| PROVIDER SERVICES CONTACT NUMBER | |
|---|---|
| Name | Allance Health Provider Support Line |
| Description | Alliance provider support is available to answer provider questions about authorization, billing, claims, enrollment and credentialing, ACS, or other issues. It operates Monday-Saturday from 7:00 a.m. to 6:00 p.m. including Holidays. |
| Provider Services Number | 855-759-9700 |
| PROVIDER PORTAL | |
|---|---|
| Website | AllianceHealth.okta.com |
| Description | The above URL is the site for the Alliance Health Provider Portal Single Sign-On. Providers and their users will be required to contact [email protected] and submit the necessary documentation in order to be granted access rights to the single sign-on portal and the approved supported applications. |
| PRIOR AUTHORIZATIONS / NOTIFICATIONS | |
|---|---|
| Name | Clinical Resources |
| Description | Resource page to provide links and instructions on how to submit a prior authozation, look up codes that may require prior authorization and where to locate clinical coverage policies and practice guidelines. |
| Web Link | AllianceHealthPlan.org/tp/providers/clinical-resources/ |
| Phone Number | 855-759-9700 |
| Fax Number | 919-651-8691 |
| MEMBER SERVICES / ELIGIBILITY | |
|---|---|
| Name | Member and Recipient Services |
| Description | Member and Recipient Services operates from Monday-Saturday, 6:00 a.m. to 7:00 p.m. |
| Web Link | AllianceHealthPlan.org/members |
| Phone Number | 800-510-9132 |
| CLAIMS/ELECTRONIC DATA INTERCHANGE (EDI) | |
|---|---|
| Name | Claims and Enrollment |
| Description | Claims and Enrollment Services operates from Monday-Friday, 8:00 a.m. to 5:00 p.m. For claims questions, please email [email protected]. |
| Web Link | AllianceHealth.okta.com |
| Phone Number | 919-651-8500 |
| Address for Paper Claims | Alliance Health ATTN: Claims Department with Appeals Department 5200 W. Paramount Parkway, Suite 200 Morrisville, NC 27560 |
| PROVIDER APPEALS | |
|---|---|
| Name | |
| Description | Providers may file an appeal of an action issued by Alliance via the provider web portal, certified US Mail, email [email protected], or in person at an Alliance office. |
| Web Link | AllianceHealth.okta.com |
| Phone Number | 919-651-8641 |
| Address | Alliance Health ATTN: Claims Department with Appeals Department 5200 W. Paramount Parkway, Suite 200 Morrisville, NC 27560 |
| PHARMACY SERVICES | |
|---|---|
| Name | Navitus Health Solutions |
| Description | For assistance with claims processing or to submit a prior authorization request, please visit the Alliance pharmacy webpage or call the Navitus Pharmacy Service line. |
| Web Link | AllianceHealthPlan.org/tp/prescribers/pharmacy-guidance-for-providers |
| Phone Number | 855-759-9300 |
| Fax Number | 855-668-8553 |
| NURSE LINE | |
|---|---|
| Name | Alliance Health Nurse Advice Line |
| Description | If you have basic questions or concerns about your health, you can call our Nurse Line at 855-759-9400 at any time, 24 hours a day, 7 days a week. This is a free call. You can get advice on when to go to your primary care provider or ask questions about symptoms or medicines. |
| Phone Number | 855-759-9400 |
| BEHAVIORAL HEALTH CRISIS | |
|---|---|
| Name | Alliance Health Behavioral Health Crisis Line |
| Description | If you are thinking of hurting yourself or others, or are in emotional or mental pain or distress, call the Behavioral Health Crisis Line at 877-223-4617 at any time, 24 hours a day, 7 days a week. You can speak with someone who will listen and help. This is a free call. We are here to help you with problems like stress, depression or anxiety. We can get you the support you need to feel better. |
| Phone Number | 877-223-4617 |
| TRANSPORTATION | |
|---|---|
| Name | ModivCare |
| Description | ModivCare Solutions provides non-emergency medical transportation for Alliance Members. Alliance Members need to call ModivCare directly to secure a ride to medical appointments. |
| Web Link | modivcare.com |
| Phone Number | 855-759-9600 |
| INTERPRETER SERVICES | |
|---|---|
| Name | Member and Recipient Services |
| Description | Telephonic and face-to-face interpretation can be requested through the Member and Recipient Service Line. |
| Web Link | AllianceHealthPlan.org/members |
| Phone Number | 800-510-9132 or TTY/TDD: 711 or 800-735-2962 |
| FRAUD, WASTE, and ABUSE | |
|---|---|
| Name | Fraud Waste and Abuse Hotline |
| Description | If you suspect that a service provider or member/recipient has engaged in fraudulent, abusive, or wasteful behavior resulting in payment that should not have happened, please call 1-855-727-6721. This toll free number is staffed by live operators 24 hours each day, 7 days per week. The hotline is operated by a third party and you can remain anonymous. Please share as much information about who did what, when they did it, how they did it, and where it happened. |
| Phone Number | 855-727-6721 |
| ID CARDS | |
|---|---|
| Front |  |
| Back |  |
| PATIENT CARE | |
|---|---|
| Name | Patient Care |
| Description | As a member of Alliance Health, you are eligible for Tailored Care Management. Tailored Care Management provides you with a care manager who is trained to help people with mental health, substance use, intellectual/developmental disability, and/or traumatic brain injury needs. You may contact Alliance Member and Recipient Services from 7 a.m. to 6 p.m. Monday through Saturday to get connected to your care management provider. An Alliance Member and Recipient Services representative can transfer you to your care management provider if you want them to. |
| Web Link | AllianceHealthPlan.org/tp/members/accessing-services/contactmember- and-recipient-services-and-care-managers/ |
| Phone Number | 800-510-9132 |
| VENDORS Northwood | |
|---|---|
| Name | 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. 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, contact Northwood’s provider relations or visit northwoodinc.com. Authorization requests from non-Northwood contracted providers may be requested by phone or fax. 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 greater than $500 do not require prior authorization but need to request within 2 business days in order for the claim to be considered for payment. |
| Web Link | northwoodinc.com |
| Phone Number | 877-403-6164 Northwood’s phone number 877-403-6164 will go live on October 1, 2023 |
| Fax Number | 877-552-6551 |
| VENDORS Avesis | |
|---|---|
| Name | 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 will be responsible for contracting, provider relations, and network development. On behalf of Alliance, Avesis will administer comprehensive routine and eye medical vision care benefits. |
| Web Link | providerportal.northwoodinc.com |
| Phone Number | 800-843-0558 Avesis’ phone number 800-843-0558 will go live on October 1, 2023 |
| Fax Number | UM Authorization Fax #: 855-591-3566 Appeals & Grievance Fax #: 855-691-3243 |
