|
Additional
Information |
|
| Active
Contracts |
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Molina Healthcare Of Texas
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| |
STAR |
| |
|
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| |
FRONT OFFICE |
|
Eligibility/Verification Phone Number:
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1-866-449-6849 |
Precert/Authorization Phone Number:
|
1-866-449-6849 |
Precert/Authorization Fax Number:
|
1-866-969-6350 |
Mental Health Carve Out :
|
CompCorp 1-800-435-5348 |
| |
CLAIMS FILING &
BILLING INFORMATION |
|
Claim Filing Deadline:
|
95 days |
Appeal Time Frame:
|
180 days from the date of EOB |
Claim Payor:
|
See Patient Card |
Claim Address:
|
P.O. Box 22719
Long Beach, CA, 90801 |
Electronic Claim Accepted?
|
Yes |
| |
LABS |
|
UT
Pathology, Quest,
LabCorp,
Clinical Pathology Labs
|
| |
|
Memorial Hermann Contracted?
|
Yes |
|
| 
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|
STAR PLUS |
| |
|
|
| |
FRONT OFFICE |
|
Eligibility/Verification Phone Number:
|
1-866-449-6849 |
Precert/Authorization Phone Number:
|
1-866-449-6849 |
Precert/Authorization Fax Number:
|
1-866-969-6350 |
Mental Health Carve Out :
|
CompCorp 1-800-435-5348 |
| |
CLAIMS FILING &
BILLING INFORMATION |
|
Claim Filing Deadline:
|
95 days |
Appeal Time Frame:
|
180 days from the date of EOB |
Claim Payor:
|
See Patient Card |
Claim Address:
|
P.O. Box 22719
Long Beach, CA, 90801 |
Electronic Claim Accepted?
|
Yes |
| |
LABS |
|
UT
Pathology, Quest,
LabCorp,
Clinical Pathology Labs
|
| |
|
Memorial Hermann Contracted?
|
Yes |
|
|
|
|
CHIPS |
| |
|
|
| |
FRONT OFFICE |
|
Eligibility/Verification Phone Number:
|
1-866-449-6849 |
Precert/Authorization Phone Number:
|
1-866-449-6849 |
Precert/Authorization Fax Number:
|
1-866-969-6350 |
Mental Health Carve Out :
|
CompCorp 1-800-435-5348 |
| |
CLAIMS FILING &
BILLING INFORMATION |
|
Claim Filing Deadline:
|
95 days |
Appeal Time Frame:
|
180 days from the date of EOB |
Claim Payor:
|
See Patient Card |
Claim Address:
|
P.O. Box 22719
Long Beach, CA, 90801 |
Electronic Claim Accepted?
|
Yes |
| |
LABS |
|
UT
Pathology, Quest,
LabCorp,
Clinical Pathology Labs
|
| |
|
Memorial Hermann Contracted?
|
Yes |
|
|
|
| |
|
| |
|
Address: