 3. 11 0 obj 174 0 obj <> endobj H|VYOF~G[Z7} X#`) 4cb{X_5 Your patients health and your ability to access their information is important to us. 51 0 obj endobj Provider Quick Reference Guide - MultiPlan To reach us by phone, dial the toll-free number on the back of the patient . endstream All rights reserved. 14 0 obj 50 0 obj 7 0 obj <>/Subtype/Form/Type/XObject>>stream xb```f`` |@1V Xpc>'Y&y7PhKZVQH0XDA1 <>/Subtype/Form/Type/XObject>>stream endobj For more information, please call Meridian Member Services at 888-437-0606 (Michigan) or 866-606-3700 (Illinois). <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 77.52 599.04 341.16 621.24]/Subtype/Widget/T(Home Address)/TU(Home Address)/Type/Annot>> address where services were provided and Tax Identification Number (TIN) z Detailed invoice including CPT code or description of services and diagnosis code How to submit a claim online 1. Box 853921 Richardson, TX 75085-3921 Fax: 1.763.852.5057 0 On-demand services such as Teladoc, giving you access to qualified physicians 24/7/365 by phone, online or app, Convenient access to information and support via our online member portal, Meritain Health app, printed and digital resources, and customer service, Healthcare Bluebook, an online tool that allows you to compare health care services you need to find the best prices, Access to wellness programs like the Healthy Merits Wellness Program, letting you focus on your own wellness journey in areas like nutrition, fitness, financial wellness, and social and emotional health, Aetnas network of providers, connecting you to over 600,000 doctors and ancillary providers nationwide, Nurse Health Coaching and support services for your health care journey, including diabetes care and fertility care. x3P0 t.C=63E\i\ g3s endstream endstream 1 0 obj <>/Subtype/Form/Type/XObject>>stream 0000005626 00000 n endstream <>/Subtype/Form/Type/XObject>>stream Select Dental and DVH (Dental Only) ** Network by Aetna. Meritain Health builds connections and solutions that drive down 47 0 obj endobj Individuals & Families. endobj Addresses and accounts , https://www.mbh-eap.com/wp-content/uploads/Claim-Submission-and-Payment-Addresses-7-1-2017.pdf, Health (2 days ago) WebContact us. 0000077747 00000 n Have you checked out your personalized web site? xPpurb & endobj 19 0 obj If the patient is the employee, go directly to the area below the shaded box. h\O(DaDHK%aai"bca3e1KN[2F7pt;==:D/dHie,C6nkd0l`r <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 278.04 506.76 302.88 528.96]/Subtype/Widget/T(Sex_2)/TU(Sex)/Type/Annot>> 93 0 obj <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 359.76 483.36 441.24 505.56]/Subtype/Widget/T(Childs Birthdate)/TU(Childs Birthdate)/Type/Annot>> Welcome to Meritain Health - Meritain Health endobj endstream Your patients health and your ability to access their information is important to us. 2 0 obj <>/Subtype/Form/Type/XObject>>stream Looking to build a benefits plan? endobj 1-866-221-4988. (5 days ago) WebClaims Mailing Address: Meritain Health PO Box 853921 Richardson, TX 75085-3921. endobj %PDF-1.4 % 120 0 obj Aetna Meritain Health Claims Address endobj 57 0 obj Section 2. 123 0 obj endstream xPpurb & %PDF-1.5 % 13 0 obj xPpuVru 117 0 obj 0000244743 00000 n 0000030531 00000 n H23U0t.=s#0agf!R As a member, you can log into your member portal for a more personalized experience. 0000075005 00000 n Our innovative solutions identify emerging products and trends for better member engagement, improved outcomes and lower costs. <>/Subtype/Form/Type/XObject>>stream Toll free number 800.877.1444 Clients/Payers: For claims and other inquiries, you can request service online here or call 800.877.1444 Healthcare Providers: For the fastest service, please contact us online here or use the contact information provided here. 0000243858 00000 n endobj Meritain Health Provider Services - Meritain Health Address, phone number, and practice changes Contact us online Contact us by phone For non-participating health care professionals Network applications (behavioral health, dental, facility, and pharmacy) Practice changes and provider termination Request a medical application Request Part D pharmacy participation 28 0 obj Allow time for your claim to be processed and your reimbursement check to be mailed to you. <>/Subtype/Form/Type/XObject>>stream endobj H23U0t.=s#0agf!R All rights reserved. You can locate the number on the back of your ID Card. Questions? <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 233.16 371.76 372.6 393.96]/Subtype/Widget/T(Address)/TU(Address)/Type/Annot>> "LR@PBPBLM, k PDF Important Information for Healthcare Providers 0000220357 00000 n Our Meritain Health client management team is by far the best weve ever worked with. You can submit . endstream <>/Subtype/Form/Type/XObject>>stream endobj endobj endobj Health (3 days ago) WebFor 24-hour automated phone benefits and claims information, call us at 1.800.566.9311. 4 0 obj Hours are 5 am - 6 pm PST. Richardson, TX 75085. x <>/Subtype/Form/Type/XObject>>stream endstream x3P0 t.C=C=33=aP gos 45 0 obj x To reach us by phone: For the fastest service, dial the toll-free number on the back of your ID card or call 1.888.324.5789 ** This is a general line, so you may experience hold times and/or need to be transferred. xPpurb & At Meritain Health, our goal is simpletake a creative approach to health care and build industry-leading connections. 20 0 obj x3P0 t.C=63E\i\ g3s endobj s0G}JbfX^Z@0R ;]Vomm.mu:bq[0iiz=s7^weqE|ZV%%|-%9 Provider services - Meritain Health. 0000026482 00000 n <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 433.2 622.44 579.6 644.52]/Subtype/Widget/T(Employer Name)/TU(Employer Name)/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream xPpurb & 15 0 obj <>/Subtype/Form/Type/XObject>>stream 31 0 obj 566.9311. 0000003072 00000 n Sure, youve probably trusted a gut feeling when deciding something. endobj <>/Subtype/Form/Type/XObject>>stream 127 0 obj endstream <<3E4E844C759D00498F9F96196CE1CA18>]>> <>/Subtype/Form/Type/XObject>>stream Customer service representatives are available to help you Monday through Fridayjust call 1.800.925.2272. . endobj endobj endstream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 142.44 254.76 219.48 279]/Subtype/Widget/T(Injury Illness Date and time of accident)/TU(Injury Illness Date and time of accident:)/Type/Annot>> <> 58 0 obj <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream Meritain Health Mailing Address For Claims <>/Subtype/Form/Type/XObject>>stream 0000009558 00000 n xPpurb & <>/Subtype/Form/Type/XObject>>stream 71 0 obj endstream 39 0 obj By prioritizing data for plan building and success to a variety of member tools, well support you every step of the way. 0000007217 00000 n 0000075478 00000 n 89 0 obj <> endstream H23U0t.=s#0agf!R@PBLX n The member whose information is to be released is required to sign the authorization form. <>/Subtype/Form/Type/XObject>>stream Section 4. endobj endobj Contact Aetna xPpurb & 300K . 0000070996 00000 n x endobj endstream 0000026596 00000 n LA[@:Ty6jI ]( endobj Box 30111 Health (3 days ago) WebAddress: Telephone #: City: State: Zip: Is this a change of address? endobj Your patients health and your ability to access their information is important to us. Mail the Claims Form and supporting documents to the address on the Claim Form or on the back of your Member ID Card. IMPORTANT: Please have your doctor or supplier of medical services complete the reverse of this form or attach a fully itemized bill. endobj Have your ID card with you so set-up is fast and easy. }i&;nHf%l#%YYN:,#OY%, O$S-]2!Q` [Bp x endobj 0000091570 00000 n 32 0 obj Click the Register button to get started. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 464.16 213.36 579.84 225.24]/Subtype/Widget/T(Address city state zip)/TU(Address \(city, state, zip\))/Type/Annot>> 0000026709 00000 n endobj This means we can connect you to over 700,000 providers nationwide, unmatched network discounts and one of the largest pharmacies. endobj x 0000243974 00000 n 103 0 obj endobj endobj <>/Subtype/Form/Type/XObject>>stream endobj <>/Subtype/Form/Type/XObject>>stream Once you register, youll be able to view: If you are a client or broker with questions about an existing plan, please contact your client solutions manager. 156 0 obj Protect yourself and your community.Telehealth for Cold and Flu - Meritain Healthwww.meritain.com/telehealth-for-cold-and-flu/FeedbackMeritainhttps://www.meritain.com/about-us-self-fundedProvider services - Meritain HealthWebIf you have questions about claims or benefits, were happy to help. Email Members: memberservices.mi@mhplan.com Mail Meridian 777 Woodward Ave, Ste 700 Detroit, MI 48226 Meridian Healthy Michigan Phone endobj endstream Meritain health prior authorization form, Health (8 days ago) FeedbackThanks!Tell us moreWelcome to the new BingYour AI-powered copilot for the webAsk anythingLet's ChatPeople also askIs meritain health the same as Aetna?Meritain Health is a subsidiary of Aetna and is one of the nations largest administrators of health benefits. endstream endobj 178 0 obj <>stream %%EOF x3P0 t.C=63E\i\ g3s 151 0 obj Customer Service for answers to questions you might have about your benefits, eligibility, claims and more. !@;P`C&Nu:cHe,S Ms WqY+oApg]DLz948=j\#.$,^`#s%/"8@GIL3K endstream 0000000016 00000 n 0000071642 00000 n x3P0 t.C=3C=3=3 6P(JJ grs endobj endobj xref We are your Advocates for Healthier Living, and we're here to connect you and your family to the care you need, right when you need it. endstream 10 0 obj endstream x3P0 t.C=63E\i\ g3s endobj 0000071023 00000 n <> endobj endobj Meritain Health Claims Mailing Address Health (9 days ago) WebClaims Information UFCW Local 655 Welfare Fund. 0000006310 00000 n endstream <>/Subtype/Form/Type/XObject>>stream 0000263097 00000 n Copyright 2023 Meritain Health. endstream 0000222259 00000 n This will delay the processing of the claim. endobj 130 0 obj endobj endstream 75 0 obj . <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 90.84 75.6 302.88 95.64]/Subtype/Widget/T(Provider to be paid)/TU(Provider to be paid)/Type/Annot>> 60 0 obj You can also click here for our Member User Guide. /I|;5iqOb: 8]m endobj 0000026631 00000 n ]W9n9. For 24-hour access to your patients health information,log in to your account. endobj 0000075278 00000 n % endstream 55 0 obj Well share all our advice endstream PDF Claims Submission and Payment - mbh-eap.com H23U0t.=s#0agf!R@PBLX n <>/Subtype/Form/Type/XObject>>stream Administered by Meritain , Health (3 days ago) WebYou can call Meritain Health Customer Service: {For verification of eligibility and benefit information. <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 90.84 483.36 164.52 505.56]/Subtype/Widget/T(Spouses Birthdate)/TU(Spouses Birthdate)/Type/Annot>> {To receive a copy of an Explanation of , https://epc.org/wp-content/uploads/Files/4-Resources/1-Benefits/6-2022/2022MeritainCustomerServiceInformation.pdf, Health (8 days ago) WebASA and Meritain - use phone number on member's ID card; BRCA genetic testing (precertification and information) - 1-877-794-8720 (TTY: 711) Claims - if you have , https://qawww.aetna.com/health-care-professionals/contact-aetna.html, Unitedhealthcare medicare advantage claims address, Drexel behavioral health continuing education, Prohealth westwood health and fitness center, Philippines one health pass registration, Devoted health plan of florida providers, Shadow health gastrointestinal subjective, 2021 health-improve.org. 0000030202 00000 n 0000011755 00000 n x 27 0 obj MERITAIN HEALTH - 117 Reviews - 1405 Xenium Ln, Minneapolis - Yelp 126 0 obj x3P0 t.C=63E\i\ g3s endstream 0000090829 00000 n endobj For privacy purposes, the member's spouse and adult dependents, covered by the plan, must each establish logins to access their individual information. 0000000616 00000 n endobj H23U0t.=s#0agf!R@PBLX n <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 390.6 371.76 471.6 393.96]/Subtype/Widget/T(City_2)/TU(City)/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream 49 0 obj H23U0t.=s#0ag endstream H23U0t.=s#0ag 0000047749 00000 n 124 0 obj xPpurb & At Meritain Health, we create unrivaled connections. Contact us If you have questions about claims or benefits, we're happy to help. 26 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Tabs/W/Type/Page>> 0000091099 00000 n But do you listen to your gut when it comes to your health? endobj Please forward this completed form to the privacy officer of the employer or to: Meritain Health <>stream <>/Subtype/Form/Type/XObject>>stream endstream H23U0t.=s#0ag endobj 150 0 obj <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream <>/Subtype/Form/Type/XObject>>stream 42 0 obj The form linked below should be completed by a member who needs togrant access to their PHIto another individual in connection with an appeal. 142 0 obj 0000006809 00000 n xPpurb & <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 27.84 371.76 201.72 388.08]/Subtype/Widget/T(Name of Other Health Insurance Carrier or Plan)/TU(Name of Other Health Insurance Carrier or Plan)/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream <>/DA(/Helv 0 Tf 0 g)/DR<>/Font<>>>/F 4/FT/Tx/P 4 0 R /Rect[ 124.92 301.56 579.6 323.76]/Subtype/Widget/T(Spouses Employers Address_2)/TU(Spouses Employers Address)/Type/Annot>> Were adding new tools and resources all the time. 35 0 obj How do I contact meritain health? PDF Vision Complete and send to: Claim Form P.O. Box 853921 - Meritain endstream 0000262548 00000 n . 76 0 obj endobj endobj endstream endobj startxref If you havent created an account, click Register at the top right of this page and follow the prompts. endobj and helpful tips for boosting good healthfor you, and your family. <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 127.56 541.08 137.64 551.16]/Subtype/Widget/T(The employee)/TU(The employee)/Type/Annot>> <>/Subtype/Form/Type/XObject>>stream xPpurb & xHMef2'oj,Fm'6bCL{@4t./~I2_d>\@+h?Mu(\bu 7FY,Q$jJ <>/Subtype/Form/Type/XObject>>stream 0000030713 00000 n hmo6 "LR@PBPBLM, k It is believed to be accurate at the time of posting and is subject to change. Claims Information | UFCW Local 655 Welfare Fund 158 0 obj xPpurb & In a year sure to be filled with many milestones, For some people, memory loss can simply occur as a natural part of getting older. endstream 44 0 obj 30 0 obj [ 313 0 R 160 0 R 161 0 R 162 0 R 163 0 R 164 0 R 165 0 R 166 0 R 167 0 R 314 0 R 315 0 R ] 0000001063 00000 n endobj endobj <>/N<>>>/AS/Off/DA(/ZaDb 0 Tf 0 g)/F 4/FT/Btn/MK<>/P 4 0 R /Rect[ 384.12 541.08 394.08 551.16]/Subtype/Widget/T(Employees Child)/TU(Employees Child)/Type/Annot>> 0000222181 00000 n endstream endobj 9 0 obj endobj Business Profile for CBSA Performax, A Meritain Health Company MERITAIN HEALTH - 117 Reviews - 1405 Xenium Ln, Minneapolis, Minnesota - Insurance - Phone Number - Yelp Restaurants Home Services Auto Services Meritain Health 117 reviews Unclaimed Insurance Write a review Add photo Photos & videos See all 7 photos Add photo endobj <>/Subtype/Form/Type/XObject>>stream Our industry-leading programs and partnerships with health care innovators allow us to connect our plan sponsors with the right benefits to meet commonand not-so-commonself-funding challenges. Box 853921 Richardson, TX 75085-3921 Fax: 1.763.852.5057 If the patient is a dependent, please complete ALL of the following. C endobj endstream Mississippi Physicians Care Network (MPCN), Presbyterian Select Provider Network (SPN). endobj endstream Meritain Health PO Box 853921 Richardson, TX 75085-3921 WEBMD/Emdeon #41124, Mckesson/Relay Health #1761 (618) 344-2002 IBEW Local No. For 24-hour , https://qa.meritain.com/about-us-self-funded-employee-benefit-plans/meritain-health-provider-services/, Health (8 days ago) WebMailing Address. H23U0t.=s#0agf!R xPpurb & 159 0 obj 0000030938 00000 n endobj <>/Subtype/Form/Type/XObject>>stream 0000026121 00000 n endstream endstream Not only can we customize your plan, we want to. endstream 12 0 obj xPpurb & Aetna Provider Phone Number List (California) Aetna Medicare Advantage Plans and. 137 0 obj <>/Subtype/Form/Type/XObject>>stream endstream Section 3. Who you authorize to receive your PHI information; for example, spouse, child or friend
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