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Providers of medical services are the backbone of any health plan. The information on this site should help expedite claims processing and payment by keeping providers up to date on policies and procedures.

Tools For You

Tools for Medical Providers AHIN: Advanced Health Information Network (AHIN) for determining eligibility, claim status, correcting errant claims and submitting new claims. Providers who are interested in this service should click here for an AHIN demo and link to enrollment information.

Claims Filing Guide: Information about filing claims.

Electronic Data Interchange (EDI): A resource for physicians and other providers of professional health-care services in assessing options for meeting the Health Insurance Portability and Accountability Act (HIPAA) transactions and code-set requirements and for completing testing necessary for the submission of claims in the HIPAA-mandated format.

Forms for Providers: A section that links to miscellaneous forms for medical providers.

Pharmacy Search: A network of pharmacies participating in the Caremark managed pharmacy network. Note: Not all groups use Caremark as their managed pharmacy vendor.

Tools for Dental Providers
Authorization Form for Clinic/Group Billing (PDF): Use for notification that a practitioner is joining a clinic or group.

Provider Change of Data Form (PDF): Use to report a change of address or other data. Completion of this form DOES NOT create any network participation.

Termination Form for Clinic/Group Billing (PDF): Use for notification that a practitioner is leaving a clinic.

Member Dental Claim Form (PDF)

Claims and Benefits Information

Dental Bulletin

Dental Network Development Representatives

Provider Participation Information

Network Participation Guidelines: Notice of Payer Policies and Procedures and Terms and Conditions applicable to all individual network participants and applicants and Credentialing Standards by eligible discipline.

Provider Directory: Physicians, hospitals and other health-care providers and facilities participating in health-plan networks administered by USAble Administrators.

Better Service For You

Better Service For You Contact Us: Telephone numbers and e-mail addresses.

Frequently Asked Questions (FAQs): Answers to common questions about our products and services.

Network Development Representatives: A list of regional representatives who can provide assistance with any questions you have regarding USAble Administrators.

Pharmacy Benefits
Note: Not all groups use Caremark as their managed pharmacy vendor, and some groups customize this list to meet their individual needs. This list is not a guarantee of coverage.




Note: Not all USAble Administrators groups use our preferred dental vendor.

 
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