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  • Provider Forms and Resources - Vivant Health
    Vivant Health is committed to assisting network providers with process improvement support The resources and forms on this page are among those most requested by our providers and are here for your convenience
  • Documents and Forms - paramounthealthcare. com
    Documents and FormsA Access Standards Appointment of Representative Form B Behavioral Health OH Commercial Prior Authorization Form C Claim Adjustment Coding Review Request Form Clinical Authorization Appeal Form D Decision Timeframes E Electronic Claims Waiver Request F Fax Inquiry Form - Benefit Inquiry Form Fax Inquiry Form - Claims Provider Inquiry Fax Numbers - Utilization Care
  • All necessary information received at time of request Requires . . .
    Retro: All necessary information received at time of request Urgent: Requires immediate action, although not life threatening Routine: Diagnostic studies, elective surgeries, consults, and follow-up
  • For Providers - Vivant Health
    Please use the button below to complete the Contracting Request Form and the pertinent Credentialing application and submit to contracting@vivanthealth com From there we will be in touch! Your successes define ours Read on to see how we’ve helped our providers elevate their practices
  • EZ-NET™ Login - River City Medical Group
    Vivant Health will be transitioning claims EOB's to a new platform! If you are a current EZ NET user and download copies of your claims EOB's, please reach out to providerservices@vivanthealth com to request access to the Report Library Thank you! Please visit the Vivant Health website for information regarding CO-VID 19, Medicare, and more
  • Vivant Health Authorization Form Pdf
    (7 days ago) Fax the completed form to the Prior Authorization Department at (800) 743-1655 To check the status of your request, call (800) 421-8578, (800) 628-2705 or (800) 642-4746
  • VIVA Health | Viva Health
    When requesting authorization for an unclassified drug, please submit the NDC#, Drug Name, and Dosage Other Specialty Medications not listed on this list may be covered under your medical benefits
  • Prior Authorization Forms – Vivanta
    Managed Health Care Services Incorporated Hello! Have you heard the news? We've rebranded to Vivanta! We can't wait for you to see our new website Please wait while we take you there You loved us as MHCSI, you will LOVE us as Vivanta


















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