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Doing Business with CoOportunity Health
You'll Notice Changes to our Website
In a few weeks, you'll see visual and organizational updates at coOportunityhealth.com/provider.
As we move closer to January 1, you'll have access to additional information. In mid-December, you'll be able to review medical policy details and register for our secure provider portal.
Register for Phase 2 Webinars
During the week of November 25, you'll be able to register for new webinars covering the following topics:
- Benefits & Claims Overview
- Utilization Management
Preview Services Requiring Prior Authorization
Lists of services that require prior authorization are now available. The detailed searchable medical policies become available in mid-December.
How Our "Three for Free" Benefit Works
Some of our members have a "Three for Free" benefit for office visits. This means that:
- CoOportunity Health waives the member's copayment for the first three nonpreventive office visit CPT codes processed each calendar year.
- For other services provided during the visit, such as a laboratory service, the member is responsible for any applicable cost-share amounts.
- Each covered family member has a "three for free" benefit.
Read more details...
Using our EnhancedRx Drug List
We use one drug list for all of our products. Three common symbols and a brief explanation of each follow; please see the EnhancedRx Drug List key for details:
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F |
Formulary |
Covered |
Formulary generic or preferred brand-name drugs. Generics are in lower case italics have lower copays than preferred brand-name drugs. Brand-name drugs are in all CAPS. | |
NF |
Non-Formulary |
Covered |
Non-formulary generic and brand-name drugs.
These drugs have a higher copay than formulary drugs. | |
Excluded |
Excluded |
Noncovered |
Member responsibility. |
Iowa Marketplace Choice Plan
CoOportunity Health is one of two carriers covering Iowa Marketplace Choice Plan (Medicaid Expansion) members. Unless a member designates a particular carrier, the Iowa Medicaid Enterprise will assign eligible members evenly between the two carriers. Learn more about this plan and view ID cards...
Why Our Members Want a Physical Exam
In addition to receiving full coverage for preventive care services, members who are 18 years old and older can earn $100 for visiting you for a physical exam. Read more about Rewards for Healthy Living...
Specialty Pharmacy Information
CVS Caremark Specialty Pharmacy is our specialty pharmacy provider for self-administered specialty medications.
As you care for our members in 2014, please forward all specialty pharmacy prescription requests to CVS Caremark. Information you may need for your Electronic Health Record system or your internal contact document follows.
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NCPDP |
NPI |
Address |
Phone # |
Fax # | |
CVS Caremark Specialty Pharmacy, LLC
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3958898 |
1043382302 |
105 Mall Boulevard
Monroeville, PA
15146 |
1.888.493.5392 |
1.800.441.5809 |
For additional information, visit CVSCaremarkSpecialtyRx.com or call 888.493.5392. Enrollment forms are available at http://cvscaremarkspecialtyrx.com/physicians/enrollment-forms.
Reminders
- It's fast. It's efficient. It's how we send news. Register your email address and stay in touch!
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We contract with Midlands Choice to use their provider network. Find more information about our relationship with Midlands Choice on our Contracting and Credentialing page. -
CoOportunity Health contracts with HealthPartners Administrators, Inc. to provide claims processing, medical management and certain other administrative services on our behalf. Be prepared to file electronically in 2014.
Questions about CoOportunity Health? Contact us at
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