Click on the browser name below to download the latest versions. Supported browser are : The Medicare-Medicaid Plan (MMP) is a joint effort between the Ohio Department of Medicaid (ODM) and the Centers for Medicare and Medicaid Services (CMS). Welcome New Providers Learn More Welcome Members We will help you get the help you need. Staywell Health Plan and Sunshine Health are bringing our health plans together to better serve our members, providers, partners and communities. %PDF-1.7
OneCare Kansas focuses on the whole person and all of his or her needs to manage his or her conditions and be as healthy as possible. Envolve Vision Unsupported browser detected Contact Us Close Please note. Through this transition, we are committed to adding more value to better serve you. 0000089796 00000 n
If you have questions about a topic in the manual or if you have any suggestions, we welcome your input. endobj
In accordance with the Provider Contract, providers are required to comply with the provisions of this Manual. endstream
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Office Visit Checklist - Give this to your patients before their appointments to help create a more thorough conversation and encourage patients to plan ahead and focus on any health changes or issues. 10 0 obj
Provider Contracting & Credentialing Forms have been moved to the Contracting & Credentialing Forms page. 9Lxx$ZiGZYI. Providers cannot request to alter or remove reviews. Envolve Vision prefers that providers utilize an ELOA lab, however, providers may choose any lab to fulill their eyewear orders. <>/Metadata 1616 0 R/ViewerPreferences 1617 0 R>>
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How to Use This Manual Envolve Vision is committed to working with our Provider community and Members to provide a high level of satisfaction in delivering quality healthcare benefits. stream
h}o6 OneCare Kansas expands upon medical home models to include links to community and social supports. Member Services, Eligibility & Enrollment, Informatics, Data Aggregation & Analytics, Keeping Pace with Social Determinants of Health, Strategies for Payer-Provider Collaboration Around Social Determinants of Health, Choosing the Right Approach to Social Determinants of Health, Perfecting Population Health Survey Brief, Advice in Action: Trends and Best Practices in Influencing Patient Behavior, Hall of Fame Names Envolve and Centene as Official Youth Wellness Partner | Envolve Health, Washington DC Welcomes SeeMore the Envolve Vision Van | Envolve Health, Envolve Joins Marys Center for the Heroes to Care Health Fair on Veterans Day, Envolve Wins Gold Stevie Award | Envolve Health, Follow SeeMore, the Envolve Vision Van, on his Holiday Travels | Envolve Health, Eye Health Tips in Honor of Glaucoma Awareness Month | Envolve Health, Is it the Flu or a Cold? Vision: Call the member services number on the back of your card Dental: Call the member services number on the back of your card Pharmacy or 800-460-8988 Questions about the Vision Van seemore@envolvehealth.com Providers Vision Dental Pharmacy or 800-460-8988 Pharmacy Prior Authorization Department: 866-399-0928 0000012380 00000 n
The email is not encrypted and is not transmitted in a secured format. Holiday Season Healthy Eating Yes, it Can be Done! 0000032711 00000 n
JFIF ` ` C They are now called Envolve Vision of Texas. Holiday Season Healthy Eating Yes, it Can be Done! On February 1, 2020, Envolve Vision will offer benefits for Phase 1 former YouthCare HealthChoice Illinois members. 0000004576 00000 n
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Nothing is more important than taking care of you and your family. 0000002829 00000 n
I Am: * To ensure the safety of your personal health information, please send us a message through the Secure Member or Provider portal, or you can call us using the information found on the Members & Providers page. 0000089419 00000 n
27804 Contacting Envolve Vision Customer Service: Member Eligibility and Claims Inquiries (888) 282-6025 . <>
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Apple Health (Medicaid) Manual and Guides Apple Health (Medicaid) Forms Behavioral Health Collaborative Care MemberConnections General High Tech Imaging: MRAs, MRIs, CT and PET Scans Reconsideration Resources Vision National Resources Policies and Procedures Pharmacy Resources Member Forms Ambetter Manuals & Forms Provider Services for Medicaid 844-464-5634 Members: call the number on the back of your ID card or go to the plan site. ;'[)AmnYnA}UG6+c;jW|yW6v$]T{2DfY2
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YouthCare HealthChoice Illinois is a specialty health plan designed by Illinois Healthcare and Family Services (HFS) and Department of Children and Family Services (DCFS) to serve current youth in care and former youth in care. 0000037843 00000 n
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Interpreter Services-Providers may call Sunflower directly or direct members to contact Sunflower to arrange for interpreter services. Use the filters to search by plan endstream
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1 . From the Provider Web Portal, providers and authorized office staff can log in for secure access anytime from anywhere and handle a variety of day-to-day tasks, including: The Envolve VisionProvider Web Portalallow us to maintain our commitment of helping you keep your office costs low, access information efficiently, get paid faster and submit claims and authorizations electronically. 0000005930 00000 n
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Envolve Visions Web Portal allows providers to manage benefit administration via a host of web-based services. 0000004539 00000 n
Choosing Wisely - ABIM Decision Making Aid, Follow-Up After Hospitalization Resources, Grievance and Appeals Process for Members, Provider Remittance and Recoupment Guides, Provider Training and Education Request Form, Centers for Disease Control and Prevention, Consumer-Directed Attendant Care (CDAC) User Guide (PDF), Authorized Representative Designation Form (PDF), Inpatient Medicaid Prior Authorization Form (PDF), Medicaid Supplemental Information Prior Authorization Form (PDF), Notification of Pregnancy (NOP) Form: English (PDF), Notification of Pregnancy (NOP) Form: Spanish (PDF), Outpatient Medicaid Prior Authorization Form (PDF), Provider Formal Administrative Complaint Form (PDF), Cardiac and Orthopedic PA Code Updates: 11.1.2022 (PDF), Childhood Immunization Review: Rotavirus & Influenza (PDF), Chlamydia: Increasing Screening & Testing Rates (PDF), Early Periodic Screening, Diagnosis, and Treatment CAHPS Powerpoint (PDF), Health Literacy & Cultural Competency Flyer (PDF), HEDIS Behavioral Health Measures Toolkit: 2022 (PDF). July 1 - 7, 2021. Ourvendor affiliatesmanage vision, dental, pharmacy, transportation, OT/PT/ST and radiology benefits. HealthDrive connects patients in need of vital healthcare to doctors committed to dignity and excellence. Wellcare (Medicare) New Provider Orientation, Wellcare By Allwell 2023 In-Network Provider Acknowledgment, Wellcare By Allwell 2024 In-Network Provider Acknowledgment, SSBCI Attestations for Chronically Ill Members, Member Day at the KCK Farmers Market at Catholic Charities | Sunflower Health Plan, Member Day at the KCK Community College Campus Farmers Market | Sunflower Health Plan, Ambetter from Sunflower Health Plan website, Provider resources, forms and manuals can be found here, Envolve Dental Kansas Plan Specifics (PDF), Envolve Pharmacy Solutions Provider Manual (PDF), Provider Quick Reference Guide (QRG) (PDF), Corrected Claims Quick Reference Guide (QRG), Sunflower Member ID Card Reference Sheet (PDF), Pregnancy Quick Reference Guide for Providers, KAN Be Healthy (KBH) and Early and Periodic Screening, Diagnostic, Treatment (EPSDT) Guide, Coordination of Benefits Entry Walk-Through Guide (PDF), PCSP and Completing the PCSP Signature Addendum (PDF), Quality Care Pointers for Providers (PDF), Preventive and Clinical Practice Guidelines, Consumer Access Guide to HCBS Services in Kansas, Unsolicited Overpayments, Refunds Worksheet (XLS), Outpatient Prior Authorization Form (PDF), Provider Reconsideration and Appeal Form (PDF), Provider Request for External Independent Third Party Review (EITPR) Form (PDF), Authorized Representative Designation Form (PDF), Discharge Consultation Documentation (PDF), Behavioral Health UM Inpatient Request (PDF), Electroconvulsive Therapy (ECT) Authorization Request Form (PDF), Inpatient Neuropsychological Testing Authorization Request Form (PDF), Outpatient Psychological Testing Authorization Request Form (PDF), Psychiatric Residential Treatment Facilities (PRTF) Prior Authorization Request (DOCX), Prior Authorization for Supported HousingOperation Community Integration (OCI) Program (PDF), Parent Management Training Oregon Request Form (PDF), Pharmacy Solutions MAC Pricing Inquiry Form, Sunflower KanCare Provider Directory (PDF). Envolve Vision Providers Login Webpage
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General or Routine Questions: Call Provider Services at 1-844-518-9505 ( TTY 1-844-546-9713) Complex Questions or Concerns: Please use this Contact Us Form. 907 0 obj
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You must call the national provider assistance line, 1-800-454-3730 for assistance. Superior's vision provider, Total Vision Health Plan, also has a new name. 0000074282 00000 n
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Ancillary Provider Manuals. Medicaid renewals are starting again. Five Healthy Dessert Swaps to Enjoy During the Holiday Season! Review the Billing Manual (PDF) for guidance. %
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Five Healthy Dessert Swaps to Enjoy During the Holiday Season! Use any of the filters below to find your plan's vision details. ]s,7L-4eHy}5TMpg\in7jMcJp;8{py Our goal is to They can be members who also receive Medicare along with Medicaid. | Envolve Health, Genetic Testing & Health Behavior Change | Envolve Health, Grants Support Deeper Understanding of Health Outcomes | Envolve Health, Research on Health Coach Titles | Envolve Health, The Envolve Center: Health Plan Partnership a Win-Win | Envolve Health, Treating Depression from the Outside In | Envolve Health, Controlling Diabetes: Why's It So Hard? 0000002326 00000 n
| Envolve Health, The Envolve Center for Health Behavior Change Barriers to Better Health Video Wins Award, The Wrong and Right Way to Brush Teeth Upgrade Your Routine | Envolve Health, How to Never Get Tired - Tips from People Who Don't | Envolve Health, Health Promotion Practice Publishes Envolve Center Research on Health Coaching-Related Terms and Associations, 5 Protein Rich Breakfast Foods to Fuel Your Body | Envolve Health, Knowledge Not Enough to Drive Behavior Change | Envolve Health, The psychology behind food indulgences: How we trick ourselves into thinking overeating is fine and that well bounce back quickly, Envolve Presents Diabetic Retinopathy Quality Initiatives at Texas Association of Health Plans Fall Directors Forum, Envolve Center Research to Be Presented at Americas Health Insurance Plans Medicare, Medicaid and Duals Conference, Social Norm Marketing Tactics for Health Communications | Envolve Health, Health Benefits of Tea - Infographic | Envolve Health, Envolve Provides Childrens Home Network with Oral Health Books in Honor of National Dental Hygiene Month, Make This Year Different: Behavioral Science Will Teach You How to Keep Your New Year's Resolution, Envolve Center/LA Healthcare Connections Diabetes Study | Envolve Health, The Future of Rx Benefits: Takeaways from Envolve at Medicaid Innovations Forum | Envolve Health, Dr. Jeremy Corbett Addresses Attendees at the Population Health Management Summit for Payers and Providers, Five Ways to Prevent Asthma Attacks in Children | Envolve Health, Five Quick Workout Tips for Busy Women | Envolve Health, Envolve Named 2019 Aster Winner | Envolve Health, Envolve Recognized as Bronze Stevie Award Winner in 2019 American Business Awards, Achieving Better Outcomes, Lower Cost with a Healthcare Benefits Management Partner, Five Ways to Avoid the Health Risks of Being Too Busy, How Vision and Dental Benefits Positively Impact Member Engagement and Health Outcomes, Envolve Panel Addresses How Unmet Basic Needs Impact Health Behaviors of Low-Income and Diabetic Populations, Five Tips to Keep Kids Safe During the Holidays, Human-Driven Technology Allows Fewer Clinicians to Care for More Patients, Five Ways to Workout When It's Cold Outside, Five Ways to Get Creative to Reduce Holiday Stress, Tapping Into Small Data for Bigger Results, How to Have a Successful First Doctor's Appointment with Baby, Five Tips for Protecting Your Eyes This Winter, Five Signs Your Child Has a Toothache - Even if They Can't Tell You it Hurts, Behavior Change Theorem: Using a Debt Model to Promote Whole Patient Health, Tech, Personalized Care, and Population Health Brighten the Future for Diabetes Patients | Envolve Health, Five Ways Relationships Are Good for Your Health, Five Tips to Help You Recover From a Heart Attack, Five Easy Ways to Lower Your Sodium Intake, Health Benefits of Spring Fruits & Veggies, Personalized Healthcare Is the Future, But We're Not There Yet | Envolve Health, Can Artificial Intelligence Humanize Patient Care? | Envolve Health, The Envolve Center for Health Behavior Change Barriers to Better Health Video Wins Award, The Wrong and Right Way to Brush Teeth Upgrade Your Routine | Envolve Health, How to Never Get Tired - Tips from People Who Don't | Envolve Health, Health Promotion Practice Publishes Envolve Center Research on Health Coaching-Related Terms and Associations, 5 Protein Rich Breakfast Foods to Fuel Your Body | Envolve Health, Knowledge Not Enough to Drive Behavior Change | Envolve Health, The psychology behind food indulgences: How we trick ourselves into thinking overeating is fine and that well bounce back quickly, Envolve Presents Diabetic Retinopathy Quality Initiatives at Texas Association of Health Plans Fall Directors Forum, Envolve Center Research to Be Presented at Americas Health Insurance Plans Medicare, Medicaid and Duals Conference, Social Norm Marketing Tactics for Health Communications | Envolve Health, Health Benefits of Tea - Infographic | Envolve Health, Envolve Provides Childrens Home Network with Oral Health Books in Honor of National Dental Hygiene Month, Make This Year Different: Behavioral Science Will Teach You How to Keep Your New Year's Resolution, Envolve Center/LA Healthcare Connections Diabetes Study | Envolve Health, The Future of Rx Benefits: Takeaways from Envolve at Medicaid Innovations Forum | Envolve Health, Dr. Jeremy Corbett Addresses Attendees at the Population Health Management Summit for Payers and Providers, Five Ways to Prevent Asthma Attacks in Children | Envolve Health, Five Quick Workout Tips for Busy Women | Envolve Health, Envolve Named 2019 Aster Winner | Envolve Health, Envolve Recognized as Bronze Stevie Award Winner in 2019 American Business Awards, Achieving Better Outcomes, Lower Cost with a Healthcare Benefits Management Partner, Five Ways to Avoid the Health Risks of Being Too Busy, How Vision and Dental Benefits Positively Impact Member Engagement and Health Outcomes, Envolve Panel Addresses How Unmet Basic Needs Impact Health Behaviors of Low-Income and Diabetic Populations, Five Tips to Keep Kids Safe During the Holidays, Human-Driven Technology Allows Fewer Clinicians to Care for More Patients, Five Ways to Workout When It's Cold Outside, Five Ways to Get Creative to Reduce Holiday Stress, Tapping Into Small Data for Bigger Results, How to Have a Successful First Doctor's Appointment with Baby, Five Tips for Protecting Your Eyes This Winter, Five Signs Your Child Has a Toothache - Even if They Can't Tell You it Hurts, Behavior Change Theorem: Using a Debt Model to Promote Whole Patient Health, Tech, Personalized Care, and Population Health Brighten the Future for Diabetes Patients | Envolve Health, Five Ways Relationships Are Good for Your Health, Five Tips to Help You Recover From a Heart Attack, Five Easy Ways to Lower Your Sodium Intake, Health Benefits of Spring Fruits & Veggies, Personalized Healthcare Is the Future, But We're Not There Yet | Envolve Health, Can Artificial Intelligence Humanize Patient Care? We are the only MCO that will be delivering this specialty health plan called YouthCare effective February 1, 2020. 0000028565 00000 n
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How Supplemental Health Benefits Improve Patient Outcomes, Increase Medicaid Patient Engagement With Three Simple Steps, Why Understanding Behavioral Science Is Important To Engaging Members, Population Health Analytics & Management | Envolve Health. . 1675 0 obj
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Envolve understands your need to procure quality health benefits at a reasonable price to address the specific health needs of your union. Payspan offers healthcare reimbursement and payment systems that are secure, efficient, cost-effective choices for providers and payers. 0000011185 00000 n
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This Envolve Dental provider manual supplies useful information about working with us. NIA. <>
Read more and plan to attend an upcomingSunflower Project ECHO! Conveniently located off Route 9, close to routes 90 and 495 in a spacious modern office! #Xf5cZpi ~_`Q!}HK]Z==;|R3@:. We are dedicated to provide comprehensive information through this Provider Manual as it relates to Envolve Vision's operation, benefits, and stream
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We serve as your partner in building a customized set of benefits that deliver positive health outcomes and effectively manage your spend. Providers shall contact Envolve Vision for additional details. f&UOctle~if)B\RK 7\lGX0ZVXGqNvXu4v"e],>8@j|\aqk!O\ IVVv:&k/{[X}D{2!%ha1e4/G_KWYgU!#?Bf@o xmR$DcU/aQb!ZBNwRe1GrE endstream
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If you are a member of the media, please contact mediainquiries@envolvehealth.com. PLAN OVERVIEW: Allwell from Arkansas Health and Wellness provides covered health beneits for individuals eligible for Medicare. Additionally, providers may be notified via bulletins and notices posted on the website. 0000089532 00000 n
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You will receive a follow-up message within 48 hours. Providers should use the terms of that contract for resolution of any issues or disputes. The YouthCare HealthChoice Illinois plan was designed by Illinois Healthcare and Family Services (HFS) and Department of Children and Family Services (DCFS) to serve former and current youth in care. Please contact HealthSelect of Texas at (800) 252-8039 or visit www.healthselectoftexas.com for more information about plan information and claims incurred on and after September 1. X@~%Wi9uLHm)luxS?6]&@@I7FLH 0000075332 00000 n
How to Use This Manual Envolve Vision is committed to working with our Provider community and Members to provide a high level of satisfaction in delivering quality healthcare benefits. Please complete the captcha by selecting the checkbox, I am not a robot. <>
Language Access Services and Guidelines Quick Reference Guide (PDF), Language Access Services Request Form (PDF), Language Interpretation Services Poster (PDF), My Health Pays Rewards Information & Codes (PDF), Provider Coding Incentive: Initial Prenatal Visit (PDF), Provider Portal Batch Claim Submission (PDF), Provider Portal: Quality Care & Risk Gaps/Interpreta Demo (PDF), Provider Portal: Quality Care & Risk Gaps Daily View How-To Guide (PDF), Provider Portal: Recurring Claims Submission (PDF), Provider Portal & Registration Login (PDF), Provider Portal: Single Claim Submission (PDF), Provider Portal: Uploading Documents (PDF), Provider Portal: Viewing Prior Authorizations (PDF). Click here to join our ever-growing network of providers.
Providers have an on-going contractual relationship which survives the KanCare contract termination. 0000033394 00000 n
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If you are a member of the media, please contactmediainquiries@envolvehealth.com. The provisions outlined in these Plan Speciics shall prevail over any provision in the Envolve Vision Provider Manual which may conlict or appear inconsistent with any provision contained in this document. Envolve does not accept responsibility or liability for any loss or damage arising from the use of email. For information on claims incurred through . All the caregivers involved in a OneCare Kansas members health communicate with one another so that all of a patient's needs are addressed in a comprehensive manner. <<7410A90B714FE94587D1A7B635ACF1B4>]/Prev 235332/XRefStm 2326>>
By utilizing theProvider Web Portal, providers see the following benefits: A web browser, a valid user ID and password are required for online access. July 1 - 9, 2021. Download the free version of Adobe Reader. <>
Learn More Contact Us Contact Us Providers may contact our Provider Services Department at 1-866-874-0633 regarding any questions about this manual or its contents. endobj
Envolve Vision provides expert eye care benefit services for Medicaid, Medicare, and Health Insurance Marketplace member products with more than 30 years of experience operating as a full-service, eye care speciality Health Management Organization (HMO). Weekly, Wednesday. <>
Provider Manual (PDF) - Includes information on, but not limited to, program benefits and limitations, prior authorizations, urgent and emergency care, member rights, provider rights for advocating on behalf of members, cultural competence, grievances and appeals, and key contacts. PO Box 7548 Rocky Mount, NC . Participating eye care providers may use this guide for administering the Superior Vision Plan for members and dependents. | Envolve Health, Genetic Testing & Health Behavior Change | Envolve Health, Grants Support Deeper Understanding of Health Outcomes | Envolve Health, Research on Health Coach Titles | Envolve Health, The Envolve Center: Health Plan Partnership a Win-Win | Envolve Health, Treating Depression from the Outside In | Envolve Health, Controlling Diabetes: Why's It So Hard? endobj
show Social Determinants of Health Insights submenu, show Population Health Analytics & Management | Envolve Health submenu. 11 0 obj
These are Confidential and Proprietary materials of Envolve Vision Benefits, Inc. (Envolve Vision), which should not be reproduced in any manner or shared with any third party without the prior written consent of Envolve Vision. July 8, 2021. 0000009749 00000 n
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If you are a Member or Provider use the contact information below or fill out the form to receive an email response. <>
Eye care is a fundamental component of a wholeperson approach to healthcare delivery. 9 0 obj
Providers may visit. We strive to make information clear and user-friendly. 0000032560 00000 n
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If you'd prefer, please use the toll-free number for more information or assistance. Read more about the importance of perfecting population health for payers and providers. OneCare Kansas is intended for people with certain chronic conditions, like diabetes, asthma, or mental illness.
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