Claims, Eligibility, Benefits and Medical Policies
The online benefits system allows you to review information and send or receive inquiries. Your provider account provides secure, 24/7 access to:
- Claims history/payment
- Explanation of benefits
- Summary plan description
- Deductible and out-of-pocket accumulators
- ID cards
- Customer service
- Medical policies
Transitional Care Form
Secure Health’s transitional care management helps you during the critical transitional period from acute care to care in the home. Our services assist in avoiding unnecessary readmissions or emergency room visits. If you need transitional management from Secure Health, please download the form below and mail it to:
Medical Management Department
P.O. Box 13447
Macon, GA 31208
To access client-specific provider directories, please visit the link below and enter the three-digit group number on your patient’s Secure Health ID card. For assistance, please contact us at 800.648.7563. Services listed in the directory are not necessarily covered by your patient’s plan. Please verify coverage with their Plan Administrator.
Services listed in the directory are not necessarily covered by your plan. Please verify coverage with your Plan Administrator.
Certain procedures require pre-authorization. Using evidence-based, nationally recognized guidelines, our goal is to balance quality patient care with safety and cost-effectiveness.
Click here for a list of procedures that require pre-authorization.
Claim Filing Information
Effective January 01, 2023
Effective with service dates on or after January 1, 2023, providers should file claims to the following:
Medical EDI 56162
Dental EDI 56205
MedCost Benefit Services
PO Box 25307
Winston-Salem, NC 27114-5307
Dialysis providers should contact MedCost at 800-648-7563 regarding filing of claims and benefits.
Please contact your claims clearinghouse to set up this new EDI information.