Provider Help
Preferred Provider Organization Questions
WeShare by UHSM is a caring community dedicated to keeping our members healthy, happy, and in control of their well-being.
We are are equally committed to our PHCS® PPO Network. Our goal is to be the best healthcare sharing program on the planet and to provide an AWESOME* experience, every time, for our members and network providers!
We want to hear from you!
Questions?
Concerns?
Healthcare Sharing Preauth Form
In order to request and obtain preauthorization, please follow the steps below:
- Click here to download and complete this PDF form
- Complete form and attach any necessary documentation for the procedure
- Send the completed form plus any additional documentation to Fax number: (888) 317-9602
Please note that WeShare by UHSM has a standard turnaround time of five (5) business days on all prior authorization requests. If you require any help with the form, need status of your request, or are unable to determine if a procedure requires preauthorization please contact us at (757) 210-3435.
Prior Authorizations are for professional and institutional services only. All oral medication requests must go through members’ pharmacy benefits. By submitting this prior authorization, you are agreeing to work with WeShare by UHSM on in-network pricing.
Preferred Providers FAQ
At WeShare by UHSM we work hard to make sure our members and providers have simple and fast medical bill processing. Our members will have preset, per-visit consult fees that operate similar to your insurance patient’s co-pay. We promptly process your remaining network-contracted fees. Here are some frequently asked questions and answers regarding care within PHCS® PPO Network.
I AM NOT FINDING THE PAYER ID IN OUR CLEARINGHOUSE SYSTEM?
WeShare by UHSM currently uses Claimsnet for the clearinghouse and is in the system as “UHSM WeShare” with NAIC# 07689, claim type HCFA. While all the trading partners have been notified, many won’t set up the payer ID until a provider requests it. To request UHSM setup, as the provider all you have to do is:
- Open a customer service ticket at your clearinghouse — Request the setup of payer ID 07689, with routing to SSI Claimsnet.
- Then send that service ticket number along with the clearinghouse name to Claimsnet helpdesk to complete the integration [email protected].
DO I NEED TO BE CONTRACTED WITH UHSM TO SEE PATIENTS?
You will need to be contracted with our preferred network PHCS PPO. Please click here to join PHCS. If you are contracted as a PHCS provider, you will be paid at the contracted rate. UHSM is committed to processing all medical bills promptly and efficiently, and to making your job as a provider as seamless as possible.
WHAT IS THE EXPECTED RETURN TIME FOR MY REIMBURSEMENT?
WeShare by UHSM is committed to quickly processing all medical bills and reimbursements through the PHCS PPO Network. We work as fast as we can. It can take up to 60 days to process the medical bill according to PHCS PPO network policies.
WHERE DO I SUBMIT HCFA OR UB FORMS?
Mail paper HCFAs or UBs to:
UHSM WeShare
PO Box 247
Alpharetta, GA 30009
WHAT MEDICAL SERVICES ARE ELIGIBLE UNDER THIS PROGRAM? WHAT DO I CHARGE FOR A VISIT?
Just like any other payer within the PHCS PPO Network, your medical service fees will be paid according to your contracted rate.
All WeShare by UHSM programs include benefits in which members pay you (the provider) a consult fee per office visit, unless the appointment is annual wellness or preventive care, in which case the per visit fee to members is $0.
If you are wondering how much to charge a WeShare by UHSM member for a particular visit please reference the front of the PHCS WeShare member ID card or the specific Program Details. The per visit consult fee each WeShare member pays varies per program, but operates similarly to co-pay by aligning with the type of medical consult: primary doctor, specialist, urgent care and emergency room visits. If you have additional questions please contact us.
For questions about the eligibility of medical services that may be recommended following an appointment, please submit a WeShare preauthorization form here or contact us at (757) 210-3435.
HOW LONG DOES IT TAKE TO GET A PRIOR AUTHORIZATION RETURNED?
Preauths take 3 – 5 business days maximum. To learn more or obtain a preauth form, please see below or visit www.weshare.org/preauth
Phone
+1 757-210-3435
Press #2
Fax
+1 888-858-3315
Main Office
Dominion Tower
999 Waterside Suite 2600
Norfolk, VA 23510
Hours
Monday – Friday:
10am – 8:30pm ET
Request information from our Member Services Team
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