Collective Health

Contact page for medical providers looking for claims verification or status updates. Do not send PHI by email. Independent third-party administrator for self-funded employers; Each employer plan differs: the number on the member's ID card is authoritative for that plan.

Provider resource page for members whose employers partner with Collective Health and the Highmark network: 'For urgent matters related to the Highmark network, please call' this number. Claims for Highmark-network members go to the local Blue Cross and/or Blue Shield plan per the member ID card.

Page says prior authorizations are handled through American Health Holding (AHH); for faster service call the number on the back of the member ID card, otherwise call this number and select 'Medical Authorizations'. Online portal listed on the page: collectivehealth.getprecert.com.

Fax for clinicals only (the AHH portal has no option to upload clinicals). Include the reference number if you have one.

Prior authorization appeals go to AHH within 180 days of the adverse determination, with the Appointment of Authorized Representative form (if appealing for the patient), the Request for Internal Appeal form and supporting records.

Page: for questions about Providence Health Plan Powered by Collective Health members, call the number on the back of the member ID card; otherwise call this number and select 'Medical Authorizations'. Check that the ID card says 'Powered by Collective Health' before using this line; PA is handled by American Health Holding or Cigna per the PA requirements page.

Page directs electronic claims through Availity Essentials or an Optum clearinghouse connection using Optum payer ID 36481. Eligibility and claim status are checked in Availity Essentials; do NOT use the ProvLink portal for these members. Provider reconsideration form: collective.link/php-prr.

Page: if you cannot complete enrollment in the Collective Health Electronic Payments Center, contact Zelis Provider Support for EFT setup (fee-based and fee-free options). Zelis line, not a Collective Health claims line.