PCPs and plan participating specialists may refer members to a nonparticipating plan specialist if there is not a participating specialist in a particular field. Copyright 2001-2023 SELECT HEALTH OF SOUTH CAROLINA INC. All rights reserved. QUESTIONS? A copy of the specific medical necessity criteria used in our UM decisions is available by mail, fax, or secure email upon request. Some services offered at the participating specialists office may require prior authorization. ADHD Screening Algorithm. Opens a new window. All Commercial Plans How to submit a request for prior authorization Online: NaviNet Provider Portal https://navinet.navimedix.com > Medical Authorizations By phone: 1-888-559-1010 (toll-free) or 1-843-764-1988 in Charleston Fax: Prior Authorization Request Form to 1-866-368-4562 Prior authorization information Prior authorization information grid (PDF) SelectHealth does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. medications covered by the plan. If you enroll in SelectHealth, members receive all their care from our . Learn More. For Prescription Drugs: Name of drug/medication Strength of the drug (example 5 mg) Quantity being prescribed Days supply PROVIDER PHONE NUMBER : PROVIDER FAX NUMBER . 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. Start the application process here. ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Provider Newsletter: Email us, here. Monday Friday, 8 am 6 pm For generations, New Yorkers have known us as the Visiting Nurse Service of New York. QUESTIONS? SelectHealth is an HMO plan sponsor with a Medicare contract. Martha is a native St. Louisan, has three grown children and currently lives in the St. Louis area with her husband. Use your ZIP Code to find your personal plan. VNS Health offers multiple online platforms to help streamline and simplify home care and hospice referrals and order signing and allow for easy access to patient records and plans of care. . To receive the EFT, you must also be able to accept the 835. In her role at Essence, Erin provides strategic vision and oversight to the compliance and internal audit functions of the company. 8 am 6 pm. Providers may not bill members for services that require prior authorization, and the authorization was not obtained, resulting in denial of the claim. 1-866-469-7774, TTY/TDD 711. Remember, if you dont get re-certified by Medicaid, you can lose your coverage under SelectHealth. ABA Treatment Request Form, Resources: From 2000 to 2005, she served as executive director of Esse Health, one of the nations largest independent physician groups. medications covered by the plan. Llame al 1-866-469-7774, TTY/TDD 711. At SelectHealth from VNS Health, experienced healthcare professionals guide all care. Its a specialized Medicaid plan for people living with HIV, people of transgender experience, gender non-conforming or homeless individuals, regardless of HIV status. 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). Need help finding something? Monday - Friday. You must be fully licensed and able practice independently in your state in order to be considered. Prefer to speak to us directly? PROVIDER STREET ADDRESS: CITY. At VNS Health, were more than your health care team. Offering you an elite group of providers, including primary care physicians and specialty physicians, Local businesses choose Select Health Network because of the depth of our provider network, Get instant access to downloadable forms, monthly newsletters, and general information, we are issuing notice of a recent event that may impact the privacy of personal information, What does a health network do anyway? All communications are in All rights reserved. How to Start: It's Simple Step One: Download Using the access buttons above, download the My Health+ app from the App Store or Google Play, or visit My Health+ on the web (no download required). Before joining Essence Healthcare, she served as chief medical officer of Mercy Health Plans, a providersponsored plan owned by Sisters of Mercy. 1-866-469-7774 (TTY: 711) 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. Please review them and contact your account manager or the portal training specialist team listed below to discuss what works best for you. Information on the Provider application process Medical Management Portal Request Pre-Authorization Forms & Resources Information, Policies and publications Claims & Payments Claim Status Search for payor websites that offer claims processing status (websites may require a password in addition to your OneHealthPort credentials). With SelectHealth, your primary care Were here to help. Or click this link to use our online drug search. Our new name reflects the full range of easy-to-access services and health plans we offer you. Referring patients to in-home care Review and sign plans of care and invite staff to review and approve. Access Your SelectHealth Health Data with a Health App. Before joining the Essence family of companies in 2006, he served as vice president of marketing for e-MDs and held a variety of management positions at several healthcare technology companies, including Trizetto, Nightingale and Mariner Systems. Targeted information to keep you healthy and help you care for a loved one. 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? Copyright 2023 VNS Health. 8 am 6 pm. Notice of Privacy Practices, Treatment Request Forms: SelectHealth from VNSNY CHOICE is now SelectHealth from VNS Health. Select Health Network collaborates with Saint Joseph Health System and over 750 healthcare providers to promote quality healthcare. Learn about the rigorous research thats driving the future of care. Call 844-442-4106. services/procedures requiring preauthorization, Redetermination of Medicare Prescription Drug Denial, The Electronic Remittance Advice (ERA or 835) , which details payment information on claims. (TTY: 711) 8 am 6 pm. SelectHealth from VNS Health (SelectHealth), complies with Federal civil rights laws. Search Prescription Drugs Search our formulary list of covered prescription medications; Find a Doctor Search for primary care physicians, specialists, dentists and more within the Essence Healthcare provider network; Important Plan Documents Find important plan information like Summary of Benefits, Evidence of Coverage, Formulary guides and more {activePanel = null})" @keydown.tab.prevent="$nextTick(() => {activePanel = null})" Click here to search for a health care provider or to find a pharmacy near you. Access plans of care, medication histories, and discharge summaries. Below you will findforms utilized by Mercy Managed Behavioral Health, along with links to valuable resources. Were with you, every step of the way. The South Carolina Department of Health and Human Services (SCDHHS) launched its School-based Mental Health Services Initiative effective July 1, 2022. All rights reserved. MEDICARE WELLNESS REIMBURSEMENT FORM As a SelectHealth Advantage Medicare member, you're free to manage your health-your way. Erin brings over a decade of public accounting experience to Essence Healthcare, with nine years focused on the insurance industry serving life, health, property/casualty insurers, captive insurers and reinsurers. Learn more about Essence Healthcare plans at one of our FREE local or online Medicare seminars. 1-866-469-7774 (TTY: 711) The next site will open in a new browser window or tab. 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. Your state in order to be considered Saint Joseph Health System and over 750 healthcare providers to promote quality.! Notice of Privacy Practices, Treatment Request Forms: SelectHealth from VNS Health, were more than Health! Our New name reflects the full range of easy-to-access services and Health plans a... 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