Information for Providers
USFHP has the following resources for providers:
Important News
Provider Manual
Provider Newsletter
Member Eligibility / Claim Status
To check Member Eligibility, Claims Status or Authorization Status (via the internet using E Power) click here , or via our Fax Recall System by dialing 212-868-9447.
Provider Quick Reference Guide
To print the Provider Quick Reference Guide (PDF document)
» Click here
Outpatient Referral Form
» Click here to print out the Outpatient Referral Form.
Fill out the form, leaving the Form Number box blank.
Give a copy of the completed referral form to the patient and keep one copy for office records
Utilization Management
Contact 866-390-0933 (or fax 866-813-1722) to precertify all services except outpatient PT and OT.
Behavioral Healthcare
Contact Health Integrated to pre-certify services, or to obtain a listing of behavioral health providers at 1 866-390-0933. For more information on Health Integrated visit their website at www.healthintegrated.com
Labcorp
All lab work should be referred to Labcorp with the exception of In-office Stat Procedures. For a listing of allowed In-office Stat Lab Procedures, click here . To obtain a listing of Labcorp Patient Sevice Centers contact Labcorp at 800-788-9091, or visit the Labcorp web site at www.labcorp.com
Physical Therapy/ Occupational Therapy
To precertify Outpatient PT/OT services contact Orthonet at 800-401-0062. For more information on Orthonet, visit their website at www.orthonet-online.com .
Pharmacy
To download a copy of our Preferred Drug Listing, click here .
To download the Non-Preferred Drug Request form (providers only), click here .
To review a list of injectables available through Maxor Mail order, click here .
For additional pharmacy information, contact Maxor at 1 800-687-0707 or visit their web site at www.maxor.com.
Claims and Billing Information
Submit Medical Claims Electronically via WebMD, Payor ID 13407.
Use ONLY updated or current diagnosis and procedure codes.
USFHP members cannot be balanced billed for any amounts in excess of the allowed amount, other than for copayments and coinsurance.
USFHP is primary to Medicare and Medicare (with few exceptions) and is secondary to commercial health insurance.
Claims status can be checked online by accessing E Power by clicking here or by dialing 212-868-9447 and accessing our Fax Recall system.
Medical Claims Address:
US Family Health Plan at SVCMC
PO Box 830745
Birmingham , AL 35283-0745
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