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What kind of company is Corphealth?
Corphealth is a managed behavioral
health care company. Your employer/insurer has contracted
with us to assist you with your behavioral health care
needs.
Where is Corphealth located?
Corphealth's national corporate offices
are located in Fort Worth, Texas. The mailing address
is:
Corphealth, Inc
1300 Summit Avenue, Suite 800
Fort Worth, Texas 76102-4420
Corphealth has a regional office in
Little Rock, Arkansas. That mailing address is:
Corphealth, Inc.
10816 Executive Center Drive, Suite 206
Little Rock, Arkansas 72211
What can Corphealth do for me?
Corphealth can assist you in selecting
a behavioral health care provider or practitioner and
will act as your patient care liaison throughout your
care episode.
How do I use Corphealth's services?
Using Corphealth's services is as
easy as calling the toll-free number on your insurance
card. You may also access Corphealth through this web
site.
What number do I call? Is it free?
Call the toll-free number on your
insurance or member card. The call is free from anywhere
in the United States.
Here is a list of some of the Help
Line numbers for Corphealth client companies:
| Arkansas
State Employees Helpline |
 |
866-378-1645 |
| Burlington
Northern Santa Fe |
|
800-383-2327 |
| CHIP |
|
866-258-0942 |
| EAP
Helpline |
|
866-219-1232 |
| Guardian |
|
866-877-1111 |
| Health
Advocacy |
|
866-831-2477 |
| HEB |
|
800
929-0068 |
| Humana
Chicago |
|
800-331-9040 |
| Humana
Kansas City |
|
800-851-9536 |
| Humana
Kentucky |
|
800-659-0349 |
| Humana
MOCHA |
|
888-897-8932 |
| Humana
Ohio HMO |
|
877-275-9868 |
|
800-591-4809 |
| Humana
PPO - CO, IL, IN, OH, TN |
|
800-432-4809 |
|
800-591-9950 |
| Humana
Texas/Employers Health |
|
800-760-3263 |
| Miller
EAP (Fort Worth) |
|
817-332-3556 |
| Trustmark |
|
800-242-2596 |
Corphealth
Help Line
(For
the following companies use this Helpline number:
City of Mesquite, Texas; Heritage; IBEW; Miller
Brewery; St. Joseph; Valley Baptist) |
|
800-777-6330 |
What if I lose my card?
Contact your employer for a new card
with Corphealth's toll-free number on it.
What hours can I call Corphealth?
Our customer service helpline provides
toll-free access 24 hours a day, 365 days a year. When
you call the number on your member card, we can help
you find network providers, verify benefits and eligibility,
and help you with claim status inquiries.
What do I do if I have an emergency?
If you or your family member are experiencing
a life threatening emergency, go to the nearest hospital
for stabilization (whether in-network or out-of-network).
The hospital personnel will assess your condition and
call your doctor and Corphealth. If you are in an out-of-network
facility and are stabilized, you may be required to
move to a facility that is in the network with your
medical plan and Corphealth's. If your condition is
not life threatening but requires immediate attention,
please call Corphealth for assistance in finding an
in-network facility..
Who am I going to talk with when I call Corphealth?
You will initially speak with a customer
service representative who will provide the answers
you need or put you in touch with someone who can help
you.
What kind of information will I need when I call Corphealth?
You will need your insured's ID number,
group number and employer's company name. This information
should be listed on your insurance card.
What about my privacy?
Corphealth follows all national and
state laws regarding confidentiality to protect your
privacy. For more information, please see Corphealth's
Privacy Policies.
Where does Corphealth have providers?
Corphealth has in-network providers
and practitioners located across the country in all
50 states. A Corphealth representative can assist you
in selecting an appropriate practitioner or facility
near you. You may also locate a Corphealth practitioner
or facility near you through the Corphealth web site.
Do I have to call Corphealth to see a behavioral health
care practitioner?
It is best if you call Corphealth
to find out what your particular plan requires. Some
plans require that you receive authorization prior to
seeing a practitioner. In some case, you do not have
to call Corphealth in order to see a behavioral health
care practitioner, although, depending on your benefit
plan, you may not receive the maximum amount of benefits.
Do I have to see a Corphealth network provider?
You do not have to see a Corphealth
network provider, but, depending on your particular
benefit plan, benefits may be paid at a reduced rate
if you see a non-network provider. Some plans require
that you see an in-network practitioner to receive any
type of reimbursement. It is best if you call Corphealth
to find out what your benefits are so that you can make
an informed decision about which practitioner you would
like to see.
What if my provider isn't in the Corphealth network?
You can do two things if you would
like to try and get your provider into the Corphealth
network:
- Ask your provider to call the provider relations
department at Corphealth and speak with them about
establishing a contractual relationship to become
part of the network.
- Call the toll-free number on your insurance card
and request your practitioner be contacted about joining
the Corphealth network.
- Some provider and practitioner networks are contracted
with your health plan. A case manager or customer
service representative can tell you if you need to
contact the health plan about adding a practitioner.
What do I do if I have problems with my provider?
Please call the Corphealth number
on your card and give specific information to the customer
service representative. They will inform the department
that oversees these types of issues so an immediate
investigation can begin. Meanwhile, a Corphealth representative
can assist you in deciding if you need a referral to
a different Corphealth practitioner in your area.
What is pre-certification (pre-cert)?
Pre-certification is when care is
authorized before services are rendered. The procedure
insures that there is coverage in your plan for the
service and for the type of practitioner and /or facility
you are accessing.
Is pre-certification required?
Some plans require pre-certification
and others do not. It is best if you call Corphealth
to find out if your plan requires pre-certification.
If your plan does require pre-certification, our customer
service representative will connect you to one of our
clinical case managers who will help you with this process.
What is medical necessity?
Medical necessity is when a type or
level of care is deemed necessary or appropriate to
maintain or restore daily functioning. Medical necessity
is related to the type of treatment and level of care
determined to be appropriate by a qualified mental health
professional to be appropriate.
Do pre-existing condition limits apply with my plan?
This depends on what kind of insurance
you have. For example, Federally qualified HMO plans
do not have pre-existing clauses. Other types of insurance
such as PPO's, Indemnity, and POP plans may have pre-existing
clauses. It is best to call the customer service department
at your insurance company for this information.
Where do I mail Claims?
If you are a member seeking reimbursement
from Corphealth, please mail your claim to:
Corphealth, Inc.
1300 Summit Ave. Suite 800
Fort Worth, Texas 76102-4420
If you are a resident of Arkansas,
you may mail your claim to:
Corphealth, Inc.
10816 Executive Center Drive, Suite 206
Little Rock, Arkansas 72211
Please remember to have the insured's
and patient's ID numbers, the group number and provider's
name and tax ID number. You will also need the correct
CPT code (a universal number given to each type of procedure),
diagnosis code and the date of service on the receipt
you submit. Usually, the practitioner or provider submits
the claims for reimbursement.
What do I do if my claim is denied?
Corphealth has an appeals process.
Please submit a letter to Corphealth asking us to appeal
this denial. Include the date(s) of service, the provider
you saw and anyone you may have spoken with at Corphealth
about this visit. Please include the name of Corphealth
employee and date of call. Mail this to the attention
of:
Corphealth
Attention: Claims Appeal Specialist
Claims Department
1300 Summit Avenue, Suite 800
Fort Worth, Texas 76102-4420
Arkansas claims appeals should be
mailed to the Arkansas Regional Office:
Corphealth, Inc.
10816 Executive Center Drive, Suite 206
Little Rock, Arkansas 72211
What
is an independent review organization (IRO)?
If you do not agree with the outcome
of the Corphealth appeal process, you may be eligible
for a review by an independent review organization (IRO).
Please refer to the attachments to your denial letter
or contact customer service for instructions and information
on the availability of an IRO.
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