WORKING WITH GLOBALHEALTH

We are driven by our passion to deliver the best healthcare coverage in the industry. We are committed to continuous innovation and comprehensive member engagement to earn the satisfaction and confidence of those we serve.

We aspire to earn and retain provider confidence and trust in us.

We believe in developing and maintain valued relationships with our partners.

Products and Plans

GlobalHealth has been a provider- and member-centric organization since its beginning nearly 15 years ago in the state of Oklahoma. The health plan was started by a group of Primary Care Physicians who were passionate about improving patient outcomes and controlling healthcare spend by focusing on patient service and quality outcomes.

GlobalHealth plans are designed to encourage members to receive proper healthcare while reducing out of pocket expenses. We line our plans up with strong benefits including $0 unlimited Primary Care Physician visits and most plans have no medical or drug deductibles.

Relationships

We believe managing and navigating healthcare should be easier. This starts by developing and maintaining valued relationships with our members and network provider partners.

At GlobalHealth, we:

• Listen to the needs of outreach managers and clinicians and share information that allows them to refine their services.
• Deliver insights that allow nurses to coordinate and facilitate available healthcare services to support our members.
• Give our providers solutions that go beyond standard healthcare options.
• Serve members using a proactive outreach strategy that includes finding community services, scheduling appointments and coordinating healthcare services to navigate a complex healthcare system.

Giving Back

GlobalHealth is committed to improving the health of people in the communities it services. GlobalHealth is a strong financial and volunteer supporter of community-based organizations to encourage people to lead healthier lives.

Important Notice to Providers

Click here to view the Provider Manual (Revised Jan 2019). It includes valuable information about working with GlobalHealth and our policies. Please become familiar with it as it is an extension of your provider contract.

For a deep dive into the Provider Manual with a Q&A session, register for a training session. Click here.

Resources

Find all the resources you need as a provider right here. Click here for forms and other resources. Get answers to many questions on the FAQ page or contact Provider Relations.

GlobalHealth Products

• Plan for State, Education and Local Government Employees
• Plan options for Federal Employees
• Plans for Medicare-eligible beneficiaries – Generations Medicare Advantage Plans
• Plan for Medicare-eligible State of Oklahoma Retirees – Generations State of Oklahoma Retiree Medicare Advantage Plan
• Plans for Small and Large Groups

Important Changes Effective November 3, 2016: GlobalHealth implements new claims editing system. Click here to read full details.

Medical Authorizations

Healthcare services, such as for specialty care, hospitalizations, and outpatient surgery require preauthorization from GlobalHealth. Authorization requests are processed through GlobalLink™, an online tool available to all contracted providers.

Need to process a medical referral? Click here.

Commercial Prescription Referral Information

To request a prescription referral, please access our gh.pharmacy@globalhealth.com and inform us of the requested prescription(s) for your patient. We will provide the appropriate form to be completed by the physician via fax or email. Please do not send confidential patient information to this email. You may contact the pharmacy department at (918) 878-7361, 8 am - 5 pm, Monday - Friday, to speak to a representative from the pharmacy department. If no one is available, please leave a message and your call will be returned as soon as possible. You may also fax the information to us at (405) 280-5613.

Medicare Coverage Determinations Information

To request a coverage decision for Part D Prescription Drugs, contact the Pharmacy Benefit Manager, CVS Caremark, by calling (866) 494-3927 (TTY users call 711), 24 hours a day, 7 days a week, or writing:

CVS Caremark
Part D Coverage Appeals and Exceptions
Department MC 109
P.O. Box 52000
Phoenix, AZ 85072-2000

Or via Fax: 855-633-7673
 

Need to request a Part D Coverage Determination? Click here.