Network Operations (February 2019)

Directory Updates

A person who enrolls in a health insurance plan relies on provider directories to access in-network providers for their care. When the information is incorrect, it can create a barrier to members getting the healthcare they need.

Premier Health Plan’s provider directories, utilized by Premier Health Employee Plan members, should be updated every 30 calendar days for continued accuracy. Practices must provide accurate office location, phone number(s) and hours of operation data to Premier Health Group (PHG). It’s important to notify us when this information changes. Please communicate all provider changes (i.e. new providers, terminations, office changes, accepting new patients/not accepting new patients, etc.) to the PHG team using the Provider/Change of Address/Deletion Form.

This form is a fillable PDF file, which means you can type the needed information directly into the form on our website. Please email the completed form to [email protected] or fax to (937) 641-7377.

Medical Pay Policies

View the most recent commercial policies and procedures.

Last Day to Submit Medicare and Commercial Group Plan Claims

This does not impact the Premier Health Employee plan. Please continue to submit claims for Premier Health Employee plan members following the normal process. 

The last day to submit Medicare claims for Premier Health Plan Medicare Advantage members is March 31, 2019. CMS regulations allow claim submission for 365 days after the date of service.

The last day to submit Commercial Group plan member claims is June 30, 2019 which is 180 days after the date of service. Please allow 30 days for processing of all claims.