Geisinger Health Plan® - Provider Guide

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Provider Guide

The Participating Provider Guide is part of your agreement with the Health Plan and is effective for all participating providers. It is designed for use by participating providers and their office staff who provide and coordinate services to Health Plan members.

The Participating Provider Guide includes detailed reference information about the Health Plan, referrals and coordination of services, claim reporting requirements, quality improvement, utilization management, member rights and responsibilities, plus much more.

Please contact your provider relations representative if you have any questions concerning the information contained within your Provider Guide.

Table of Contents

Section 1 General Information
Section 2 Referrals
Section 3 Precertification Requirements
Section 4 Reimbursement and Claim Submission
Section 5 Credentialing
Section 6 Provider Administrative Rights
Section 7 Member Rights and Responsibilities
Section 8 Additional Participating Provider Responsibilities
Section 9 Medical Management and Quality Improvement and Accreditation
Section 10 Glossary and Acronyms

Full Provider Guide in PDF (Rev 04/11)

Operations Bulletins which amend this Guide

 

Recent News

Contacts for Provider
Network Management

If you have questions or need information, please contact your Geisinger Health Plan provider relations representative at
(800) 876-5357.



For Participating Providers

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