If you are a provider interested in joining the Alliance Provider Network to offer Vision, Pharmacy, or DME services, please visit our Becoming a Vision, Pharmacy, or DME provider page.
Vision Providers - Avesis
Administrator: Avesis
Description: Avesis will provide the full spectrum of Medicaid-covered vision services through an integrated delivery system of eye care services. Avesis will provide a vision network for Alliance Tailored Plan members and is responsible for Vision provider contracting, authorizations, provider relations, and network development. For any questions regarding contracts, rates or any other Vision related questions or concerns, contact Avesis at avesis.com.
To determine if services need prior authorization please utilize the Procedure Lookup tool.
Web Link: avesis.com
Phone Number: 800-843-0558
Fax Numbers:
UM Authorization Fax #: 855-591-3566
Appeals and Grievance Fax #: 855-691-3243
Pharmacy Providers - Navitus
Administrator: Navitus Health Solutions
Description: Navitus is responsible for administering pharmacy services for Alliance Health and contracting directly with pharmacies. For assistance with claims processing or to submit a prior authorization request, please visit the Alliance pharmacy webpage below or call the Navitus Pharmacy Service line. For any questions regarding contracts, rates or any other Pharmacy related questions or concerns, contact Navitus at [email protected] or call 866-333-2757.
To determine if services need prior authorization please utilize the Procedure Lookup tool.
Web Link: AllianceHealthPlan.org/tp/prescribers/pharmacy-guidance-for-providers
Phone Number: 855-759-9300
Fax Number: 855-668-8553
DME Providers - Northwood
Administrator: Northwood
Description: Alliance and Northwood have entered into a partnership to ensure access to quality, cost-effective durable medical equipment, prosthetics, orthotics and medical supplies (DMEPOS) for Alliance Tailored Plan members. Any providers that wish to contract for DME services will need to contact Northwood at northwoodinc.com. Authorization requests by Northwood contracted DMEPOS providers shall be requested using Northwood’s online provider portal at providerportal.northwoodinc.com. To request access to Northwood’s provider portal or any questions regarding contracts, rates or any other DME related questions or concerns, contact Northwood Provider Relations or visit northwoodinc.com. Authorization requests from non-Northwood contracted providers may be requested by phone or fax. Items under $500 do not require an authorization for claim consideration. Urgent/emergent requests do not require prior authorization. However, these requests must be submitted to Northwood within the next 2 regularly scheduled business days in order for the claim to be considered for payment.
To determine if services need prior authorization please utilize the Procedure Lookup tool.
Web Link: northwoodinc.com
Phone Number: 877-403-6164
Fax Number: 877-552-6551
