Providers

View our 2023 Provider Manual

2023 plan documents

Find state-specific reference guides, information about joining our network, and more here:

Alabama | Arizona | Colorado | Florida

Hawaii | Illinois | North Carolina | Ohio | Oregon

Pennsylvania | South Carolina | Tennessee | Texas

Go to the learning center

View guides and tips

Get faster PA responses by following these guidelines.

2023 prior authorization list

Prior authorization request form

2023 referral list

2023 OTC Catalog: English | Spanish

Before ordering durable medical equipment for our members, check our list of covered items for 2023. To place an order, contact Integrated Home Care Services directly:

• Phone 1-844-215-4264
• Fax 1-844-215-4265
• Integrated Home Care Services referral guide

Or if you're in Alabama, Illinois, or Texas, call us directly at 1-800-338-6833 (TTY 711)

• What can you say about our plans to patients? We’ve made a handy cheat sheet that can help with that.
• View our clinical guidelines for best practices for managing chronic diseases
• View our in-office lab list to find out which lab tests you can do in your office
• Learn about sharing discharge summaries with us
• View our guide for treating PPO plan members as an out-of-network provider
• Looking for ways to improve your CAHPS score? Consider implementing some of these best practices.
• Learn more about Devoted Medical Group. We offer virtual and home-based care.

• Search for in-network providers, pharmacies, and facilities
• Search our formulary

Change Healthcare
You'll need to work with your practice management system to connect to Change Healthcare.

Availity
You can use Availity to submit claims, referrals, and more. See the next section for detailed instructions.

Paper claims
We suggest submitting your claims electronically through Change Healthcare or Availity. If you'd rather use paper claims, here's the data you'll need:

• Professional CMS 1500
• Institutional CMS 1450 (“UB-04”)

Make sure to send your paper claims to:
Devoted Health, Inc.
Claims
PO Box 211524
Eagan, MN 55121

Send any mail via USPS to ensure delivery. Some mail carriers don’t deliver to PO boxes.

• Log in to Availity to submit claims, check member eligibility, enroll for Electronic Remittance Advice (ERA), access electronic versions of Explanation of Payments (EOPs), and request referrals and prior authorizations. Note: The list of services that require Prior Authorization may change for 1/1/2023.
• Use our Provider portal training library to get training resources for Availity, our Provider Portal, authorizations, referrals, member eligibility, and more.

• Log in to Payspan to register for EFT and download and print electronic versions of Explanation of Payments (EOPs)
• Find out how to register for Payspan

Submit online

• Coverage determination request form
• Redetermination request form

Download for printing

• Coverage determination request form
• Redetermination request form
• Reconsideration request form

• Provider roster template
• Facility roster template

Review our policy documents

We're adhering to federal guidance during the current public health emergency. Learn about what that means for you and our members.

• Waiver of Liability Statement
• Medicare Advantage Regulatory Attachment
• Annual office visit CPT code list