Third-Party Administrator Update

Medical Mutual of Ohio will become the third-party administrator (TPA) for Premier Health Employee Plan as of January 1, 2020. The PHG network will continue to serve as the Tier 1 provider network for the Premier Health Employee Plan. 

It is important to note that you must submit all claims by May 1, 2020 to receive payment for claims submitted January 1 – December 31, 2019. Current reimbursement rates apply.

There are three ways to submit claims:

1. Provider OnLine: You can submit claims through the online portal and check on the status of a claim. Access the portal at PremierHealthGroup.com
2. Electronic Submissions: Submit via electronic payer id#251PR
3. Paper Claim Forms
   CMS-1500 forms: These forms are for professional services performed in a provider’s office, hospital or ancillary facility. (Provider-specific billing forms are not accepted).
   UB-04 forms: These forms are for inpatient hospital services or ancillary services performed in the hospital. (Hospital‐specific billing forms are not accepted).

Paper Claim forms should be mailed to:

Premier Health Plan
P.O. Box 3076
Pittsburgh, Pennsylvania 15230-3076

You can also contact Provider Services at (855) 514-3678(855) 514-3678 to check on the status of a claim or call Premier Health Group at (937) 499-7441(937) 499-7441 with any additional questions.

Back to the October 2019 Issue