1. What are the benefits of being in the
Devon Health Provider Network?
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Access to 3 million lives
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No gatekeeper function - specialty referrals are unnecessary
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No capitation- compensation is on a fee-for-service basis
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Simplified claims procedure geared toward minimal administrative costs
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Easy contracting process with standard application
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Simple credentialing process
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Claims submitted on standard HCFA-1500 and UB92 forms or equivalents
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Joint marketing opportunities – contact the
Marketing Department
for more information
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Dedicated Provider Relations Department
to handle provider questions or concerns with designated Provider Relations
toll-free phone line (866.498.4773)
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FREE on-site staff orientations
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Regular communications from Devon Health regarding information about new client
relationships as well as other pertinent news from the company
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Membership rewards through our
partnerships with other medical companies
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2. How do I become a Participating Provider
in the Devon Health Network?
To become a Participating Provider in the Devon Health Network, visit the
How to Join section of this website or contact our Network Development
Department by calling 1.800.431.CARE or emailing
sscavone@devonhealth.com.
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3. How do I update my practice information
after a change has occurred to ensure accurate information in the Provider
Directory and on this website's Provider Finder?
Provider practice location information can be updated three different ways:
By filling out the online Provider
Information Change
form
By calling our Provider Relations Department at 866.498.4773
By faxing location information and W-9 forms (In the case of a tax
identification number change) directly to 610.757.1392
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4. How do I get insurance information from
the patient?
Each Devon Health patient carries a medical identification card that has all the
information necessary to file and submit claims. The name and the logo of the
insurance carrier/ administrator is clearly stated on the front of each card
along with Devon Health logo. Devon Health Services is the provider network
only and does not pay claims.
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5. Who is the patient's insurance company or
benefit administrator?
The name and logo of the patient's insurance company or benefit administrator
are printed in bold type on the front of the member's medical identification
card.
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6. Do patients have any financial
responsibility?
A patient's financial responsibility depends on his/her benefit plan and will
vary from patient to patient. Applicable co-payments are listed on the patient
medical identification card and should be collected up front. Should the
patient have a deductible and/or coinsurance the explanation of benefits (EOB)
that is issued by the insurance carrier/ administrator will state the amount
that the patient is responsible for. The provider can bill the patient for that
amount.
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7. What encounter fees (co-payments) should I
collect from the patient at the time of service?
If a patient has an encounter fee (co-payment) for an office visit, the amount
will be printed on the patient's medical identification card. This fee can be
collected from the patient at the time of service.
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8. Who do we contact about benefit coverage
and eligibility?
Devon Health does not design insurance plans or coverage. Therefore providers
should call the insurance carrier/ administrator to check benefit limitations
and coverage. This number is listed on each patient's medical identification
card.
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9. Do patients need a referral?
Devon Health is a Preferred Provider Organization and patients do not need to
obtain referrals from their primary care physicians.
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10. Do patients need precertification?
For programs that require precertification, necessary information is printed on
the member's medical ID card along with a phone number to call for additional
questions.
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11. How do I file a claim?
Devon Health follows standard Medicare claims submission guidelines. Claims
should be submitted on HCFA 1500 for physician billing or UB 92 for
hospital/ancillary billing.
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12. Where do I submit claims?
The claims address, along with the phone number for claims inquiries, is printed
each patient's ID card. Claims addresses will vary depending on the patient's
employer. The patient's medical identification card is the best source for this
information.
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13. What should I do if I have outstanding
claims or claims denied as out-of-network?
Devon Health Services does not pay claims; however, we have established
procedures to help our providers have their claims paid correctly and in a
timely manner. Should you have any problems getting claims paid correctly or
processed as in-network, you are welcome to contact Devon Health's
Provider Relations Department for assistance. In order to help, we will
need to get a copy of the HCFA 1500/UB 92 and the explanation of benefits, if
applicable.
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14. Additional Questions?
Contact Provider Relations toll-free by calling 866.498.4773 or email
nleh@devonhealth.com.
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