Call to Inquire About:
|
Telephone Number
|
Hours of Operation
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Community Behavioral Healthcare Network of Pennsylvania
Member Services
|
1-866-755-7299 (PA)
1-866-341-7022 (OH)
|
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
|
1-800-685-5207 (PA)
1-888-447-4375 (OH)
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 (PA) or
1-888-447-4505 (OH). 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 (PA)
1-888-447-4505 (OH)
|
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 (PA)
1-888-447-4507 (OH)
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 (PA)
1-888-447-4506 (OH)
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
|
|
Fitness Assured®
|
1-877-211-3917 |
Monday-Friday
8:30 AM to 5:30 PM
|
|
MTM (Transportation Services) |
1-866-670-3063 (TTY 1-800-855-2880) |
Monday-Friday
8:00 AM to 5:00 PM,
Saturday 9:00 AM to 1:00 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
|