Meritain Health

This is a self-funded plan administrator, so each employer plan differs: the provider number, claim address and payer ID printed on the member's ID card are authoritative. The provider services page says to call this number for 24-hour automated phone benefits and claims information. For precertification and other inquiries the provider portal page says Customer Support is reached by phone but does not print a number: use the number on the member ID card.

This is a self-funded plan administrator, so each employer plan differs: the provider number, claim address and payer ID printed on the member's ID card are authoritative. Meritain's medical claim form says to send claims to this P.O. Box or fax. Form is the Texas version; plan-specific claim addresses on the member's ID card or EOB take precedence.

The claim form prints 1.800.925.2272 under 'Status and benefit information'. Meritain's contact page (last fetched showing a maintenance notice) lists the same number for members who need an ID card or EOB copy. Prefer the provider number on the member ID card for plan-specific eligibility.

For predetermination of coverage only, not preauthorization/precertification. Use the Predetermination Request Form on top; verify eligibility first; fax each patient separately; mail photos rather than fax. Predetermination is not a guarantee of payment.

This is a self-funded plan administrator, so each employer plan differs: the provider number, claim address and payer ID printed on the member's ID card are authoritative. The Appeal Request Form (mandatory) says to return it to the Meritain Health Appeals Department at this P.O. Box, and also says information can be sent to the address on the EOB or other correspondence. Types: medical, dental, vision. No appeals phone is published on the form.

For the HealthCare Transition of Care Request Form (continued coverage with an out-of-network treating provider). Questions: call the Member Services number on the ID card. Not for claims or precert.

Meritain's vendor list shows Availity for claims submission. Number is Availity's, not Meritain's. Other listed vendors: Optum (formerly Change Healthcare) 866.817.3813 for eligibility, claim status and claims; Change Healthcare Dental 877.469.3263; SSI (ClaimsNet) 800.356.0092. Companion guides are linked on the page. No Meritain payer ID is published on this page.

Optum is listed by Meritain for eligibility, claim status inquiry and claims submission. Number is Optum's, not Meritain's. Dental option via Change Healthcare Dental is on the same page.

Meritain online provider portal for patient eligibility, claims information and forms; Appeal request form, Medical claim form and clearinghouse vendor list are linked from the page.