Ò°»¨ÉçÇø Medicare Advantage Network
Ò°»¨ÉçÇø’s provider network for access to Medicare Advantage programs
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Get access to Medicare Advantage programs
Medicare Advantage Organizations that administer these programs use our network in defined geographic areas to supplement their own networks to provide greater access to quality affordable healthcare for their members. Note that Ò°»¨ÉçÇø does not process, reprice or pay Medicare Advantage claims.
Welcome Medicare Advantage Providers
Our network is your partner in delivering care to individuals participating in Medicare Advantage and related health plans.
Join the network
This application request applies to participation in the Ò°»¨ÉçÇø Medicare Advantage Network only. You may already participate in one or more of our PPO networks (e.g., PHCS, Ò°»¨ÉçÇø, HealthEOS, etc.) that serve privately-funded health plans, which are covered by a separate agreement.
Our Medicare Advantage Clients
Our Medicare Advantage clients have been approved by the Centers for Medicare and Medicaid Ò°»¨ÉçÇø (CMS) to administer Medicare Advantage programs in defined geographical areas. These clients manage all aspects of the plan including claim processing and payment. Note that Ò°»¨ÉçÇø does not process, reprice or pay Medicare Advantage claims.
Alignment Health Plan
States: CA, NV
AllyAlign Health
American Health Advantage of Florida
State: FL
American Health Advantage of Mississippi
State: MS
American Health Advantage of Oklahoma
State: OK
American Health Advantage of Texas
State: TX
Florida Complete Care
States: FL
Georgia Health Advantage
State: GA
Gold Kidney
States: FL
Imperial Health
States: AZ, CA, NM, NV, TX
Iowa Health Advantage
State: IA
Kaiser Foundation Health Plan of Colorado
State: National Travel Network
Kaiser Foundation Health Plan of Washington
State: National Travel Network
Mass Advantage
States: FL & AZ Travel Network
Presbyterian Health Plan​
States: AZ, CO, NM, TX
Priority Health
States: National except for MI
Provider Partners
States: NC
SCAN Desert Health Plan​
State: AZ
SCAN Health Plan​
State: CA & TX
UCare
States: National Travel Network
Vantage Health Plan, Inc. ​
States: AR and counties in the following bordering states: LA, MO, MS, OK, TN, TX
Verda Healthcare
States: TX
Wellpoint
Zing Health
States: IL, MI, IN, OH
Working with the Ò°»¨ÉçÇø Medicare Advantage Network
Please promptly inform Ò°»¨ÉçÇø of any changes to your directory or other information.
- Click here to update your directory information.
- Centers for Medicare & Medicaid Ò°»¨ÉçÇø (CMS) requires Medicare Advantage Organizations to maintain information regarding network adequacy and availability. To support this requirement, Ò°»¨ÉçÇø asks all providers participating in our Medicare Advantage network to inform us of any changes to your provider directory information (e.g., street address, phone number, office hours) and whether you accept new patients.
The Medicare Advantage ID card identifies the Medicare Advantage Organization and plan and may contain the Ò°»¨ÉçÇø Medicare Advantage (or Beech Street Network) logo. The Ò°»¨ÉçÇø network accessed by the Medicare Advantage Organization may be referenced in the claim reimbursement documentation.
Submit claims as indicated on the member’s Medicare Advantage ID card.
- Inquiries regarding payment related issues should be directed to the payer identified on the ID card. It is the payer’s responsibility to ensure that payments are made in compliance with the program.
- Note that Ò°»¨ÉçÇø does not process, reprice or pay Medicare Advantage claims. Contact the payer listed on the member ID card for questions regarding claim payment.Ìý
To verify eligibility, contact the payer as indicated on the patient’s Medicare Advantage ID card.
Required general compliance and fraud, waste and abuse training
The Centers for Medicare & Medicaid Ò°»¨ÉçÇø (CMS) and your Ò°»¨ÉçÇø Medicare Advantage Network provider agreement mandate all those contracted to provide health care services to Medicare Advantage beneficiaries must complete the applicable Medicare Advantage program compliance trainings.
Ò°»¨ÉçÇø’s code of conduct
Ò°»¨ÉçÇø’sÌýCode of Business Conduct and EthicsÌýcontains the legal and ethical standards of conduct required of all parties with which Ò°»¨ÉçÇø contracts. We expect all providers participating with Ò°»¨ÉçÇø to comply with our Code in every aspect of their business conduct.
Contact us
Contact our Government Business Service Center for issues related to your participation in our Medicare Advantage Network, such as:
- Questions about your participation status
- Changes to your demographic information
- Inquires about our credentialing criteria
- Copies of your provider contract
- Credentialing application submissions (W-9 required)
[email protected]
(±Ê³ó´Ç²Ô±ð)Ìý1-866-971-7427Ìý(Fax) 630-799-3587
Ò°»¨ÉçÇø, ATTN: GBSC
6116 Shallowford Road Suite109B
Chattanooga, TN 37421
More information
Get more information about Ò°»¨ÉçÇø’sÌý
Are you a payor?ÌýTo learn more about Ò°»¨ÉçÇø,Ìýcontact us.
Are you a patient?ÌýPlease refer to your patient ID card for instructions on where to find program information about your healthcare plan, or visit our member page.
This page was updated on 02/16/24.