Contact Reference Guide - Empire Blue Cross Blue Shield

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Contact Reference Guide 2009 SmartValue Medicare Advantage PFFS Plan

Customer Service For questions related to member eligibility, benefits, copays and claim status, speak with one of our dedicated provider representatives by calling: (866) 364-2374 8:00 a.m. – 8:00 p.m. Seven days a week. Interactive Voice Response System (IVR) available 24/7.

Submission of Claims File claims to your local Blue Cross and Blue Shield plan.

Sample Member Identification Card

Custom Care Connection A free benefit that offers members an experienced nurse care manager to help plan and coordinate care with our valued healthcare providers. (866) 797-9884 8:00 a.m. – 5:00 p.m. EST Monday - Friday

Grievance and Appeals Resolution As a health care provider rendering covered services to a SmartValue member, you have the right to file a grievance or appeal. If you disagree with the payment made to you for services provided, call Customer Service at (866) 364-2374. You also have the option to submit a grievance or appeal in writing. Please include supporting documentation with your request and submit to: SmartValue P.O. Box 1975 Fond Du Lac, WI 54936

Additional plan information is available at: www.empireblue.com

Interim Rate Letters Fax interim rate letters and updates to:

Click on the Provider & Facilities tab Click Enter Click Plans & Benefits Choose from the list of Medicare Advantage products to access the information you need.

Fax: (920) 923-8995

Empire HealthChoice Assurance, Inc. ("Empire") is the legal entity that has contracted with the Centers for Medicare and Medicaid Services (CMS) to offer the Private Fee for Service plan(s) (PFFS) noted above or herein. Empire is the risk bearing entity licensed under New York state law to offer the PFFS plan(s) noted. Empire has retained the services of its related companies and the authorized agents/ brokers/producers to provide administrative services and/or to make the PFFS plan(s) available in this region. Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association

Contact Reference Guide 2009 SmartValue Medicare Advantage PFFS Plan

Customer Service For questions related to member eligibility, benefits, copays and claim status, speak with one of our dedicated provider representatives by calling: (866) 364-2374 8:00 a.m. – 8:00 p.m. Seven days a week. Interactive Voice Response System (IVR) available 24/7.

Submission of Claims File claims to your local Blue Cross plan.

Sample Member Identification Card

Custom Care Connection A free benefit that offers members an experienced nurse care manager to help plan and coordinate care with our valued healthcare providers. (866) 797-9884 8:00 a.m. – 5:00 p.m. EST Monday - Friday

Grievance and Appeals Resolution As a health care provider rendering covered services to a SmartValue member, you have the right to file a grievance or appeal. If you disagree with the payment made to you for services provided, call Customer Service at (866) 364-2374 You also have the option to submit a grievance or appeal in writing. Please include supporting documentation with your request and submit to: SmartValue P.O. Box 1975 Fond Du Lac, WI 54936

Additional plan information is available at: www.empireblue.com

Interim Rate Letters Fax interim rate letters and updates to: Fax: (920) 923-8995

Click on the Provider & Facilities tab Click Enter Click Plans & Benefits Choose from the list of Medicare Advantage products to access the information you need.

Empire HealthChoice Assurance, Inc. ("Empire") is the legal entity that has contracted with the Centers for Medicare and Medicaid Services (CMS) to offer the Private Fee for Service plan(s) (PFFS) noted above or herein. Empire is the risk bearing entity licensed under New York state law to offer the PFFS plan(s) noted. Empire has retained the services of its related companies and the authorized agents/ brokers/producers to provide administrative services and/or to make the PFFS plan(s) available in this region. Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association

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Contact Reference Guide - Empire Blue Cross Blue Shield

Contact Reference Guide 2009 SmartValue Medicare Advantage PFFS Plan Customer Service For questions related to member eligibility, benefits, copays a...

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