Contact us
Availity® Essentials self-service portal
Availity Essentials HealthSpring Medicare Advantage payer space
If you aren’t yet registered for Availity Essentials, sign up at no cost.
Payer ID: 52192
Provider customer service
Provider directory
Refer to Find Care.
Claims processing
| For: | Contact: |
|---|---|
| Claims questions | |
| Appeals questions | Call Fax |
| Electronic claims | HealthSpring – Payer ID 52192 |
| Paper claims | HealthSpring |
| Appeals | HealthSpring Appeals |
| Medical necessity claim disputes | HealthSpring Appeals |
| Reconsideration requests | HealthSpring Reconsiderations |
Prior authorizations
To access our interactive prior authorization requirements, refer to our Clinical Review page. To search our prior authorization guide for a code, enter Ctrl+F > the five-digit code.
To submit a prior authorization request
Log in to Availity Essentials and access the prior authorization portal in the HealthSpring Medicare Advantage payer space.
Call
Prior authorization:
Part B:
Fax
Prior authorization:
Part B:
EviCore healthcare
| For: | Contact: |
|---|---|
| EviCore prior authorization by service line | EviCore website or call for the service lines listed below Web portal support Non-prior authorization inquiries |
| High-technology, radiology and diagnostic cardiology | Clinical support and program inquiries |
| Medical oncology and radiation therapy | Medical oncology Radiation therapy |
| Musculoskeletal procedures | Call |
Fraud
If you suspect fraud, report it.
Report by phone
Call
The toll-free Fraud Hotline is available 24 hours a day, seven days a week. You can remain anonymous or let us know if you want to be contacted.
Report by U.S. mail
HealthSpring
Special Investigations Department
300 E. Randolph St., 35th floor
Chicago, IL 60601
Patient support programs
To evaluate patient eligibility, refer to patient support programs.
To learn more about a program or request a patient eligibility evaluation, email us.
Pharmacy
Pharmacy Part D prior authorization requests
- Visit CoverMyMeds
- Call
- Fax
Express Scripts® Pharmacy by Evernorth® Health Services
Call
Home delivery pharmacy
Call
Accredo® Specialty Pharmacy by Evernorth Health Service
Provider service center:
Accredo prescribers
Accredo specialty medication list
Accredo medications
Referrals
HMO referrals vary by plan. PPO plan referrals are not required.
Obtain referrals for specialists at Availity Essentials. Access the prior authorization portal through the HealthSpring Medicare Advantage payer space.
Supplemental benefits and ancillary services
Outpatient laboratory services
- LabCorp
Call - Quest Diagnostic Laboratories
Call
Behavioral health substance use disorder (authorizations)
Call
Fax
For questions about supplemental benefits, call provider customer service at