Detailed claim should include the include the following: Claims can be mailed on the corresponding WPS addresses. For Providers - Auxiant The Alliance payer identification numbers are as follows: RelayHealth (McKesson): Payer ID # 2712 (CMS-1500) and # 1935 (UB)Emdeon/Optum EDI/most others: Payer ID # 88461. The intent of this advertisement is solicitation of insurance, and contact may be made by the insurer or a licensed agent. Suite 1100 Milwaukee Brewers partnership is a paid endorsement. WI: 800-236-1448 Auxiant is known for its innovation and technology, constantly evolving to meet the needs of its clients. Individual & Family HMO/POS Health Plans, Agent portal/Reporting (Employer Reports), WPS Health Insurance and WPS Health Plan Employer Enrollment/Reporting (Employer Reports), WPS Administrative Services (ASO) Powered by Auxiant, Medicare MAC J5, MAC J8, and J5 National Part A, Getting Started with Electronic Claim Filing, Provider Portal User Guide for Family Care and CLTS, Espaol | Hmoob | | Deutsch | | | Ting Vit | Deitsch | | Franais | Polski | | Shqip | Tagalog. Box 21352 This amount acts as a cap on the employer's financial exposure and is known as the aggregate stop-loss limit or attachment point. contracted provider and feel your contract is being inappropriately applied, please contact your Provider Relations Representative or email providerrelations@alliantplans.com. The main difference between the two models is how paying for employee health claims is handled. Administrative Services Only (ASO) | WPS ASO stands for Administrative Services Only, which refers to a type of health plan where an employer contracts with a third-party administrator (TPA) to provide administrative services to self-funded employers. We serve customers with a personalized approach: listening to their needs, resolving their issues, and guiding them through the challenges of health coverage and health care. Provide your email address to subscribe to our most essential updates. Eagan, MN 55121, WPS Administrative Services We have been in business since 1982 and are dedicated to providing our clients with the best possible service. With WPS, employers can design their own health plan with confidence, knowing theyre protected from the unexpected. 1717 W. Broadway Wisconsin Physicians Service Insurance Corporation and WPS Health Plan, Inc. EEO/AA employer. P.O. new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], MondayFriday, 8 a.m.4 p.m. (CT) Access client website for possible features such as benefits & eligibility and claims payment status. And we help verify the group is paying the right amounts for those services. Claims should be itemized and state the provider of the server, diagnosis, release of service, customer provided . Contact your WPS Account Manager for questions for groups that have plans through our WPS Powered by Auxiant partnership. If you do not To access secure messaging, log in to your online account. Through progressive innovation and cutting-edge management options, we deliver a dynamic new offering with solutions tailored to fit any employers needswith superior customer service that is second to none. If you are a chiropractic provider interested in joining our network, please contact Evolent Health. 832 0 obj <>/Filter/FlateDecode/ID[<6C82FC46F3A23D4E95ABBF0E013906FB><17FDBBEB2DBCEB4FB44F309ECAB06A21>]/Index[812 55]/Info 811 0 R/Length 96/Prev 113539/Root 813 0 R/Size 867/Type/XRef/W[1 2 1]>>stream you have forgotten your user ID or password, please use the link provided on the login page. have an account, please use the link below to register or see your administrator for details. Auxiants Integrated Buy Down product integrates with a clients fully insured benefits plan as a way to decrease the premium but limit the cost to the employee. Our strong employer connections and employee guidance initiatives can benefit your practice (or hospital or health system) while helping you care for your local community. A third-party administrator, or TPA, provides administrative support to employers who choose to self-fund their employee health benefits, allowing them to save money and have more control over their health plan. IL: 800-221-5319 888-915-5108, J5 Part A and B: All rights reserved. '&l='+l:'';j.async=true;j.src= Self-funded groups have complex needs, and WPS is here to support them with high-quality group service. About | Careers | Diversity, Equity, and Inclusion | Privacy Policy | Terms and Conditions | Code of Conduct | Supplier Code of Conduct | Notice of Privacy Practices | Fraud and Abuse Many employees arent satisfied with their employers benefit plan and feel their plan doesnt meet their needs. The TPA (third-party administrator) assists the employer in ensuring that the plan complies with all applicable laws and regulations. Box 1450 Milwaukee,WI 53201-1450 Contact our Team at our Corporate Headquarters 1000 North Water Street, Suite 1100 Milwaukee, WI 53202-3197 Send Us A Message Claims may be submitted to the following address: WPS Health Insurance. Lastly, employers that choose an ASO health plan receive a call center team to help their employees navigate their health benefits plan. | Vulnerability Disclosure, Espaol | Hmoob | | Deutsch | | | Ting Vit | Deitsch | | Franais | Polski | | Shqip | Tagalog | 'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); For accurate claim(s) filing, follow the submission instructions on the patients ID card. hbbd``b`+D b q@b@; "8A ,@; Auxiant is an independent third-party administrator with over 150 full-time employees and offices in Cedar Rapids, Iowa, Madison, Wis., and Milwaukee, Wis. Auxiant has been in business since 1982 and is dedicated to providing our clients with the best possible service. Eagan, MN 55121, WPS Health Plan Please enable it to continue. To date, we've partnered with 38,000 doctors and health care providers across the Midwest, offering coverage to more than 115,000 people. Out of Network Claim Payment Dispute Form. Please review this overview of important contract reminders for participating providers. })(window,document,'script','dataLayer','GTM-WLTLTNW'); The WPS provider portal is your resource for quick, convenient access to customer and claim information. Contact | WPS - WPS Health For Providers - Auxiant AUXIANT- EMPLOYEE GROUP SERVICES 10134 36326 PO Box 0392 Milwaukee, WI 53201 www.auxiant.com 800-475-2232 4/1/2019 AUXIANT-MEDICAL BENEFIT ADMINISTRATORS MBA02 36326 PO Box 0392 Milwaukee, WI 53201 www.auxiant.com 800-475-2232 4/1/2019 CYPRESS BENEFIT ADMIN CBA03 88056 Cypress Benefit Administrators P.O. To reach customer service, please select the line of business indicated on your WPS ID Card. Create a plan document: A plan document outlines the terms and conditions of your self-funded health plan. This amount is known as the stop-loss limit or attachment point. Allegiance Benefit Plan Management is responsible for administering various aspects of this patient's plan, which may include claim processing, utilization management or eligibility verification. please utilize the Find a Provider feature on our website or . Contact us based on the type of plan youre interested in. Wisconsin Physicians Service. WPS, powered by Auxiant, works with The Alliance to offer employers Administrative Services Only (ASO) health plans. Midlands Choice > For Healthcare Providers > Payer Resources We appreciate the confidence you have placed in us and pledge to provide you with friendly service and innovative products. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. How to File a Claim | WPS - WPS Health In the last five years, over half of American adults - more than 100 million people - reported having medical debt. Fully insured plans offer more stability and protection for the employer, but they can also come with higher costs. Here are some steps you can follow to set up a self-funded health plan for your small business. The Alliance Provider Claims Portal is a comprehensive resource for participating providers that offers information such as: claim filing status, detailed TPA information, customized claims processing, and more! With EDI claims, were able to reprice and send the claim on to the Third-Party Administrator (TPA) in just a few hours. Box 211597 For specific Assurant contact numbers, please refer to the directory below. The size of the claims fund will depend on the size of your company and the expected claims of your employees. Stop loss and stop limit both serve as risk-management tools in an administrative services only (ASO) health plan, but they have slightly different purposes. This partnership combines WPS deep expertise in health insurance and unparalleled service with Auxiants flexible systems and approach to third-party health administration. WPS performs a variety of checks, audits, reviews, and investigations to help ensure the groups health care dollars are spent wisely for the highest value. Make sure you choose a TPA that is experienced and reputable. All rights reserved. Claims should be itemized and state the provider of the service, diagnosis, date of service, services provided, and amount charged for the services. Explain the plan to employees: Once you have established your self-funded health plan, explain the plan and its benefits to your employees. Make sure they understand the plan and how to use it. P.O. Eagan, MN 55121, WPS Health Plan WPSIndividualSales@wpsic.com, 800-332-0893 And only 35% of employees trust their employer to design a By Mike Roche | May 8, 2023 | 4 min read. Typically, only employees and their dependents are eligible to participate in the plan. It includes details such as the benefits you will offer, the eligibility criteria for employees to join the plan, and the procedures for submitting and processing claims. Auxiant Company Profile | Management and Employees List - Datanyze (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': Submit Claims To: AUXIANT PMB#418 15560 N FLW Blvd Scottsdale, AZ 85260. Auxiant Health on the App Store Auxiant PDF Provider Appeal Request Instructions - AlliantPlans.com })(window,document,'script','dataLayer','GTM-WLTLTNW'); It is your responsibility to ensure that a claim is submitted to us. You must have Adobe Reader to view and print pdf documents. '&l='+l:'';j.async=true;j.src= A self-funded group typically qualifies for stop-loss coverage after claims exceed a specified dollar amount in a predetermined period of time. PDF Cofinity Platform Migration Fully Migrated Payers - Lakeland Care P.O. PDF Cigna Payer Solutions Active Accounts Update - MemberClicks Stop-loss insurance is a type of insurance that provides protection for a self-funded employer against the risk of high medical claims costs. Wisconsin Physicians Service Insurance Corporation and WPS Health Plan, Inc. EEO/AA employer. WPS, powered by Auxiant, works with The Alliance to offer employers Administrative Services Only (ASO) health plans. Auxiant specializes in customization, cost-control, health management, and technological tools for self-funded clients and members. WPS offers a secure way for you to send us any questions you might have, including those related to your health or customer account. Medical Management includes a comprehensive suite of programs to address diverse health needs across employer group populations. 2023 Health Payment Systems. The contact information on this page is for the WPS Health Insurance/WPS Health Plan commercial insurance division. PO Box 2667. WPS offers a secure way for you to send us any questions you might have, including those related to your health or customer account. Auxiants Integrated Buy Down program allow you to reduce the costs and maintain the benefits without cost shifting to employees which allow you to focus again on attracting and retaining quality employees. Almost 6 in 10 employees said their employers health plan was not aligned with their needs. '&l='+l:'';j.async=true;j.src= Wisconsin Physicians Service. P.O. new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], CLAIM.MD | Payer Information | Auxiant To learn more, watch our explainer video: What is Administrative Services Only? Madison, WI 53708-8190. Also submit the entire original claim with all line items and not just the line being corrected. new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], A sample Alliance ID card provides a detailed explanation of the information to look for. The main risk of a self-funded health plan is that the employer is responsible for paying all claims, even if the cost is higher than expected. AuxiantHealth provides you with access to your personal health care account information. We bridge the gap between providers and employers, partnering with you to bring high-quality, fairly priced services to employers, employees, and their families. With fully insured plans, the employer pays premiums to the insurance company, which in turn assumes the financial risk for paying employee health claims. TPAs, or third-party administrators, are often hired by employers to handle the day-to-day administration of employee benefits, such as processing claims, managing provider networks, and handling customer service inquiries. The action you just performed triggered the security solution. Please send these to: The AllianceP.O. If the cost of medical claims exceeds the stop-loss limit, the stop-loss insurance coverage kicks in and the stop-loss carrier pays the excess claims costs. Non-Discrimination Policy | Interoperability | Price Transparency. Box 211595 '&l='+l:'';j.async=true;j.src= Wisconsin Physicians Service. Provider Information | Claims Portal, Forms & More - The Alliance Eagan, MN 55121, Correspondence (medical records, notes, etc. With these values, Auxiant provides high quality health care plan administration at the most competitive price possible. Box 21341 AuxiantHealth is an interactive application that provides access to health plan information. Self-funded and fully insured group health insurance plans are two different models for providing group health insurance coverage to employees. ), Wisconsin Physicians Insurance Wisconsin Physicians Service Insurance Corporation and WPS Health Plan, Inc. EEO/AA employer. You can email the site owner to let them know you were blocked. Fax: 920-490-6955 or 608-221-5479. First Health Network, Partnership Overview Refund Form | WPS Health Insurance Contact Us - HPS Contact Information | Health Payment Systems FL: 800-221-5696 hb```f``: @1V 0bgzk30wt4 R `g`,[X$ 0y*3tfL^fi=btf5 }@9`q :l8F: 58$ Please be at your computer when you call. How to File a Claim | WPS - Customer Service: Eagan, MN 55121, WPS Health Insurance There you will find enrollment and claims information (including copies of Explanations of Benefits) and the ability to track claims. (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': Use our online Provider Portal or call 1-800-950-7040. new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], Please do not submit a duplicate claim it wont result in returning the status of the claim and adds more costs and resources to the claims process. Group leaders get the efficient, friendly claims management services of WPS and have access to a billing specialist, a dedicated account manager, and enrollment help. 7:30 a.m. to 7:30 p.m. (EST) Friday. Box 21352 Your company should be financially stable and have the means to cover potential large claims. A site specifically for Midlands Choice providers: learn more about the Midlands Choice credentialing process and claims policies, stay up to date on the latest news, submit demographic changes, submit CMS-1500 claims on-line, and more. In an ASO health plan, the employer contracts with a stop-loss insurance provider to provide this type of insurance coverage. Administrative Health Plan (ASO) Option - The Alliance Directory of Assurant Phone Numbers & Global Addresses Step 1: Contact Alliant's Customer Service department at 800-811-4793 to review adverse coverage determinations and/or payment reductions. systems, and physicians in northern Illinois Enter names exactly as they appear on the ID card. All Rights Reserved. Box 21341 The degree or education level of the servicing health care provider is required to reprice most claims. This field is for validation purposes and should be left unchanged. With our claim portals, our global-wide office locations, and virtual chat teams, we're here to help you find what you need, whenever you need. These are the most current logos that could appear on the front or back of the ID Card. Medical debt in the US is a serious and worsening issue, with combined debt reaching over $195 billion in 2022. Each of our clients has a customized benefit plan and access to a reporting package and standard reports that help them manage their plan. Let us know how we can help you. To determine whether patients' healthcare plans cover specific services, what their co-pays are, or to obtain details about precertification requirements, contact payers who administer the patients' healthcare plans. For questions about claims submitted through your EDI vendor, contact your vendor directly. | Vulnerability Disclosure, Espaol | Hmoob | | Deutsch | | | Ting Vit | Deitsch | | Franais | Polski | | Shqip | Tagalog | Another common mistake is entering a name without punctuation, for example John Smith Jones when the ID card says John Smith-Jones.. Payer Information Auxiant Payer ID: AUX01 Other ID's: 26202 Need to submit transactions to this insurance carrier? Healthcare Provider FAQs > MultiPlan Performance & security by Cloudflare. Milwaukee Brewers partnership is a paid endorsement. We work with several clearinghouses for electronic claims submissions. In this model, the employer takes on the financial risk of paying for employee health claims, rather than paying premiums to an insurance company. The degree or education level of the servicing health care provider is required to reprice most claims. Youll also have access to a best-in-class portfolio of vendors, including PBM, stop loss, and care and cost management. Address 1717 W. Broadway P.O. All the forms you need. Box 21341 SuperMed Network You may request that the provider of services file the claim on your behalf. Both help limit the financial impact of high claims costs and provide peace of mind for the employer. '&l='+l:'';j.async=true;j.src= Claims submitted electronically gain higher priority and are filed (and paid) faster than paper claims. Box 8190 })(window,document,'script','dataLayer','GTM-WLTLTNW'); Two powerful Wisconsin companies, WPS and Auxiant, are teaming up to bring top-tier Administrative Services Only (ASO) services to the employee benefits marketplace. P.O. The benefits of a self-funded health plan include the potential for lower costs, greater flexibility, and the ability to tailor the plan to the specific needs of the employer and its employees. The portal is designed to provide real-time access to the following: Administrators: If this is your first visit to our new, secure provider portal, you will need to create a new P.O. Employers should consider their needs and risk tolerance when deciding which model is right for their company. Confirm Alliance network status at each visit. Our credentialing process verifies training, experience, licensure, and competence to determine if a provider is fit to partner with The Alliance. Box 44365 Madison, WI 53744-4365 (Paper Claims) EDI Payer ID # 88461 (Electronic Claims) EyeMed Vision Care Program The employer must have enough money set aside to cover these costs or the plan may become insolvent. })(window,document,'script','dataLayer','GTM-WLTLTNW'); Entering nicknames, such as Shelly when the ID card says Michelle, can cause an electronic claim to be rejected. Click to reveal Check a patients health plan ID card at each visit to ensure there havent been any changes in eligibility or employment status. The level of exposure that triggers the need for stop-loss coverage varies based on the size of the group and the details of its health plan. The stop-loss insurance provider assumes the risk of paying the excess claims costs, giving the employer peace of mind and allowing it to focus on providing health benefits to its employees. Head to our Provider Networks page to view our Comprehensive Network service areas which extend from Wisconsin into Michigan, Minnesota, Illinois, and Iowa. To our valued customers, we thank you for doing business with us. If you dont already, consider sending and receiving claims electronically. Then click on the New Provider Request dropdown menu, choose How to Become a WPS Provider, and follow the prompts. Non-Discrimination Policy | Interoperability | Price Transparency. Claims Address: PO Box 5809 Troy, MI 48007-5809. At WPS, the minimum is 10 enrolled employees. Auxiant's specialty is customized tools for unions and their contractors. Provider Claims Submission Guidelines | The Alliance * Claims questions and rework . For example, if the stop-loss limit is set at $500,000 and the cost of medical claims for a given year is $600,000, the stop-loss carrier would pay the $100,000 difference. Eagan, MN 55121. Other states: 800-236-8809, WPS Health Insurance: 800-332-1398 Your IP: This website is using a security service to protect itself from online attacks. In an administrative services only (ASO) health plan, stop-loss insurance is used to limit the financial exposure of the employer in the event of unexpectedly high claims costs. Stop-loss insurance works by setting a specific dollar amount or a percentage of total claims that the employer is responsible for paying. Assess your financial stability: Self-funded health plans can be risky for small businesses because the company is responsible for paying its employees medical claims. endstream endobj startxref 800-333-5003 Please proceed with one of the following options instead (in order of effectiveness): 5510 Nobel DrSuite 200Fitchburg, WI 53711. %PDF-1.5 % Most of our enrollees claims are submitted directly to The Alliance, unless otherwise indicated on the ID card. Provider Portal Overview The WPS provider portal is your resource for quick, convenient access to customer and claim information. Electronic claims submission are required for new contracts. WPS forms partnerships with health care providers that benefit our customers. View Current and Past Provider Newsletters: 5510 Nobel DrSuite 200Fitchburg, WI 53711. The best self-funded health plan solutions come from a - Auxiant
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