Devon Health Provider Manual
Welcome to Devon Health Services, Inc., a leading Preferred Provider
Organization (PPO) currently serving the northeast region. Devon Health prides
itself on providing its members with the best possible healthcare, while
operating a user-friendly system that is unencumbered by excessive paperwork.
This manual is designed to aid in your orientation as a new Devon Health network
provider. The following information will serve as a guide for your office
personnel to follow when treating Devon Health patients.
Should you have any questions that are not answered in this manual, please
contact Devon Health’s Provider Relations Department at 866.498.4773.
Patient Identification
All Devon Health patients are issued an official Devon Health Services
identification card. Your office administrators should request this card from
the patient before the treatment is delivered. The card will feature the Devon
Health Services logo, as well as the patient’s name and identification number.
Information regarding copayment, deductible, precertification requirements, as
well as the claims mailing address will be clearly displayed.
Top of Page
Billing Procedures
Due to our diverse client base, plan designs do tend to vary. However, the
reimbursement rates will always remain the same once all applicable copayments
and deductibles are considered. To alleviate any confusion, Devon Health’s
patient identification card clearly indicates both the insurer and patient
financial responsibility for services rendered.
All claims are to be submitted on standard HCFA-1500 forms or their equivalents.
The completed form must include the following:
-
Insured’s name, address and social security number
-
Patient’s name and relationship to insured
-
Employer’s name
-
CPT – 4 procedure codes
-
ICD – 9 diagnostic codes
-
Provider's name, address, signature and tax identification number
-
Date and location of service
-
Accident-related information, if applicable
Claims are to be completed and submitted to the billing address on the back of
the patient’s ID card within 60 days of service. As a network provider, your
reimbursement rate shall constitute payment in full less any applicable
copayment or deductible received from patient. You may not bill members for any
difference between your charge and Devon Health’s reimbursement rate. Any
questions regarding claim status or billing procedures should be directed to
the billing information number on the patient’s ID card.
Top of Page
Labs
When laboratory services are part of an employers’ benefit plan, all Devon
Health patients should have their labwork sent to a participating laboratory.
Top of Page
Scheduling
Devon Health requests that all reasonable efforts be made to schedule our
patients within 48 hours.
Top of Page
Specialty Care
When additional care is necessary, Devon Health encourages its providers to
refer patients to other network providers. Each Devon Health member is issued a
provider directory that contains eligible providers listed by county or
specialty. If a quality provider is missing from the directory, patients are
instructed to forward a physician request form to Devon Health’s Provider
Relations Department. For an updated listing of network providers, please check
our Provider Finder.
Top of Page
Provider Manual Download
Please click here to view the
Provider Manual (pdf).
You will need
Adobe Reader
Top of Page