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Additional Information
 
Active Contracts
 

Fiesta Mart

PPO - - Effective Date: August 1, 2004
     

FRONT OFFICE  

Eligibility/Verification Phone Number:

See Patient Card

Precert/Authorization Phone Number:

See Patient Card

Precert/Authorization Fax Number:

See Patient Card

Mental Health Carve Out:

Call Benefits

CLAIMS FILING & BILLING INFORMATION  

Claim Filing Deadline:

95 days

Appeal Time Frame:

95 days

Claim Payor:

See Patient Card

Claim Address:

See Patient Card

Electronic Claim Accepted?

No
  LABS  

ANY

   

Memorial Hermann Contracted? YES

 

 

 

Visit the UCP Provider DirectoryQuestions? Email us at UTPBusinessOperations@uthouston.edu.
For individual physician participation status, please refer to the UT Physicians Provider Participation Directory.
 
 
Visit the Health Plan's Website
Provider Directory
Contact the Plan Representative
Michelle Lawton
Address:
P.O. Box 9189
Austin, Texas 78766
See Sample ID Cards
Additional Sample *

 

 
     
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