| Call to Inquire About: |
Telephone Number |
Hours of Operation |
Community Behavioral Healthcare Network of Pennsylvania
Member Services |
1-866-755-7299 (PA) |
24 hours a day
7 days a week |
| Davis Vision – Provider Servicing |
1-800-933-9371 |
Monday-Friday
8:00 AM to 6:00 PM |
| United Concordia Companies, Inc. |
1-866-568-5467 |
Monday-Friday
8:00 AM to 6:00 PM |
Digital Voice Assistant (DIVA)
(Eligibility Check) |
1-800-642-3515 |
24 hours a day
7 days a week |
Gateway Health Plan®
Credentialing Department |
(412) 255-4320 |
Monday-Friday
8:30 AM to 4:30 PM |
Gateway Health Plan®
Fraud and Abuse Hotline |
(412) 255-4340 or
1-800-685-5235 |
24 hours a day
7 days a week |
Gateway Health Plan®
Utilization Medical Management |
Due to lower call volumes, the best time to call is between 8:30 AM and 11:30 AM. For urgent requests, please stay on the line to have your call serviced. |
Monday-Friday
8:30 AM to 4:30 PM (Calls received during non-business hours are referred to 1-800-685-5209. Multiple calls and messages for the same request within one day are unnecessary and may impede response times.) |
Gateway Health Plan®
Member Services |
1-800-685-5209 |
8:00 AM to 8:00 PM
7 days a week |
Gateway Health Plan®
Pharmacy
(Non-Formulary Requests and Prior Authorization) |
1-800-685-5215
Fax 1-888-447-4369 |
Monday-Friday
8:30 AM to 4:30 PM |
Gateway Health Plan®
Preventive Health
Disease/Case Management |
1-800-685-5212
Option 1—Case Management
Option 2—Maternity/MOM Matters®
Option 3—Congestive Heart Failure/Asthma
Option 4—Preventive Health Services |
Monday-Friday
8:30 AM to 4:30 PM |
Gateway Health Plan®
Provider Services
(Claim Inquiries, Eligibility Verification and Supplies) |
1-800-685-5205 |
Monday-Friday
8:30 AM to 4:30 PM |
Gateway Health Plan®
Part D Prescriber Appeals |
1-800-213-7083 |
24 hours a day
7 days a week |
Health Management Corporation
Diabetes Disease Management Program) |
1-866-366-9415 |
24 hours a day
7 days a week |
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 |
| Reason for Mailing |
Address |
Claims
(Medical and Behavioral Health) |
Gateway Health Plan® (PA)
Claims Processing Department
P.O. Box 11-560
Albany, NY 12211-0560
Gateway Health Plan® (OH)
Claims Processing Department
P.O. Box 11-725
Albany, NY 12211-0725 |
| Claims Inquiries and Administrative Reviews |
Gateway Health Plan®
Attention: Claims Review
US Steel Tower, Floor 41
600 Grant Street
Pittsburgh, PA 15219 |
| Member and Provider Appeals |
Gateway Health Plan®
Attention: Medicare Complaints Administrator
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 |
| Vision Claims |
Davis Vision
Attention: Vision Card Processing Unit
P.O. Box 1525
Latham, NY 12110 |
| Dental Claims |
United Concordia Companies, Inc.
Claims Processing
PO Box 69427
Harrisburg, PA 17106-9427 |