PROVIDER FORMS AND RESOURCES
Behavioral Health Coordination of Care
Eligibility and Benefits
GlobalHealth has partnered with Change Healthcare to provide real-time solution to our providers to request information like eligibility, benefits and remaining out of pocket amount for our members.
To take advantage, please contact your Practice Management System Vendor or Change Healthcare Customer Support to update your systems.
GlobalHealth’s Payer ID for requesting Eligibility and Benefits inquiry is GLOBH.
If you are a Participating provider, you can also login to our Provider Portal to review member’s eligibility, benefits, claim status and member’s current out of pocket amount.
HAX Provider Portal
Provider Resources
- How do I log into the Provider Portal?
- How do I get credentialed?
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AT-A-GLANCE Provider Education Information
- Provider Orientation
Pharmacy Prior Authorization
- Commercial Pharmacy
- Prescription Drug Transition of Care Form
- Prior Authorization Form
- Use the above Prior Authorization Form for Prescription Drug Prior Authorizations and Formulary Exceptions.
- Medicare Advantage Pharmacy
- Request for Medicare Prescription Drug Coverage Determination Form
- Request for Medicare Prescription Drug Appeal (Redetermination) Form
- Use the above Coverage Determination Form for Exceptions, Prescription Drug Prior Authorization, Quantity Limits, Step Therapy, and Reimbursements.
- Prescription Drug Cost Calculators
Provider Policies and Training
Quality Portal
Transparency in Coverage (Commercial Providers)
What is Transparency in Coverage?
On November 12, 2020, the Departments of Health and Human Services, Labor and the Treasury finalized the Transparency in Coverage Rule that requires health insurers and group health plans to create a member-facing price comparison tool and post publicly available machine-readable files that include in-network negotiated payment rates and historical out - of network charges for covered items and services, including prescriptions drugs. The requirements in this rule will give consumers the tools needed to access pricing information through their health plans.
For more information about the Transparency in Coverage rule, please click here to access CMS final rule.
Transparency in Coverage (Machine Readable files)
Insurers and Plans are required to publish Machine Readable Files and make available to public by 07/01/2022. Data in machine readable files must be updated monthly.
To access GlobalHealth MRF file please click below.