(精选)【医学英文课件】 CUSTOMER CARE教学课件.ppt

WHIRLPOOL CORPORTATION ? CONFIDENTIAL WHIRLPOOL CORPORTATION ? CONFIDENTIAL WHIRLPOOL CORPORTATION ? CONFIDENTIAL Pre-certification/Pre-authorization Claim Status Eligibility Benefit Information Provider Network verification IVR- Available 24/7 1st Level Appeals 1-800-660-6212 CUSTOMER CARE REPRESENTATIVES Whirlpool Service Line 1-800-660-6212 M-F 8:00 a.m. – 6:00 p.m. EST HealthSCOPE Benefits * Click on Provider Enter WHIRL for group name Check on: Claim Status Eligibility Benefit Information Precert Information Copies of EOBs HealthSCOPE Benefits * Claim Submission Information: HealthSCOPE Benefits PO Box 99006 Lubbock, TX 79490-9006 EDI Payor ID: 71063 HealthSCOPE Benefits * ALERT! WHIRLPOOL HSB ID CARD 2017 CHANGES New id cards will be issued for 2017. Whirlpool is changing PBM to MedImpact effective 1/1/17. Member id’s, claims submission provider networks are the same. The Aetna logo is for outside the local Lakeland area. Whirlpool is moving to 2 cards per family instead of a card with each dependent name. The card will indicate coverage status of EMPLOYEE only, EE and SPOUSE, FAMILY etc. HealthSCOPE Benefits * HealthSCOPE Benefits Whirlpool 2017 Benefit Plan Options * HealthSCOPE Benefits Whirlpool 2017 Biometric Screening Incentive Info * HealthSCOPE Benefits Whirlpool Prescription Drug Benefit 2017 * PRE-CERTIFICATION PROCEDURES All members, along with their providers, will be required to pre-certify all: Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI, PET and CT Scans Outpatient mental health facility admits or visits Dialysis Chemotherapy Contact HealthSCOPE Benefits for pre-certification at 1-800-660-212 Member ID card has reminder statement regarding pre-certification HealthSCOPE Benefits * WHIRLPOOL CORPORTATION ? CONFIDENTIAL WHIRLPOOL CORPORTATION ? CONFIDENTIAL WHIRLPOOL CORPORTATION ? CONFIDENTIAL