Webimportant for the review, e.g. Referrals PayPal allows you to make payments using a variety of methods including: Lost or damaged Care N Care member identification card? Would you like an electronic copy emailed to you or a printed copy mailed to your home? WebSilverback Care Management. Required when UTSW IRB reviews for another site or relies on another IRB. Low-income Households Water Assistance Program (LIHWAP). Southwestern Health Resources, which blends the strengths of University of Texas Southwestern Medical Center and Texas Health Resources, includes a clinically integrated network of 29 hospital locations and more than 5,000 providers, committed to being the national leader in population health. WebOptum Care NetworkSouthwestern Valleys; OptumRedlands Family Practice; OptumSan Bernardino; Resources. Required to add an individual as study personnel if that person does not work for an assured (federalwide assurance) institution. ldimond@humana.com Choice Premium (PPO) ::EnglishorEspaol, Choice MA-Only (PPO) ::EnglishorEspaol, Southwestern Health Select (HMO) ::EnglishorEspaol, Care N Care Choice Premium (PPO) Evidence of Coverage ::EnglishorEspaol, Care N Care Choice Plus (PPO) Evidence of Coverage ::EnglishorEspaol, Care N Care Choice (PPO) Evidence of Coverage ::EnglishorEspaol, Care N Care Choice MA-Only (PPO) Evidence of Coverage ::English orEspaol, Care N Care Classic (HMO) Evidence of Coverage ::EnglishorEspaol, Southwestern Health Select (HMO) Evidence of Coverage ::EnglishorEspaol, Over-the-Counter Benefit ::EnglishorEspaol, Hearing Aid Coverage::EnglishorEspaol, Eyewear Coverage and Routine Eye Exam::EnglishorEspaol, Customer Experience Team::EnglishorEspaol. There may be occasions when a beneficiary requires services beyond those ordinarily covered by Medicaid or needs a service that requires prior authorization (PA). DME Pre-Authorization Request Form. Photographic, audio or video recordings may be used for the following purposes: By signing this release I understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in the public educational setting. Utilizing network data, predictive analytics identify patients likely to achieve measurably improved results with the addition of specialized support. Adult Behavioral Health & Developmental Disability Services. The following Prior Authorization List is not an all-inclusive list and will be updated on a periodic basis. Responsibility, Internet Privacy Brokers, For Part B (Physician Administered) Drug Part D (Self-Administered) Drugs Medicaid Plus Plans Notice of Medicare Non-coverage & Medical PA Forms CMS Lab National Coverage Determinations Home Health (HH) Pre-Authorization Form SNF, LTAC, Rehab Pre-Authorization Form Submit Pre-Authorizations and Referrals: There are 2 options to If you have questions, please call your Customer Experience Team at 1-877-374-7993 (TTY 711) from October 1 March 31, 8 am 8 pm (CST) seven days a week, or April 1 September 30, 8 am 8 pm (CST), Monday through Friday. You will continue to submit prior authorization and referral requests for utilization management services to Southwestern Health Care Management in one of the For Providers | Southwestern Health Resources Claims provider manual.