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HealthChoice Providers

HealthChoice TPA changing to UMR in 2023

EGID’s benefits administrator will transition from HealthSCOPE Benefits to UMR on Jan. 1, 2023. UMR is UnitedHealthcare’s third-party administrator.

Follow this link to the TPA Implementation page for information to ensure a smooth transition.


HealthChoice Provider Portal

Login to view or file claims, check eligibility and benefits, initiate or check certification requests, view remittance advice and more.

HealthChoice Connect Provider Login

Login to view claims and remittance advice for dates of service prior to Jan. 1, 2023.


HealthChoice Provider: Network News

In This Issue:

  • Certification penalties 
  • Claim denials for medical records
  • Credit balance resolution 
  • Dental maximum benefit
  • HealthChoice direct data entry of claims and requests for additional information
  • Overpayment notification
  • New HealthChoice ID card for medical, dental and pharmacy
  • HealthChoice is partnering with CARE
  • HealthChoice EDI payer IDs and new group numbers
  • And more...

Certification

Guidelines, services requiring certification, and certification request forms.

Fee Schedule

Recent updates and fee schedule login.


HealthChoice Patient Services

HealthChoice can help your patients find access to low or no-cost services, mental health services, and care management services for chronic conditions.

Pharmacy Benefits Information

Member copays and costs, prior authorization, limits, specialty medications, step therapy, and medication lists.

Provider Manual

The source for plan policies and information.


Provider Forms

View the most current version of HealthChoice forms in order to join the provider network or update your information.

Provider Frequently Asked Questions

Find answers to your most frequently asked questions.

Last Modified on Jan 17, 2023