Provider Relations SIHO INSURANCE SERVICES Provider-sponsored - - PowerPoint PPT Presentation

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provider relations siho insurance services
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Provider Relations SIHO INSURANCE SERVICES Provider-sponsored - - PowerPoint PPT Presentation

Jul 28, 2023 109 likes •264 views

INTRODUCTION Provider Relations SIHO INSURANCE SERVICES Provider-sponsored health plan Founded in 1987, by a fortune 100 employer, local hospitals and local physicians Created to provide a solution to rise healthcare costs for

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SLIDE 1

INTRODUCTION

Provider Relations

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SLIDE 2

SIHO INSURANCE SERVICES

  • Provider-sponsored health plan
  • Founded in 1987, by a fortune 100

employer, local hospitals and local physicians

  • Created to provide a solution to rise

healthcare costs for local businesses

  • 110,000+ members
  • Not-for-profit
  • Providing health care benefits to
  • rganizations of all sizes

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SLIDE 3

SIHO OBJECTIVES

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SIHO will be the premier healthcare delivery system administration company, known and respected for its high quality people, innovative products and outstanding services. VISION Our mission is to continually improve our products and services to meet and exceed our customer‘s needs and expectations, allowing us to prosper as a business and provide a value return for our stakeholders. MISSION

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SLIDE 4

BENEFITS OF SIHO

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  • Claims Administration
  • Pre-Certification
  • Full Service Medical

Management

  • Member Services
  • Employer Services
  • Benefit Consulting
  • National Pharmacy Network
  • Comprehensive Provider Network
  • Not For Profit
  • Provider Owned
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SLIDE 5

SIHO PROVIDER WEBSITE

Link image of website

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SLIDE 6

SIHO PROVIDER LOG IN

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SLIDE 7

WEBSITE HOMEPAGE

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SLIDE 8

CLAIMS SEARCH

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SLIDE 9

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Claims Search Demo. Screen

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SLIDE 10

ADDITIONAL OPTIONS/RESOURCES

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  • Call into SIHO and utilize the Interactive Voice Response. Phone

Number: 800.553.6027

  • The new IVR allows providers to check claim status 24 hours a

day, 7 days a week.

  • Providers have the option to opt out and speak with

representative during regular business hours or leave a voice message after hours.

  • Request precertification/authorizations on-line. The request will

be reviewed and a response released within 24 hrs.

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SLIDE 11

CREDENTIALING / RE-CREDENTIALING

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Information to include when adding a new provider to your practice:

 Provider Name, title, and date of birth  CAQH Provider ID number 

Tax Identification number

 Group NPI number  Practice demographics  Remittance address

Changes to your practice

 Adding or removing a provider  Practice address changes  Remittance address changes

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HELPFUL HINTS

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  • Member Services Department can assist members as well as providers

with questions regarding eligibility, benefits and claim status. Phone: 800.443.2980 Questions may be emailed to memberservices@siho.org

  • Claim submissions: Rendering provider’s NPI must be listed in 24j &

name in box 31; Vendor name must be in box 33 and group NPI listed in 33a

  • Electronic Claim Submission ensures timely claim payment. SIHO

utilizes a Universal Payer ID: 77153 – TK Software phone: 888.372.2808

  • Provider Relations Specialists assist with credentialing/re-credentialing,

practice changes, claims research, web portal inquiries, fee schedule requests, provider issues and education.

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SLIDE 13

CONTACT INFORMATION

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PROVIDER SERVICES

Jana Griner Email: Jana.Griner@siho.org Phone: (812) 378-7018 Melanie Brock Email: Melanie.Brock@siho.org (812) 314.2500 ext. 1107 Latisha Meyer Email: Latisha.Meyer@siho.org 812.314.2500 ext. 1187

MEMBER SERVICES:

1-800-443-2980

MEDICAL MANAGEMENT:

1-800-553-6027

Provider Relations:

Email: Provider.Services@siho.org Fax number 812.378.8721