Savoy Associates - Health Insurance Benefit Specialists

New York Small Group Reference Guide

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Customer Service and Vendors

Presale Information

Business Checklist

Member Maintenance

Carrier Appointment and BOR Procedures

	Aetna	Atlantis Health Plan	CIGNA Healthcare	GHI	Health Net	HealthPass	Oxford Health Plans	PerfectHealth
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.	866-477-9740 or members can use http://www.atlantishp.com/search/index.asp	CIGNA Behavioral Health : New Jersey group members 800-715-0791-- New York 800-692-7311	Value Options is the vendor. Members can call the number on their ID card or in NYC subscribers can call 212-501-4444 and for other areas 800-624-2414. Providers may call 800-692-2489	MHN for NJ - 800-728-9899 MHN for NY - 800-583-2990	Carrier specific.	Oxford Behavioral Health 800-201-6991
Therapy Pre- Certification	OrthoNet Pre-Cerifies for North Jersey and Aetna Pre-Certifies for South Jersey.		OrthoNet does Pre-Certification.		Landmark does Pre-Certification.		OrthoNet does their Pre-Certification.
Chiropractic	Outsourced to Triad	Atlantis does not outsource	Covered under Short Term Therapies	Not outsourced.	800-413-8695		Outsourced to Triad	Not outsourced.
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.	CatalystRx, 800-341-8570, www.catalystrx.com For Rx benefits and pharmacy list, see: http://www.atlantishp.com/brokers/benefit_rx.asp	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	As of July 1, 2008 retail is through GHI Pharmacy Services 877-444-3614. Mail Order is through Medco Health Solutions Inc. - 877-204-8150	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	All prescription plans must be the same for all offered plans. The exception is with products that have embedded Rx. There is a $2,000 maximum which is the wholesale cost of the Rx. Perfect Health has no Rx card as all their plans are H.S.A. There is mandatory Mail Order for maintenance drugs.	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	Express Scripts is strictly a discount plan that only applies after deductible and coinsurance. Call 866-374-5543. Mail order is available via www.express-scripts.com
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	866-747-8422	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	Broker Services: In NY call 212-615-4037 and for outside NY call 800-552-0103. Mail: Group Health Incorporated Broker Services Dept. 441 Ninth Avenue, 7th Floor New York, NY 10001	800-956-5565 Therapy Services: 800-413-8695 CareCore Radiology Management: 845-298-8155	888-313-7277	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.	718-370-5380
Lab Vendor	Quest Diagnostics	Depends on the member zip code. Go to www.atlantishp.com, click on Find a Physician, Search for Ancillary, then Lab in the drop down specialty box and select.	Quest or LabCorp	There are several. Call customer service 212-501-4444.	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	Carrier specific	LabCorp as of January 1, 2007