The call center is available Monday through Friday, 7 a.m. — 6 p.m. (Central time, with the exception of state-observed holidays). Providers should call Provider Services for enrollment, policy, and billing questions.
Verify Member Enrollment. Providers should make sure to submit all claims to the appropriate HMO. They can verify a member’s HMO enrollment on the ForwardHealth Portal. HMO contracts set filing guidelines for claims submissions, reconsiderations, and appeals. Providers must submit claims completely, accurately, and timely to their HMO to avoid claim denials. Providers must appeal to the HMO first. Providers can only appeal to DHS after exhausting the HMO appeal process. Providers that do not exhaust the HMO appeal process will have their appeal rejected by DHS.
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