Transcription of Clover Quick Reference Guide
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Clover Quick Reference Guide
CloverQuick Reference GuideFREQUENTLY USED SERVICESQUICK LINKSTo request a pre-authorization, check the status of an existing request, or view a list of required servicesPre-Authorization Lookup ToolTo view pharmacy pre-authorization criteriaWe typically respond to completed forms within 24 business web: Pre-Authorization Requestvia print/fax: Pre-Authorization Request FormTo submit a claim If you need to make any changes to an original claim you can resubmit a corrected claim using the above via Change Healthcare:Payer ID#: 77023via mail: Clover Box 3236 Scranton, PA 18505To find an in-network providerProvider DirectoryTo view pre-authorization criteriaFormularyTo dispute a paymentPayment Dispute Formvia fax:1-732-412-9706via mail: Attn: Appeals and Grievances Clover Box 471 Jersey City, NJ 07303To appeal a pr
Clover Quick Reference Guide FREQUENTLY USED SERVICES QUICK LINKS To request a pre-authorization, check the status of an existing request, or view a …
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