Health SCOPE Benefits CUSTOMER CARE REPRESENTATIVES Whirlpool Service
Health. SCOPE Benefits CUSTOMER CARE REPRESENTATIVES Whirlpool Service Line 1 -800 -660 -6212 M-F 8: 00 a. m. – 6: 00 p. m. EST Pre-certification/Pre-authorization Claim Status Eligibility Benefit Information Provider Network verification IVR- Available 24/7 1 st Level Appeals 1 WHIRLPOOL CORPORTATION CONFIDENTIAL
Health. SCOPE Benefits www. healthscopebenefits. com ü Click on Provider ü Enter WHIRL for group name o Check on: o Claim Status o Eligibility o Benefit Information o Precert Information o Copies of EOBs 2 WHIRLPOOL CORPORTATION CONFIDENTIAL
Health. SCOPE Benefits Claim Submission Information: Health. SCOPE Benefits PO Box 99006 Lubbock, TX 79490 -9006 EDI Payor ID: 71063 WHIRLPOOL CORPORTATION CONFIDENTIAL 3
Health. SCOPE Benefits ALERT! WHIRLPOOL HSB ID CARD 2017 CHANGES New id cards will be issued for 2017. Whirlpool is changing PBM to Med. Impact effective 1/1/17. Member id’s, claims submission provider networks are the same. The Aetna logo is for outside the local Lakeland area. Whirlpool is moving to 2 cards per family instead of a card with each dependent name. The card will indicate coverage status of EMPLOYEE only, EE and SPOUSE, FAMILY etc. WHIRLPOOL CORPORTATION CONFIDENTIAL 4
Health. SCOPE Benefits Whirlpool 2017 Benefit Plan Options 5 WHIRLPOOL CORPORTATION CONFIDENTIAL
Health. SCOPE Benefits Whirlpool 2017 Biometric Screening Incentive Info 6 WHIRLPOOL CORPORTATION CONFIDENTIAL
Health. SCOPE Benefits Whirlpool Prescription Drug Benefit 2017 7 WHIRLPOOL CORPORTATION CONFIDENTIAL
Health. SCOPE Benefits PRE-CERTIFICATION PROCEDURES All members, along with their providers, will be required to pre-certify all: Non-emergency inpatient admissions Major outpatient surgical procedures Non-stat MRI, PET and CT Scans Outpatient mental health facility admits or visits Dialysis Chemotherapy Contact Health. SCOPE Benefits for pre-certification at 1 -800 -660 -212 Member ID card has reminder statement regarding pre-certification WHIRLPOOL CORPORTATION CONFIDENTIAL 8
PRE-CERTIFICATION PROCEDURES Submit online precert requests: WHIRLPOOL CORPORTATION CONFIDENTIAL CLICK ON SUBMIT PRECERTIFICATION REQUEST 9
Health. SCOPE Benefits PRE-CERTIFICATION PROCEDURES Submit online precert requests: WHIRLPOOL CORPORTATION CONFIDENTIAL 10
Health. SCOPE Benefits Copy of provider EOB 11 WHIRLPOOL CORPORTATION CONFIDENTIAL
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