| Call to Inquire About: |
Telephone Number |
Hours of Operation |
| Care Management |
1-800-642-3550
Option 1—Care Management
Option 2—Maternity/MOM Matters®
Option 3—Congestive Heart Failure/Asthma
Option 4—Preventive Health Services/EPSDT/Outreach |
Monday-Friday 8:30 AM to 4:30 PM |
| Credentialing Department |
(412) 255-4320 |
Monday-Friday 8:30 AM to 4:30 PM |
| Digital Voice Assistant (DIVA) (Eligibility Check/Generate and Review Referrals) |
1-800-642-3515 |
24 hours a day/7 days a week |
| Fraud and Abuse Hotline |
(412) 255-4340 or
1-800-685-5235 |
24 hours a day/7days a week |
| Medical Management (Utilization Management) |
1-800-392-1146 |
Monday-Friday 8:30 AM to 4:30 PM
(Voicemail during off hours. The call will be returned the next business day.)
Please do not leave multiple voicemail messages or call for the same authorization request on the same day. |
| Member Services |
1-800-392-1147 |
Monday-Friday 8:00 AM to 6:00 PM |
| Pharmacy (Non-Formulary Requests and Prior Authorization) |
1-800-528-6738 |
Monday-Friday 8:30 AM to 4:30 PM |
| Provider Services (Claims Inquiries, Eligibility Verification and Supplies) |
1-800-392-1145 |
Monday-Friday 8:30 AM to 4:30 PM |
| Regulatory Affairs (Provider and Member Appeals) |
1-800-392-1145 |
Monday-Friday 8:30 AM to 4:30 PM |
| TTY/TDD (for all departments) |
1-800-654-5988 |
Monday-Friday 8:00 AM to 6:00 PM |
| Adagio Health (Authorization/Family Planning) |
1-800-532-9465 |
|
| Davis Vision - Provider Servicing |
1-800-773-2847 |
Monday-Friday 8:00 AM to 6:00 PM |
| Eligibility Verification System (EVS) |
1-800-766-5EVS (5387) |
|
Health Management Corporation
(Diabetes Disease Management Program) |
1-866-366-9415 |
24 hours a day/7 days a week |
MA Provider Compliance Hotline
(Fraud and Abuse Reporting) |
(412) 255-4340
1-866-DPW-TIPS
(1-866-379-8477) |
Monday-Friday 8:30 AM to 3:30 PM |
| Call to Inquire About: |
Telephone Number |
Hours of Operation |
| MA Provider Enrollment Applications |
In-process (Inpatient and Outpatient Provider Only)
717-772-6140 |
Monday-Friday 8:30 AM to 3:30 PM |
Long Term Care Provider
717-772-2571 |
Monday-Friday 8:30 AM to 5:00 PM |
National Imaging Associates (NIA)
(Authorization for CT, MRI/MRA, Nuclear Cardiology, Bone Densitometry and PET Scans) |
1-888-879-5922 |
Monday-Friday 8:00 AM to 8:00 PM |
United Concordia Companies, Inc. (UCCI)
(Dental benefit provider) |
1-866-568-5467 |
Monday-Friday 8:00 AM to 8:00 PM |
| Reason for Mailing |
Address |
| Claims and Referral Forms |
Gateway Health Plan® Claims Processing Department
P.O. Box 11-718
Albany, NY 12211-0718 |
| Claims Reviews |
Gateway Health Plan® Attention: Claims Review Department
US Steel Tower, Floor 41
600 Grant Street
Pittsburgh, PA 15219 |
| Provider Appeals |
Gateway Health Plan® Attention: Appeals Department
US Steel Tower, Floor 41
600 Grant Street
Pittsburgh, PA 15219 |
| Initial Applications for Credentialing |
Gateway Health Plan® Attention: Network Development
US Steel Tower, Floor 41
600 Grant Street
Pittsburgh, PA 15219 |
| Recredentialing Applications |
Gateway Health Plan® Attention: Credentialing
US Steel Tower, Floor 41
600 Grant Street
Pittsburgh, PA 15219 |
| Practice Change Information |
Gateway Health Plan® Attention: Provider Relations
US Steel Tower, Floor 41
600 Grant Street
Pittsburgh, PA 15219 |
| Dental Claims |
United Concordia Companies, Inc.
Claims Processing
PO Box 69427
Harrisburg, PA 17106-9427 |
| Vision Claims |
Davis Vision
Attention: Vision Card Processing Unit
P.O. Box 1525
Latham, NY 12110 |
Please note that these numbers are for members to call. Practices do not need to send a referral or authorize mental health/substance abuse services.
| County |
Agency/Area |
Telephone Number |
| Adams |
Community Care Behavioral Health |
1-866-738-9849 |
| Allegheny |
Community Care Behavioral Health |
1-800-553-7499 |
| Armstrong |
Value Behavioral Health |
1-877-688-5977 |
| Beaver |
Value Behavioral Health |
1-877-688-5977 |
| Berks |
Community Care Behavioral Health |
1-866-292-7886 |
| Blair |
Community Behavioral Health Network of Pennsylvania |
1-866-773-7917 |
| Butler |
Value Behavioral Health |
1-877-688-5971 |
| Cambria |
Value Behavioral Health |
1-866-404-4562 |
| Carbon |
Carbon County-Mental Health |
1-610-377-0773 |
| Substance Abuse-Carbon, Monroe, and Pike Drug and Alcohol Commission |
1-610-377-5177 |
| Clarion |
Mental Health and Substance Abuse Services |
1-814-226-1080 |
| Columbia |
Mental Health and Substance Abuse Services |
1-570-387-6741 |
| Cumberland |
Community Behavioral Healthcare Network of Pennsylvania |
1-888-722-8646 |
| Dauphin |
Community Behavioral Healthcare Network of Pennsylvania |
1-888-722-8646 |
| Erie |
Value Behavioral Health |
1-866-404-4560 |
| Fayette |
Value Behavioral Health |
1-877-688-5972 |
| Franklin |
Community Behavioral Health Network of Pennsylvania |
1-866-773-7917 |
| Fulton |
| Greene |
Value Behavioral Health |
1-877-688-5973 |
| Indiana |
Value Behavioral Health |
1-877-688-5969 |
| Jefferson |
Dubois-Mental Health and Substance Abuse |
1-814-371-1100 |
| Brookville-Mental Health |
1-814-849-8842 |
| Clearfield-Mental Health |
1-814-765-5337 |
| Punxsatawny-Mental Health |
1-814-938-8817 |
| County-wide 24-hour Mental Health and Substance Abuse |
1-814-371-1105; or 1-800-699-2642 |
| Falls Creek-Substance Abuse |
1-814-371-9002 |
| Lackawanna |
Scranton-Mental Health |
1-570-346-5741 |
| Scranton-Substance Abuse |
1-570-963-6820 |
| Lancaster |
Community Behavioral Healthcare Network of Pennsylvania |
1-888-722-8646 |
| Lawrence |
Value Behavioral Health |
1-877-688-5975 |
| Lebanon |
Community Behavioral Healthcare Network of Pennsylvania |
1-888-722-8646 |
| Lehigh |
Magellan Behavioral Health of PA |
1-866-238-2311 |
| Luzerne |
Luzerne and Wyoming Counties |
1-800-432-8007 |
| Mercer |
Value Behavioral Health |
1-866-404-4561 |
| Monroe |
Monroe County Mental Health |
1-570-421-2901 |
| Carbon, Monroe, and Pike Drug and Alcohol Commission-Substance Abuse |
1-270-421-3669 |
| Montour |
Mental Health and Substance Abuse |
1-570-387-6741 |
| Northampton |
Magellan Behavioral Health of PA |
1-866-238-2312 |
| Northumberland |
Mental Health Services |
1-570-495-2040 |
| Substance Abuse Services |
1-570-495-2154 |
| Perry |
Community Behavioral Health Network of Pennsylvania |
1-888-772-8646 |
| Pike |
Mental Health Services |
1-570-296-6484 |
| Carbon, Monroe, and Pike Drug and Alcohol Commission-Substance Abuse |
1-570-296-7255 |
| Schuylkill |
Mental Health-16 Hours per Day Walk-in |
1-570-628-1180 |
| Mental Health-16 Hours per Day by Phone |
1-570-472-2688 |
| Mental Health-24 Hours a Day Service |
1-800-334-8094 |
| Substance Abuse Service |
1-570-621-2890 |
| Substance Abuse- 24 Hours a Day Service |
1-800-334-8094 |
| Somerset |
Community Behavioral Health Network of Pennsylvania |
1-866-773-7891td>
|
| Susquehanna |
Tri-County Human Services Center |
1-570-346-5741 |
| Substance Abuse-Susquehanna Drug and Alcohol Commission |
1-570-278-1000 |
| Washington |
Value Behavioral Health |
1-877-688-5976 |
| Wayne |
Mental Health-Tri-County Human Services Center |
1-570-346-5741 |
| Substance Abuse-Carbon, Monroe and Pike Drug and Alcohol Commission |
1-570-253-5099 |
| Wayne County Drug and Alcohol Commission |
1-570-253-6022 |
| Westmoreland |
Value Behavioral Health |
1-877-688-5977 |
| Wyoming |
Mental Health-Luzerne and Wyoming Counties |
1-800-432-8007 |
| York |
Community Care Behavioral Health |
1-866-542-0299 |