Auxiant.com : 62777 : Boon-Chapman ; BoonChapman.com : 74238 : Christian Brothers Services (made available by . P.O. Customer service is the heart of who we are at WPS. Find out More Through progressive innovation and cutting-edge management options, we deliver a dynamic new offering with solutions tailored to fit any employers needswith superior customer service that is second to none. Provider Network Information/Claim Status: 866-670-8691 Website: www.lifestylehealthbenefits.com Claim Submission Address: Trilogy Health Networks . All rights reserved. For all others, please see below. These are the most current logos that could appear on the front or back of the ID Card. Employers should consider their needs and risk tolerance when deciding which model is right for their company. All other states: Please send these to: The AllianceP.O. | Vulnerability Disclosure, Espaol | Hmoob | | Deutsch | | | Ting Vit | Deitsch | | Franais | Polski | | Shqip | Tagalog | To access secure messaging, log in to your online account. account. Non-Discrimination Policy | Interoperability | Price Transparency. | Vulnerability Disclosure, Espaol | Hmoob | | Deutsch | | | Ting Vit | Deitsch | | Franais | Polski | | Shqip | Tagalog | Please enter a number greater than or equal to, Medical Debt is a $195 Billion Problem: Heres How Employers Can Help, Tailoring Benefit Programs to Meet Employee Needs, Switch to Self-funding for Better Benefits at a Lower Cost, Cost containment to help protect your bottom line, Extreme flexibility in administering your plan, Utilization management to help ensure appropriate care, Available value-added programs for dental, fitness, vision, hearing, and more. And only 35% of employees trust their employer to design a By Mike Roche | May 8, 2023 | 4 min read. Obtain stop-loss insurance: Stop-loss insurance provides protection against large claims. c/o WPS Health Insurance Out of Network Claim Payment Dispute Form. Wisconsin Physicians Service Insurance Corporation and WPS Health Plan, Inc. EEO/AA employer. The Alliance's Smarter NetworksSM and WPS Statewide Network Integration WPS offers a secure way for you to send us any questions you might have, including those related to your health or customer account. Thats why most employers 5510 Nobel DrSuite 200Fitchburg, WI 53711. You must have Adobe Reader to view and print pdf documents. Access client website for possible features such as benefits & eligibility and claims payment status. new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], })(window,document,'script','dataLayer','GTM-WLTLTNW'); The WPS provider portal is your resource for quick, convenient access to customer and claim information. Milwaukee, WI 53202-3197. J8 Part A and B: Dalton, GA 30722. A self-funded group typically qualifies for stop-loss coverage after claims exceed a specified dollar amount in a predetermined period of time. Because every client is different, WPS, powered by Auxiant, offers a broad suite of administrative and care services with flexibility to address their unique needs. Please do not submit a duplicate claim it wont result in returning the status of the claim and adds more costs and resources to the claims process. By using our site you consent to cookies. Provide your email address to subscribe to our most essential updates. Eligibility for a self-funded health plan is determined by the employer. ASO health plans are a great option for employers that want a turnkey self-funded solution. Auxiant has over 20 years of experience in administration of labor specific health and welfare plans. Step 1: Contact Alliant's Customer Service department at 800-811-4793 to review adverse coverage determinations and/or payment reductions. Wisconsin Physicians Service Insurance Corporation and WPS Health Plan, Inc. EEO/AA employer. Other states: 800-236-8809, WPS Health Insurance: 800-332-1398 Auxiant is an independent third-party administrator with over 150 full-time employees and offices in Cedar Rapids, Iowa, Madison, Wis., and Milwaukee, Wis. Auxiant has been in business since 1982 and is dedicated to providing our clients with the best possible service. Client Services: Toll free (TTY/TDD) (800) 811-4793. Eagan, MN 55121, Family Care Her may requirement that the provider regarding services file the assertion on your behalf. The ASO health plan wraps WPS Statewide networks with our Smarter Networks for even more coverage. This partnership combines WPS deep expertise in health insurance and unparalleled service with Auxiants flexible systems and approach to third-party health administration. Claims should be itemized and state the provider of the service, diagnosis, date of service, services provided, and amount charged for the services. Contacts. And we help verify the group is paying the right amounts for those services. WPS offers a secure way for you to send us any questions you might have, including those related to your health or customer account. ASO stands for Administrative Services Only, which refers to a type of health plan where an employer contracts with a third-party administrator (TPA) to provide administrative services to self-funded employers. Individual & Family HMO/POS Health Plans, Agent portal/Reporting (Employer Reports), WPS Health Insurance and WPS Health Plan Employer Enrollment/Reporting (Employer Reports), WPS Administrative Services (ASO) Powered by Auxiant, Medicare MAC J5, MAC J8, and J5 National Part A, Large Group ASO Express Scripts Specialty Drug Program, WPS and Express Scripts SaveonSP Specialty Drug List, Self-funded vs. fully insured health plans, Espaol | Hmoob | | Deutsch | | | Ting Vit | Deitsch | | Franais | Polski | | Shqip | Tagalog, Offers access to major hospitals, health Questions about the website or data dashboard. })(window,document,'script','dataLayer','GTM-WLTLTNW'); WI: Sending and receiving claims via Electronic Data Interchange (EDI) is a great way to ensure more timely payments. We pride ourselves on being live, local, and friendly. SuperMed Network Medical Management includes a comprehensive suite of programs to address diverse health needs across employer group populations. Click here for the Provider Portal Guide (PDF). Auxiant is known for its innovation and technology, constantly evolving to meet the needs of its clients. P.O. (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': P.O. Cofinity Platform Migration Fully Migrated Payers The degree or education level of the servicing health care provider is required to reprice most claims. 'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); Contact Us - HPS Contact Information | Health Payment Systems With these values, Auxiant provides high quality health care plan administration at the most competitive price possible. The degree or education level of the servicing health care provider is required to reprice most claims. Visit our other websites for Medicaid and Medicare Advantage. Keep in mind that self-funded health plans can be complex and involve significant risk, so you may want to seek the advice of a professional insurance broker or a benefits consultant to help you navigate the process. WPS Health Insurance Allegiance Benefit Plan Management is responsible for administering various aspects of this patient's plan, which may include claim processing, utilization management or eligibility verification. CLAIM.MD | Payer Information | Auxiant For questions about Cigna claim processing, call: Medical and behavioral PPO and OAP claims - 1.800.88Cigna (1.800.882.4462) All other behavioral claims - 1.800.926.2273 Dental claims - 1.800.Cigna24 (1.800.244.6224) View the Madison campus map. Yes, self-funded health plans are regulated by the government and must comply with laws such as the Employee Retirement Income Security Act (ERISA). 7:30 a.m. to 6:00 p.m. (EST) Saturday. Both help limit the financial impact of high claims costs and provide peace of mind for the employer. You will benefit from increased flexibility and the best network options paired with the service to help your members find the highest-quality care at the lowest cost. Box 8190 Eagan, MN 55121, Correspondence (medical records, notes, etc. Milwaukee Brewers partnership is a paid endorsement. This field is for validation purposes and should be left unchanged. 'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); %PDF-1.5 % Stop-loss insurance works by setting a specific dollar amount or a percentage of total claims that the employer is responsible for paying. Claims should be itemized and state the provider of the service, diagnosis, date of service, services provided, and amount charged for the services. Include provider name and degree in Box 31 of all CMS forms. www.auxiant.com. Provider Information | Claims Portal, Forms & More - The Alliance The portal is designed to provide real-time access to the following: Claim status Eligibility Network Copayments/deductibles Secured messaging with Customer Service Code Combination Simulation Tool If you are a member of an Auxiant administered health plan, you can log in and: View enrollment and claim information, print EOB's, and track claims Contact customer service - Auxiant Live Chat View deduct Website: www.auxiant.com Claim Submission Address: The Alliance P.O. Once the administrator account is established, the person may create new accounts for other clinic staff as needed. TPAs, or third-party administrators, are often hired by employers to handle the day-to-day administration of employee benefits, such as processing claims, managing provider networks, and handling customer service inquiries. To date, we've partnered with 38,000 doctors and health care providers across the Midwest, offering coverage to more than 115,000 people. Submit Claims To: AUXIANT PMB#418 15560 N FLW Blvd Scottsdale, AZ 85260. If your organization normally adds a two-digit suffix, please remove it before submitting the claim. P.O. Claims submitted electronically gain higher priority and are filed (and paid) faster than paper claims. New health plan offering partners The Alliance, WPS, and Auxiant Medical debt in the US is a serious and worsening issue, with combined debt reaching over $195 billion in 2022. Contact us based on the type of plan youre interested in. If the total cost of medical claims for a given period exceeds the aggregate stop-loss limit, the aggregate stop-loss insurance coverage kicks in and the stop-loss carrier pays the excess claims costs. Wisconsin Physicians Service Insurance Corporation and WPS Health Plan, Inc. EEO/AA employer. Please enter a number greater than or equal to, View Participating Provider Responsibilities. Provider Claims Portal. The payers listed below also provide claims, eligibility and/or benefits information online: Allied Benefit Systems. hb```f``: @1V 0bgzk30wt4 R `g`,[X$ 0y*3tfL^fi=btf5 }@9`q :l8F: 58$ Contact us. Mon Thur7:00am 8:00pm CTFriday 7:00am 5:00pm CTSaturday 9:00am 1:00pm CT. Visit our Online Access for members to pay your bill, search for providers, find answers to questions or seek out other customer support. Hearing Care Solutions Program })(window,document,'script','dataLayer','GTM-WLTLTNW'); It is your responsibility to ensure that a claim is submitted to us. If youre a provider with an existing account, please log in using your established credentials. Box 21341. By outsourcing these administrative functions to a TPA, the employer can save money on health benefits and have more control over the plan design and coverage. Need assistance choosing or signing up for a health plan? 832 0 obj <>/Filter/FlateDecode/ID[<6C82FC46F3A23D4E95ABBF0E013906FB><17FDBBEB2DBCEB4FB44F309ECAB06A21>]/Index[812 55]/Info 811 0 R/Length 96/Prev 113539/Root 813 0 R/Size 867/Type/XRef/W[1 2 1]>>stream Auxiant Health on the App Store Eagan, MN 55121, WPS Health Plan Auxiant's specialty is customized tools for unions and their contractors. have an account, please use the link below to register or see your administrator for details. In an ASO health plan, the employer contracts with a stop-loss insurance provider to provide this type of insurance coverage. Auxiant Company Profile | Management and Employees List - Datanyze 888-915-5477 866-518-3285 This amount is known as the stop-loss limit or attachment point. Fax: 920-490-6923, WPS Health Insurance/WPS Health Plan Credentialing, ProviderCredentialing@wpsic.com WPSIndividualSales@wpsic.com, 800-332-0893 Eagan, MN 55121. The benefits of a self-funded health plan include the potential for lower costs, greater flexibility, and the ability to tailor the plan to the specific needs of the employer and its employees. Healthcare Providers - Midlands Choice The TPA is responsible for ensuring that claims are paid accurately and promptly. d `T9@w#n 866 0 obj <>stream PDF Provider Appeal Request Instructions - AlliantPlans.com You may request that the provider of services file the claim on your behalf. Wisconsin Physicians Service. As may vary by group, please call the phone number listed on the member ID card. })(window,document,'script','dataLayer','GTM-WLTLTNW'); Two powerful Wisconsin companies, WPS and Auxiant, are teaming up to bring top-tier Administrative Services Only (ASO) services to the employee benefits marketplace. Employers can purchase specific and/or aggregate stop loss insurance to limit the financial risk. AuxiantHealth provides you with access to your personal health care account information. Auxiant has the ability to administer medical, dental, vision, Section 125 plans, Health Reimbursement Accounts, Short Term Disability and COBRA. Suite 1100 %%EOF PayMedix is our innovative payment platform that guarantees payment to providers, credit to patients, and simplicity for all. Providers Forms and Documents | Alliant Health Plans Self-funded and fully insured group health insurance plans are two different models for providing group health insurance coverage to employees. The best self-funded health plan solutions come from a - Auxiant Claims may be submitted to the following address: WPS Health Insurance. This field is for validation purposes and should be left unchanged. Please submit all paper claims to: Alliant Health Plans. The intent of this advertisement is solicitation of insurance, and contact may be made by the insurer or a licensed agent. Stop-loss insurance is a type of insurance that provides protection for a self-funded employer against the risk of high medical claims costs. Any of these logos are acceptable and mean your organization is in-network for members and their dependents. For Providers - Auxiant Here are some steps you can follow to set up a self-funded health plan for your small business. The stop-loss insurance provider assumes the risk of paying the excess claims costs, giving the employer peace of mind and allowing it to focus on providing health benefits to its employees. Each of our clients has a customized benefit plan and access to a reporting package and standard reports that help them manage their plan. P.O. View Current and Past Provider Newsletters: 5510 Nobel DrSuite 200Fitchburg, WI 53711. 2023 The Alliance | Privacy Policy & Terms of Service. You can email the site owner to let them know you were blocked. Medical and dental plan administration for over 35 employee lives including coverage for prescription and organ transplants, Referenced Based Pricing and RBP Network Contract Programs. Neither Wisconsin Physicians Service Insurance Corporation, nor its agents, nor products are connected with the federal Medicare program. By Melina Kambitsi, Ph.D. | Jun 19, 2023 | 4 min read. Mail your claims to the address on the back of your card. Box 880 Farmington, MI 48331 www . Box 21341 AuxiantHealth is an interactive application that provides access to health plan information. '&l='+l:'';j.async=true;j.src= Eagan, MN 55121, WPS Health Plan Providers | Alliant Health Plans - AlliantPlans.com you have forgotten your user ID or password, please use the link provided on the login page. Box 44365 Madison, WI 53744-4365 (Paper Claims) EDI Payer ID # 88461 (Electronic Claims) Wisconsin Physicians Service. Contact your WPS Account Manager for questions for groups that have plans through our WPS Powered by Auxiant partnership. systems, and physicians in northern Illinois All rights reserved. For example, if the stop-loss limit is set at $500,000 and the cost of medical claims for a given year is $600,000, the stop-loss carrier would pay the $100,000 difference. Box 21341 The intent of this advertisement is solicitation of insurance, and contact may be made by the insurer or a licensed agent. All clients have the flexibility to design and control their programs to fit the member population needs. Auxiants Medical Management strives to help both the plan administrator and the member with appropriate, quality and cost-effective care to improve health. You're in luck! Provider Portal Overview The WPS provider portal is your resource for quick, convenient access to customer and claim information. 'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); Please note: If you have multiple tax IDs, a separate WPS provider account is required for each one. This amount acts as a cap on the employer's financial exposure and is known as the aggregate stop-loss limit or attachment point. At WPS, the minimum is 10 enrolled employees. These are the basic steps for setting up a self-funded health plan. If you do not EyeMed Vision Care Program Almost 6 in 10 employees said their employers health plan was not aligned with their needs. Fax: 920-490-6955 or 608-221-5479. WPS performs a variety of checks, audits, reviews, and investigations to help ensure the groups health care dollars are spent wisely for the highest value. Auxiant's Integrated Buy Down program allow you to reduce the costs and maintain the benefits without cost shifting to employees - which allow you to focus again on attracting . * Claims questions and rework . Auxiants Integrated Buy Down program allow you to reduce the costs and maintain the benefits without cost shifting to employees which allow you to focus again on attracting and retaining quality employees. Another common mistake is entering a name without punctuation, for example John Smith Jones when the ID card says John Smith-Jones.. To learn more, watch our explainer video: What is Administrative Services Only? To reach customer service, please select the line of business indicated on your WPS ID Card. Provider Request for Out of Network MAC Payment . DRG Contracted Hospitals: To determine the specific claims . Youll also have access to a best-in-class portfolio of vendors, including PBM, stop loss, and care and cost management. We're sorry but Auxiant doesn't work properly without JavaScript enabled. The Alliance Provider Claims Portal is a comprehensive resource for participating providers that offers information such as: claim filing status, detailed TPA information, customized claims processing, and more! contracted provider and feel your contract is being inappropriately applied, please contact your Provider Relations Representative or email providerrelations@alliantplans.com. Claims Address: PO Box 5809 Troy, MI 48007-5809. The TPA (third-party administrator) assists the employer in ensuring that the plan complies with all applicable laws and regulations. Our integration with vendors of all types allows us to offer a benefit plan that fits the needs of each employer. For your convenience, the document can be filled out by hand or on your computer and mailed to the applicable organization. Find information on bundled services, category II codes, coding edits, a modifier reference guide, and more. Directory of Assurant Phone Numbers & Global Addresses

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