Provider Relations SIHO INSURANCE SERVICES Provider-sponsored - PowerPoint PPT Presentation

INTRODUCTION Provider Relations

SIHO INSURANCE SERVICES Provider-sponsored health plan  Founded in 1987, by a fortune 100  employer, local hospitals and local physicians Created to provide a solution to rise  healthcare costs for local businesses  110,000+ members Not-for-profit   Providing health care benefits to organizations of all sizes 2

SIHO OBJECTIVES VISION SIHO will be the premier healthcare delivery system administration company, known and respected for its high quality people, innovative products and outstanding services. MISSION Our mission is to continually improve our products and services to meet and exceed our customer‘s needs and expectations, allowing us to prosper as a business and provide a value return for our stakeholders. 3

BENEFITS OF SIHO  Claims Administration Benefit Consulting   Pre-Certification National Pharmacy Network   Full Service Medical Comprehensive Provider Network  Management Not For Profit   Member Services Provider Owned   Employer Services 4

SIHO PROVIDER WEBSITE Link image of website  5

SIHO PROVIDER LOG IN 6

WEBSITE HOMEPAGE 7

CLAIMS SEARCH 8

Claims Search Demo. Screen 9

ADDITIONAL OPTIONS/RESOURCES Call into SIHO and utilize the Interactive Voice Response. Phone  Number: 800.553.6027 The new IVR allows providers to check claim status 24 hours a  day, 7 days a week. Providers have the option to opt out and speak with  representative during regular business hours or leave a voice message after hours. Request precertification/authorizations on-line. The request will  be reviewed and a response released within 24 hrs. 10

CREDENTIALING / RE-CREDENTIALING Information to include when adding a new provider to your practice:  Provider Name, title, and date of birth  CAQH Provider ID number  Tax Identification number  Group NPI number  Practice demographics  Remittance address Changes to your practice  Adding or removing a provider  Practice address changes 11  Remittance address changes

HELPFUL HINTS Member Services Department can assist members as well as providers  with questions regarding eligibility, benefits and claim status. Phone: 800.443.2980 Questions may be emailed to memberservices@siho.org Claim submissions: Rendering provider’s NPI must be listed in 24j &  name in box 31; Vendor name must be in box 33 and group NPI listed in 33a Electronic Claim Submission ensures timely claim payment. SIHO  utilizes a Universal Payer ID: 77153 – TK Software phone: 888.372.2808 Provider Relations Specialists assist with credentialing/re-credentialing,  practice changes, claims research, web portal inquiries, fee schedule 12 requests, provider issues and education.

CONTACT INFORMATION PROVIDER SERVICES MEMBER SERVICES: Jana Griner 1-800-443-2980 Email: Jana.Griner@siho.org Phone: (812) 378-7018 MEDICAL MANAGEMENT: Melanie Brock 1-800-553-6027 Email: Melanie.Brock@siho.org (812) 314.2500 ext. 1107 Provider Relations: Email: Provider.Services@siho.org Fax number 812.378.8721 Latisha Meyer Email: Latisha.Meyer@siho.org 812.314.2500 ext. 1187 13