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Provider Resources

Centers Plan for Healthy Living’s mission is to work collaboratively with members, their families, healthcare decision makers, caregivers, and providers to break down barriers to accessing comprehensive healthcare.  Our focus is on coordinating care for Medicare and/or Medicaid eligible populations and working with our members to live healthy, productive lives.

We value having a strong presence in the communities we serve, and providers in our network receive the same dedication, quality of services, and support to make our partnership a successful one.  We are continually looking for new ways to improve our plans and welcome your input. 

If you are interested in joining the CPHL Medicare Provider Network, please click here to submit your request.

You may also contact us via the following:

·         Provider Hotline: 1-844-292-4211

·         Email:  ProviderServices@centersplan.com

Please remember to frequently review and update your information on the NPPES portal 

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PROVIDER SERVICES CONTACT INFORMATION

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CLAIMS AND PAYMENT

Electronic Claim Submission and Payment
CPHL offers electronic claim submission through RelayHealth and electronic payment through PaySpan.  Please click here for more information.  You may also submit claims by mail to:

Centers Plan for Healthy Living
P.O. Box 21033
Eagan, MN 55121

Claim Dispute Resolution
CPHL and its contracted providers are responsible for the timely resolution of any disputes between both parties.  CPHL informs providers about the dispute resolution process through the Provider Manual, provider orientation, and the CPHL website.  Providers may also obtain information about the provider dispute process by calling the CPHL Claims department at 844-292-4211, Option 2 (Monday through Friday, 9AM to 5PM).
 

Claim Reconsideration Request Form [Paper version for sending by mail or fax]

 

Claim Reconsideration Request Form [Electronic version for immediate submission]

 

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CMS REQUIREMENTS

Provider Directory Requirement

CMS requires all Medicare Advantage Organizations (MAOs) and Medicare-Medicaid Plans to conduct quarterly communications with contracted providers to ensure that provider directory information is up to date and accurately reflected on the plan’s online directory.  To ensure the plan and members have the most accurate information about your practice, completion of the Demographic Change Form is required whenever you change or update your information.

HEDIS Guidelines for Health Care Providers


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Prescription Drug Coverage Information

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COVID-19 Letter to Providers

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SNP Model of Care (MOC) Training

Last modified: Aug 15, 2023