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CoOportunity Health: Information You Need for January
Verify Coverage without an Identification Card
Many CoOportunity Health members with a January effective date have already received their ID cards. Those who enroll in late December may not receive their cards until after January 1.
As long as we've received enrollment information, we can verify coverage and the appropriate ID number when you know the patient or member name, birthdate, and/or address.
Practitioner Offices & Facilities: To verify benefits or eligibility without an ID card, contact Member Services at 1.888.324.2064 between 7 a.m. and 6 p.m., Monday through Friday.
Pharmacies: Check eligibility using RxBIN 003585/RxPCN 24002. For assistance, call the HealthPartners Pharmacy Help Desk at 1.800.492.7259 between 8 a.m. and 6 p.m., Monday through Friday. Our pharmacy benefits manager is MedImpact; our specialty pharmacy is CVS Caremark.
You can also check eligibility information with access to our secure Provider website (see registration information below).
Register for Secure Provider Website Access Today
Register today for access to CoOportunity Health's secure Provider website. Because you have not received a claim reimbursement check, you must follow the registration process that requires you to receive a PIN by mail to complete the process.
Once you receive access to the site, you can check a member's eligibility and benefits, and review our Policy Manual. Claims and remittance applications will be available by January 1, 2014.
Access Medical Policies
Now you can view our medical policy/coverage criteria. You can also find a list of procedures, services, and drugs that require prior authorization.
Attn: Prescribing Physicians
Submit Patient History for Pharmacy Step Therapy Drugs
If a patient takes a drug that requires step therapy and has already tried other required medications, please submit this information using our Prior Authorization/Exception form so that we can cover the drug. The EnhancedRx Drug List identifies drugs requiring step therapy.
If you have questions, contact the Pharmacy Help Desk at 1.800.492.7259.
Attn: Doctors of Chiropractic
Collect the Correct Office Visit Copayment
When providing a musculoskeletal treatment (chiropractic manipulation), doctors of chiropractic (D.C.s) should collect the cost-share identified as "primary" if more than one office visit cost-share is listed on the member ID card.
Register for Webinars: Doing Business with Us
Register for Phase 2 and Phase 3 webinars, currently scheduled through January.
Phase 2 topics include:
- Plan Overview
- Prescription Drug Benefits
- EDI/Claims Submission/Time Frames
- Medical Management
Phase 3 covers our secure Provider website.
Read Details about Us: Financially Solid, Secure and Protected
We've received many questions about how CoOportunity Health was formed, how we're regulated, and how we're funded. To learn more, please download this document.
Reminders
Questions about CoOportunity Health?
Contact us at providerrelations@coOportunityhealth.com,
or check our website's Help Center contact information. | 
