Providers

Need to submit a claim? Check on a payment? Find a form? Follow the links below.

Questions? Call us at 1-877-762-3515, 8am to 5pm.

Plan Resources

Select your state below to find essential info on our health plans, including requirements for referrals, prior authorizations, durable medical equipment and more.

Arizona Florida Illinois Ohio Texas

Guidance for the COVID-19 Public Health Emergency

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

Working with Devoted Health

• 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 more about Devoted Medical Group. We offer virtual and home-based care

Improving Healthcare Quality

Use these guides and forms to help improve Star Ratings and the healthcare experience for your patients:

• Annual Care of Older Adults form
• HEDIS Guide (2021)
• HEDIS Guide (2022)
• HEDIS Coding Quick Reference (2021)
• HEDIS Coding Quick Reference (2022)
• CAHPS Overview and Best Practices
• HOS Overview and Best Practices
• Adherence Tip Sheet (2021)
• Improving Statin Use for Diabetics

Provider Directory and Formulary

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

Submitting a Claim

You have 3 options: Change Healthcare, Availity, or paper claims.

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

Any claims sent to our older Waltham, MA address may be returned as undeliverable.

Using Availity

• Log in to Availity to submit claims, check member eligibility, enroll for Electronic Remittance Advice (ERA), and request referrals and prior authorizations. Note: The list of services that require Prior Authorization may change for 1/1/2022.
• Learn how to determine patient eligibility
• Learn how to submit prior authorizations and referrals
• Learn how to view Stars performance and download reports

Payspan

• Log in to Payspan to register for EFT
• Find out how to register for Payspan

Part D Forms

Submit Online

• Coverage determination request form
• Redetermination request form

Download for Printing

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

Disease and Case Management

Does one of our members need disease or case management? Use our disease and case management referral form to let us know.

Roster Updates

Use these templates to update your rosters. Please email your updates to provider-updates@devoted.com.

• Provider roster template
• Facility roster template

HIPAA Policies

Review our HIPAA compliance policies

Other Forms and Documents

• Waiver of Liability Statement
• Medicare Advantage Regulatory Attachment