Savoy Associates - Health Insurance Benefit Specialists

New Jersey Small Group Reference Guide

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Customer Service and Vendors

Presale Information

Business Checklist

Member Maintenance

Carrier Appointment and BOR Procedures

	Aetna	AmeriHealth	CIGNA HealthCare	Health Net	Horizon BCBSNJ	Oxford Health Plans
Mental Health Vendor	Aetna Behavioral Health - 800-755-2422 24-Hour Nurse Help Line 800-556-1555 For Providers, call customer service. For authorization, use the phone number on the ID card as service is based on residency address.	Magellan Behavioral Health 800-688-1911	CIGNA Behavioral Health : New Jersey group members 800-715-0791-- New York 800-692-7311	MHN for NJ - 800-728-9899 MHN for NY - 800-583-2990	Magellan 800-626-2212	Oxford Behavioral Health 800-201-6991
Therapy Pre- Certification	OrthoNet Pre-Cerifies for North Jersey and Aetna Pre-Certifies for South Jersey.	AmeriHealth does their own Pre-Certification. Their vendors are Novacare and Healthsouth.	OrthoNet does Pre-Certification.	Landmark does Pre-Certification.	Horizon does their own Pre-Certification	OrthoNet does their Pre-Certification.
Chiropractic	Outsourced to Triad	Outsourced to Triad	Covered under Short Term Therapies	800-413-8695	Horizon manages the care. It is not outsourced.	Outsourced to Triad
Alternative Therapies	Fitness Programs, DocFind, Aetna Navigator 800-755-2422. Vision One Discount Program 800-793-8616.				American Specialty Health 877-335-2746
Prescription Drug Vendor	Aetna Pharmacy Management 800-238-6279. P.O. Box 398106, Minneapolis, MN 55439-8106 Mail Order 866-612-3862, ordering address: Aetna Rx Home Delivery, PO Box 417019, Kansas City, MO 64179-9892, or www.aetnarxhomedelivery.com Rx claims forms and list of Pre Certification Rx are attached in our forms section. Carrier link: http://www.aetna.com/formulary/index.html# Refer to our Rx reference guide in our forms section.	Caremark 877-252-3485 http://www.amerihealth.com/providers/drug_formulary/index.html Rx claim forms and list of Pre Authorization Rx are attached in our forms section. FutureScripts is the retail pharmacy vendor. Caremark for Mail Order. Refer to our Rx reference guide in our forms section	CIGNA 800-462-6633 Rx claim forms attached in our forms section. For Pre Certification: www.cigna.com , then click on Drug List on left https://secure.cigna.com/health/form/drug_list.html Refer to our Rx reference guide in our forms section	Caremark for retail. Health Net with any issues: 800-441-5741. Mail order is from ExpressScripts, P.O. Box 52069, Pheonix, AZ 85072-9935. Customer Service 866-265-9458 or www.express-scripts.com Formulary: https://www.healthnet.com/static/general/unprotected/pdfs/ne/pharmacy/formulary_info/alpha_tier_commercial.pdf Prior Authorization: https://www.healthnet.com/static/general/unprotected/pdfs/ne/pharmacy/formulary_info/commercial_pa_list_nj.pdf Rx reimbursement forms are being changed. In the interim, send paid receipts with a cover letter and ID # to: Health Net of the Northeast Attn: Pharmacy Dept. One Far Mill Crossing PO Box 904 Shelton, CT 06484 Rx claim forms and Pre Authorization list are attached in our forms section. Refer to our Rx reference guide in our forms section	Caremark 866-881-5603 Pre Cert: www.horizonblue.com, click on Pharmacy Services, click on Prescription Drug Guide on the left, then enter Drug name. http://www.horizon-bcbsnj.com/pdf/pocketguide.pdf 2008 Rx claim forms and Pre Authorization list are attached in our forms section. Refer to our Rx reference guide in our forms section	Medco 800-905-0201 24 hours/7 days -- Rx Precertification - provider must call 800-753-2851, 8am-9pm EST. https://www.oxhp.com/secure/materials/3tier_pdl_2008.pdf Pre Certification: https://www.oxhp.com/druglist/drug_precert_list.html Rx claim forms attached in our forms section. Refer to our Rx reference guide in our forms section
Customer Service	Northeast Region: 888-287-4295 Options: #1-QPOS, HMO, HMO Dental Rider Plans, #2 PPO, Managed Choice,DMO/PPO/Indemnity Dental, Life or Disability, or #3 to speak to a representative. For HSA plans call 800-594-9371. Member maintenance 888-702-3862. For HSA plans call 800-594-9371. Mid-Atlantic Region: 888-287-4206	800-893-7827 Prompt # 1 Billing Prompt # 2 Delinquent or Cancelled accounts All others stay on the line For claim questions, enrollment status, new ID Cards and general benefit questions.	Members: 800-244-6224 Group Related Issues: 800-603-0125 or email to hooksettunder50ua@cigna.com New business submission queries: nesmallgroup@cigna.com 800-456-6575	800-956-5565 Therapy Services: 800-413-8695 CareCore Radiology Management: 845-298-8155	800-355-2583 Billing 800-225-1955 Fax: 973-466-7056 POS/Direct Access Star Unit for claims and benefit issues: 888-400-8533 - Fax 973-466-5919 Pre-Authorization: 1-888-621-6342 Appeal of denied authorization: 1-888-221-6392	888-201-4216 groupservices@oxhp.com Fax: 603-897-4543 OBM: If you want to have the forms there ASAP you can email them to obm@triveris.com. Some examples of the types of request that the mailbox can be used for include: • Member additions & terminations • Name or address change requests • ID card requests • Invoice requests • Renewal letter requests • General inquiries on group's coverage.
Lab Vendor	Quest Diagnostics	Quest and LabCorp	Quest or LabCorp	Quest Diagnostics NJ / NY: 800-631-1388 OOA PPO with Healthnet can use Labcorp or Quest as long as the lab vendor is listed on the First Health provider directory. For example, member is located in Miami, Florida 33186. When we ran the search for lab vendors on First Health on-line directory (below is the link), both lab vendors came up. The out of state national PPO on the left hand side of our network search page at HealthNet.com . Here is the link directly: https://www.healthnet.com/portal/member/prvfinder/frameOutOfState.do?category=DoctorSearch&topic=outOfState	Lab Corp for all products as of May 1, 2007	LabCorp as of January 1, 2007