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.
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
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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.
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.
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