Through the HealthChoice certification portal, you can complete and submit a certification request form online. You can also upload documents when requesting certification for services reviewed by the HealthChoice Health Care Management Unit.
The certification portal is organized by services reviewed by HCMU and services reviewed by the certification administrator, AHH. These changes are only applicable to HCMU-reviewed services.
Note: Certification requests that are not accurately completed or are submitted to the incorrect area could be delayed or not processed.
Visit healthchoiceconnect.com and select Certification Portal under Providers Additional Resources. For questions or assistance navigating the portal, please call Customer Care at 800-323-4314. TTY users call 711.
HealthChoice Customer Care has updated the interactive voice response system.
To help us serve you better, please choose the option for provider. After following the prompts for eligibility or claim status, you have the opportunity to speak to a customer care representative. Listen and follow the prompts carefully so you will be directed through the call flow as efficiently as possible. We have a specialized team available to assist you, so please make sure to choose the provider option to speak with one of your dedicated representatives.
For additional information, call Customer Care at 800-323-4314. TTY users call 711.
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All HealthChoice and Department of Corrections contracts contain timely filing provisions.
To align with industry standard for timely claims processing, HealthChoice and DOC accept new, clean claims or corrected claims received no later than 365 days following the date the service or supply was rendered.
You are strongly encouraged to file claims according to the timely filing limits within your existing provider contract.
For additional information, call EGID Network Management at 405-717-8790 or toll-free 866-573-8642. TTY users call 711.
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Effective Jan. 1, HealthChoice requires providers to indicate the drug name on drug administration claims, even if reimbursement for the drug is not being requested. HealthChoice will not pay for the administration charge unless the drug is covered and medically necessary.
For questions about this change, call Customer Care at 800-323-4314. TTY users call 711.
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