Attention Providers
We are pleased to provide an important update on our claims submission process and the impact on our operations following the recent cyberattack of Change Healthcare. We are once again able to accept electronic claims submissions through Availity. However, it is crucial for providers to resubmit any previously affected claims through your clearinghouse using our existing payer IDs. Please do not submit paper claims. Mailing or dropping off paper claims will significantly delay payment processing. If you have any questions, call our Care Advocates at 800-969-1805 for Medicare members, and 866-500-2741 for commercial members.
Commercial and Medicare Advantage providers have convenient access to general and region-specific information through Prominence Health Plan. Log into our secure provider portal to access healthcare tools and additional resources.
Join Our Network
Join a network for commercial providers or access administrative forms, claim information, advanced directives and other resources.
Medicare Provider Resources
Access forms and documents, including a guide to register new accounts, advanced directives, prior authorization information, sample member ID cards, quick reference guide, clinical policies and other resources.
Preventive Healthcare
View guidelines for health screenings, immunization schedules and other preventive healthcare information.
Commercial Prescription Drug and Formulary Information
Get pharmacy and formulary benefit information, including Specialty Pharmacy care and the Pharmacy by Mail program.
Utilization Management and Payment Policies
Provider Directories
Our comprehensive provider network includes many of the most notable and reputable physicians in the region, offering our members excellent access to quality medical services.
Affirmative Statement Regarding Incentives
Utilization Management decision-making is based only on appropriateness of care and services and existence of coverage.
For Providers
Attention Providers
We are pleased to provide an important update on our claims submission process and the impact on our operations following the recent cyberattack of Change Healthcare. We are once again able to accept electronic claims submissions. However, it is crucial for providers to resubmit any previously affected claims through your clearinghouse using our existing payer IDs. Please do not submit paper claims. Mailing or dropping off paper claims will significantly delay payment processing. If you have any questions, call our Care Advocates at 800-969-1805 for Medicare members, and 866-500-2741 for commercial members.
Commercial and Medicare Advantage providers have convenient access to general and region-specific information through Prominence Health Plan. Log into our provider portals and access additional resources.
Join Our Network
Join a network for commercial providers or access administrative forms, claim information, advanced directives and other resources.
Medicare Provider Resources
Access forms and documents, including a guide to register new accounts, advanced directives, sample member ID cards, quick reference guide and other resources.
Preventive Healthcare
View guidelines for health screenings, immunization schedules and other preventive healthcare information.
Commercial Prescription Drug and Formulary Information
Get pharmacy and formulary benefit information, including Specialty Pharmacy care and the Pharmacy by Mail program.
Utilization Management and Payment Policies
Provider Directories
Our comprehensive provider network includes many of the most notable and reputable physicians in the region, offering our members excellent access to quality medical services.
Affirmative Statement Regarding Incentives
Utilization Management decision-making is based only on appropriateness of care and services and existence of coverage.