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AUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PAY NOW | TOTAL HEALTH CARE All Healthcare.gov Enrollees and Individuals: To pay your premium, you need to have your Exchange Subscriber ID.. If you do not have your Exchange Subscriber ID, you can search for it by clicking on the “Where do I find this?” link next to the Exchange Subscriber ID field in the Payment Center.CYBERSECURITY
PROVIDER – CONTRACT AND CREDENTIALING Contracting and Credentialing. Items are primary-source verified upon joining THC and every 3 years thereafter through the following sources: State licensing boards: Hospital privileges, practitioner education and work history. Physicians self-report non * data PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion.TRANSPORTATION
To schedule a ride, use gas reimbursement or get a bus pass, call the Reservation Line at (800) 826-2862, x3608. If you need help, call the Customer Service Department at (800)826-2862 or (313) 871-2000, Monday – Friday, from 8:00 am- 5:00 pm. If you need an ambulance to take you to the hospital due to an emergency, call 9-1-1. PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
PROVIDER DIRECTORY HMO Nondiscrimination Notice Total Health Care complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PAY NOW | TOTAL HEALTH CARE All Healthcare.gov Enrollees and Individuals: To pay your premium, you need to have your Exchange Subscriber ID.. If you do not have your Exchange Subscriber ID, you can search for it by clicking on the “Where do I find this?” link next to the Exchange Subscriber ID field in the Payment Center.CYBERSECURITY
PROVIDER – CONTRACT AND CREDENTIALING Contracting and Credentialing. Items are primary-source verified upon joining THC and every 3 years thereafter through the following sources: State licensing boards: Hospital privileges, practitioner education and work history. Physicians self-report non * data PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion.TRANSPORTATION
To schedule a ride, use gas reimbursement or get a bus pass, call the Reservation Line at (800) 826-2862, x3608. If you need help, call the Customer Service Department at (800)826-2862 or (313) 871-2000, Monday – Friday, from 8:00 am- 5:00 pm. If you need an ambulance to take you to the hospital due to an emergency, call 9-1-1. PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
PROVIDER DIRECTORY HMO Nondiscrimination Notice Total Health Care complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. PAY NOW | TOTAL HEALTH CARE All Healthcare.gov Enrollees and Individuals: To pay your premium, you need to have your Exchange Subscriber ID.. If you do not have your Exchange Subscriber ID, you can search for it by clicking on the “Where do I find this?” link next to the Exchange Subscriber ID field in the Payment Center. CONTACT US | TOTAL HEALTH CARE Contact us with your general inquires or to request health information. Total Health Care. 3011 W. Grand Blvd. Suite 1600 Detroit, MI 48202 (313) 871-2000 or (800) 826-2862 TTY# 7-1-1 PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion.TRANSPORTATION
To schedule a ride, use gas reimbursement or get a bus pass, call the Reservation Line at (800) 826-2862, x3608. If you need help, call the Customer Service Department at (800)826-2862 or (313) 871-2000, Monday – Friday, from 8:00 am- 5:00 pm. If you need an ambulance to take you to the hospital due to an emergency, call 9-1-1.PRIOR AUTHORIZATION
Prior Authorization From THC. PCP must FAX clinical information to THC Utilization Department at 313-748-1312. Authorization Grid. Specialty Drugs. Home Care Prior Authorization Form. Home Care IV Prior Authorization Form. Abortion – (Medicaid only) Admissions: InpatientHospital –
PROVIDER – CLINICAL GUIDELINES Total Health Care adopts Clinical Practice Guidelines that are appropriate to its membership and organization. Clinical Practice Guidelines are either adopted from nationally recognized organizations, primarily Michigan Quality Improvement Consortium (MQIC), or are developed internally by Total Health Care and are based on scientific literature and reasonable medical evidence.PROVIDER – HEDIS
Why it matters. NCQA (National Committee for Quality Assurance) established Healthcare Effectiveness Data and Information Set (HEDIS) as a comprehensive set of standardized performance measures to provide purchasers and consumers with the information required to compare health plan performance. HEDIS measures clinical quality and customerFRAUD & ABUSE
Total Health Care recognizes combating health care fraud is a system wide challenge. Because there is no precise measure of health care fraud, it takes a collaborative effort with provider and members to improve the detection of fraudulent and abusive activities within ourPlan.
CHILDREN’S SPECIAL HEALTH CARE SERVICES (CSHCS) … You may also request a form by calling Total Health Care at 1-844-222-5584. Completed prior authorization forms should be faxed to1-866-422-9119.
CONSENT TO SHARE YOUR HEALTH INFORMATION DCH-3927 (12/14) Page 2 of 2 Consent ID #: My consent will expire on the following date, event or condition unless I withdraw my consent. (If expiration date is left blank or is longer than one year, the consent will expire 1 year from the signature date) TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PAY NOW | TOTAL HEALTH CARE All Healthcare.gov Enrollees and Individuals: To pay your premium, you need to have your Exchange Subscriber ID.. If you do not have your Exchange Subscriber ID, you can search for it by clicking on the “Where do I find this?” link next to the Exchange Subscriber ID field in the Payment Center. PROVIDER – CONTRACT AND CREDENTIALING Contracting and Credentialing. Items are primary-source verified upon joining THC and every 3 years thereafter through the following sources: State licensing boards: Hospital privileges, practitioner education and work history. Physicians self-report non * dataMEDICAID HMO
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion. GRIEVANCES & APPEALS Grievances & Appeals. Your satisfaction is our priority! If you have a problem or complaint, the Customer Service Department can help. The department is available Monday-Friday, 8:00 a.m.-5:00 p.m at (313) 871-2000 or (800) 826-2862 . In most cases, the Customer Service Department can resolve your concern. If the department is unable toresolve
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
INSULIN PUMP CRITERIA INSULIN PUMP CRITERIA An external insulin infusion pump is a programmable, battery-powered mechanical syringe/reservoir device controlled by a micro-computer to deliver a continuous subcutaneous insulin infusion (CSII) into TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PAY NOW | TOTAL HEALTH CARE All Healthcare.gov Enrollees and Individuals: To pay your premium, you need to have your Exchange Subscriber ID.. If you do not have your Exchange Subscriber ID, you can search for it by clicking on the “Where do I find this?” link next to the Exchange Subscriber ID field in the Payment Center. PROVIDER – CONTRACT AND CREDENTIALING Contracting and Credentialing. Items are primary-source verified upon joining THC and every 3 years thereafter through the following sources: State licensing boards: Hospital privileges, practitioner education and work history. Physicians self-report non * dataMEDICAID HMO
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion. GRIEVANCES & APPEALS Grievances & Appeals. Your satisfaction is our priority! If you have a problem or complaint, the Customer Service Department can help. The department is available Monday-Friday, 8:00 a.m.-5:00 p.m at (313) 871-2000 or (800) 826-2862 . In most cases, the Customer Service Department can resolve your concern. If the department is unable toresolve
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
INSULIN PUMP CRITERIA INSULIN PUMP CRITERIA An external insulin infusion pump is a programmable, battery-powered mechanical syringe/reservoir device controlled by a micro-computer to deliver a continuous subcutaneous insulin infusion (CSII) into PAY NOW | TOTAL HEALTH CARE All Healthcare.gov Enrollees and Individuals: To pay your premium, you need to have your Exchange Subscriber ID.. If you do not have your Exchange Subscriber ID, you can search for it by clicking on the “Where do I find this?” link next to the Exchange Subscriber ID field in the Payment Center.HEALTH EXCHANGE HMO
Totally You Complete – 2020 Plans. 67183MI0030003. Standard Silver Off Exchange Plan – 67183MI0030003-00. Standard Silver On Exchange Plan – 67183MI0030003-01. Zero Cost Sharing Plan Variation – 67183MI0030003-02. Limited Cost Sharing Plan Variation – 67183MI0030003-03. 73% AV Level Silver Plan – 67183MI0030003-04. PROVIDER – BEHAVIORAL HEALTH Beacon Health Options Referral/Scheduling Line: 877-564-8517. Access to a clinical care manager – dedicated line. Perform additional risk assessment & triage. Provider referral and scheduling of BH appointment. Available 24/7. Behavioral Health Referral Form. Claims Questions: 855-377-2416. Total Health Care Behavioral Health MemberServices.
TRANSPORTATION
To schedule a ride, use gas reimbursement or get a bus pass, call the Reservation Line at (800) 826-2862, x3608. If you need help, call the Customer Service Department at (800)826-2862 or (313) 871-2000, Monday – Friday, from 8:00 am- 5:00 pm. If you need an ambulance to take you to the hospital due to an emergency, call 9-1-1.CYBERSECURITY
Total Health Care experienced a cybersecurity incident that involved unauthorized access to several employee email accounts. Those email accounts contained sensitive personal information about the company’s members and physician partners. After conducting an extensive forensic investigation, the company found no evidence that information was viewed or misused in any way. PROVIDER – REFERRAL AND AUTHORIZATION The benefit maximum for referrals is 30 visits. Therefore, a total of 4 referrals are allowed. •If additional visits beyond 30 are clinically indicated, clinical review and approval is required through Total Health Care’s Utilization Department. The provider of service may fax clinical information to 313-748-1312 to request visits beyond30.
GRIEVANCES & APPEALS Grievances & Appeals. Your satisfaction is our priority! If you have a problem or complaint, the Customer Service Department can help. The department is available Monday-Friday, 8:00 a.m.-5:00 p.m at (313) 871-2000 or (800) 826-2862 . In most cases, the Customer Service Department can resolve your concern. If the department is unable toresolve
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
PRIOR AUTHORIZATION FORM 2181 E. Aurora Road, Suite 201 Twinsburg, OH 44087 Customer Services Phone: 1-800-361-4542 PRIOR AUTHORIZATION FORM Patient Information Prescriber Information CONSENT TO SHARE YOUR HEALTH INFORMATION DCH-3927 (12/14) Page 2 of 2 Consent ID #: My consent will expire on the following date, event or condition unless I withdraw my consent. (If expiration date is left blank or is longer than one year, the consent will expire 1 year from the signature date) TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PROVIDER – CONTRACT AND CREDENTIALING Contracting and Credentialing. Items are primary-source verified upon joining THC and every 3 years thereafter through the following sources: State licensing boards: Hospital privileges, practitioner education and work history. Physicians self-report non * dataMEDICAID HMO
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion.CYBERSECURITY
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
BIPAP/CPAP MACHINE CRITERIA BIPAP/CPAP Machine Criteria CPAP (Continuous Positive Airway Pressure) applies positive airway pressure through the nose by means of a mask in order to keep the upper airway open. INSULIN PUMP CRITERIA INSULIN PUMP CRITERIA An external insulin infusion pump is a programmable, battery-powered mechanical syringe/reservoir device controlled by a micro-computer to deliver a continuous subcutaneous insulin infusion (CSII) into TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PROVIDER – CONTRACT AND CREDENTIALING Contracting and Credentialing. Items are primary-source verified upon joining THC and every 3 years thereafter through the following sources: State licensing boards: Hospital privileges, practitioner education and work history. Physicians self-report non * dataMEDICAID HMO
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion.CYBERSECURITY
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
BIPAP/CPAP MACHINE CRITERIA BIPAP/CPAP Machine Criteria CPAP (Continuous Positive Airway Pressure) applies positive airway pressure through the nose by means of a mask in order to keep the upper airway open. INSULIN PUMP CRITERIA INSULIN PUMP CRITERIA An external insulin infusion pump is a programmable, battery-powered mechanical syringe/reservoir device controlled by a micro-computer to deliver a continuous subcutaneous insulin infusion (CSII) intoPHARMACY GENERIC
Pharmacy Benefit Information. Members may obtain the following information through Elixir:. Determine their pharmacy benefit financial responsibility; Order a refill for an existing mail order prescription (Applies only to Commercial, 3 – Tier & Qualified Health Plan Approved Drug Lists) CONTACT US | TOTAL HEALTH CARE Contact us with your general inquires or to request health information. Total Health Care. 3011 W. Grand Blvd. Suite 1600 Detroit, MI 48202 (313) 871-2000 or (800) 826-2862 TTY# 7-1-1PRIOR AUTHORIZATION
Total Health Care has Got You Covered! Your certificate of coverage is a helpful resource for covered services under your benefit plan. There are some situations where you might need to obtain a referral from your Primary Care Doctor or from Total Health Care’s (THC) utilization management department.TRANSPORTATION
To schedule a ride, use gas reimbursement or get a bus pass, call the Reservation Line at (800) 826-2862, x3608. If you need help, call the Customer Service Department at (800)826-2862 or (313) 871-2000, Monday – Friday, from 8:00 am- 5:00 pm. If you need an ambulance to take you to the hospital due to an emergency, call 9-1-1. PROVIDER – CLINICAL GUIDELINES Total Health Care adopts Clinical Practice Guidelines that are appropriate to its membership and organization. Clinical Practice Guidelines are either adopted from nationally recognized organizations, primarily Michigan Quality Improvement Consortium (MQIC), or are developed internally by Total Health Care and are based on scientific literature and reasonable medical evidence. SERVICES REQUIRING PRIOR AUTHORIZATION FROM THC EFFECTIVE Services Requiring Prior Authorization from THC Effective 4/1/2021 FAX clinical information to THC Utilization Department at 313-748-1312 Do not submit request in the THC portal PROVIDER DIRECTORY HMO Nondiscrimination Notice Total Health Care complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.EFFECTIVE 4.1
4 Audits .. 81
EFFECTIVE 4.1
71250 71550 71551 71552 71555 agog cagi0 cagil 72125 72126 72127 72128 72129 72130 ct of the chest w/o contrast mri chest mri chest withcontrast
CONSENT TO SHARE YOUR HEALTH INFORMATION DCH-3927 (12/14) Page 2 of 2 Consent ID #: My consent will expire on the following date, event or condition unless I withdraw my consent. (If expiration date is left blank or is longer than one year, the consent will expire 1 year from the signature date) TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PROVIDER – CONTRACT AND CREDENTIALING Contracting and Credentialing. Items are primary-source verified upon joining THC and every 3 years thereafter through the following sources: State licensing boards: Hospital privileges, practitioner education and work history. Physicians self-report non * dataMEDICAID HMO
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion.CYBERSECURITY
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
BIPAP/CPAP MACHINE CRITERIA BIPAP/CPAP Machine Criteria CPAP (Continuous Positive Airway Pressure) applies positive airway pressure through the nose by means of a mask in order to keep the upper airway open. INSULIN PUMP CRITERIA INSULIN PUMP CRITERIA An external insulin infusion pump is a programmable, battery-powered mechanical syringe/reservoir device controlled by a micro-computer to deliver a continuous subcutaneous insulin infusion (CSII) into TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PROVIDER – CONTRACT AND CREDENTIALING Contracting and Credentialing. Items are primary-source verified upon joining THC and every 3 years thereafter through the following sources: State licensing boards: Hospital privileges, practitioner education and work history. Physicians self-report non * dataMEDICAID HMO
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion.CYBERSECURITY
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
BIPAP/CPAP MACHINE CRITERIA BIPAP/CPAP Machine Criteria CPAP (Continuous Positive Airway Pressure) applies positive airway pressure through the nose by means of a mask in order to keep the upper airway open. INSULIN PUMP CRITERIA INSULIN PUMP CRITERIA An external insulin infusion pump is a programmable, battery-powered mechanical syringe/reservoir device controlled by a micro-computer to deliver a continuous subcutaneous insulin infusion (CSII) intoPHARMACY GENERIC
Pharmacy Benefit Information. Members may obtain the following information through Elixir:. Determine their pharmacy benefit financial responsibility; Order a refill for an existing mail order prescription (Applies only to Commercial, 3 – Tier & Qualified Health Plan Approved Drug Lists) CONTACT US | TOTAL HEALTH CARE Contact us with your general inquires or to request health information. Total Health Care. 3011 W. Grand Blvd. Suite 1600 Detroit, MI 48202 (313) 871-2000 or (800) 826-2862 TTY# 7-1-1PRIOR AUTHORIZATION
Total Health Care has Got You Covered! Your certificate of coverage is a helpful resource for covered services under your benefit plan. There are some situations where you might need to obtain a referral from your Primary Care Doctor or from Total Health Care’s (THC) utilization management department.TRANSPORTATION
To schedule a ride, use gas reimbursement or get a bus pass, call the Reservation Line at (800) 826-2862, x3608. If you need help, call the Customer Service Department at (800)826-2862 or (313) 871-2000, Monday – Friday, from 8:00 am- 5:00 pm. If you need an ambulance to take you to the hospital due to an emergency, call 9-1-1. PROVIDER – CLINICAL GUIDELINES Total Health Care adopts Clinical Practice Guidelines that are appropriate to its membership and organization. Clinical Practice Guidelines are either adopted from nationally recognized organizations, primarily Michigan Quality Improvement Consortium (MQIC), or are developed internally by Total Health Care and are based on scientific literature and reasonable medical evidence. SERVICES REQUIRING PRIOR AUTHORIZATION FROM THC EFFECTIVE Services Requiring Prior Authorization from THC Effective 4/1/2021 FAX clinical information to THC Utilization Department at 313-748-1312 Do not submit request in the THC portal PROVIDER DIRECTORY HMO Nondiscrimination Notice Total Health Care complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.EFFECTIVE 4.1
4 Audits .. 81
EFFECTIVE 4.1
71250 71550 71551 71552 71555 agog cagi0 cagil 72125 72126 72127 72128 72129 72130 ct of the chest w/o contrast mri chest mri chest withcontrast
CONSENT TO SHARE YOUR HEALTH INFORMATION DCH-3927 (12/14) Page 2 of 2 Consent ID #: My consent will expire on the following date, event or condition unless I withdraw my consent. (If expiration date is left blank or is longer than one year, the consent will expire 1 year from the signature date) TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PROVIDER – CONTRACT AND CREDENTIALING Contracting and Credentialing. Items are primary-source verified upon joining THC and every 3 years thereafter through the following sources: State licensing boards: Hospital privileges, practitioner education and work history. Physicians self-report non * dataMEDICAID HMO
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion.CYBERSECURITY
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
BIPAP/CPAP MACHINE CRITERIA BIPAP/CPAP Machine Criteria CPAP (Continuous Positive Airway Pressure) applies positive airway pressure through the nose by means of a mask in order to keep the upper airway open. INSULIN PUMP CRITERIA INSULIN PUMP CRITERIA An external insulin infusion pump is a programmable, battery-powered mechanical syringe/reservoir device controlled by a micro-computer to deliver a continuous subcutaneous insulin infusion (CSII) into TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PROVIDER – CONTRACT AND CREDENTIALING Contracting and Credentialing. Items are primary-source verified upon joining THC and every 3 years thereafter through the following sources: State licensing boards: Hospital privileges, practitioner education and work history. Physicians self-report non * dataMEDICAID HMO
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion.CYBERSECURITY
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
BIPAP/CPAP MACHINE CRITERIA BIPAP/CPAP Machine Criteria CPAP (Continuous Positive Airway Pressure) applies positive airway pressure through the nose by means of a mask in order to keep the upper airway open. INSULIN PUMP CRITERIA INSULIN PUMP CRITERIA An external insulin infusion pump is a programmable, battery-powered mechanical syringe/reservoir device controlled by a micro-computer to deliver a continuous subcutaneous insulin infusion (CSII) intoPHARMACY GENERIC
Pharmacy Benefit Information. Members may obtain the following information through Elixir:. Determine their pharmacy benefit financial responsibility; Order a refill for an existing mail order prescription (Applies only to Commercial, 3 – Tier & Qualified Health Plan Approved Drug Lists) CONTACT US | TOTAL HEALTH CARE Contact us with your general inquires or to request health information. Total Health Care. 3011 W. Grand Blvd. Suite 1600 Detroit, MI 48202 (313) 871-2000 or (800) 826-2862 TTY# 7-1-1PRIOR AUTHORIZATION
Total Health Care has Got You Covered! Your certificate of coverage is a helpful resource for covered services under your benefit plan. There are some situations where you might need to obtain a referral from your Primary Care Doctor or from Total Health Care’s (THC) utilization management department.TRANSPORTATION
To schedule a ride, use gas reimbursement or get a bus pass, call the Reservation Line at (800) 826-2862, x3608. If you need help, call the Customer Service Department at (800)826-2862 or (313) 871-2000, Monday – Friday, from 8:00 am- 5:00 pm. If you need an ambulance to take you to the hospital due to an emergency, call 9-1-1. PROVIDER – CLINICAL GUIDELINES Total Health Care adopts Clinical Practice Guidelines that are appropriate to its membership and organization. Clinical Practice Guidelines are either adopted from nationally recognized organizations, primarily Michigan Quality Improvement Consortium (MQIC), or are developed internally by Total Health Care and are based on scientific literature and reasonable medical evidence. SERVICES REQUIRING PRIOR AUTHORIZATION FROM THC EFFECTIVE Services Requiring Prior Authorization from THC Effective 4/1/2021 FAX clinical information to THC Utilization Department at 313-748-1312 Do not submit request in the THC portal PROVIDER DIRECTORY HMO Nondiscrimination Notice Total Health Care complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.EFFECTIVE 4.1
4 Audits .. 81
EFFECTIVE 4.1
71250 71550 71551 71552 71555 agog cagi0 cagil 72125 72126 72127 72128 72129 72130 ct of the chest w/o contrast mri chest mri chest withcontrast
CONSENT TO SHARE YOUR HEALTH INFORMATION DCH-3927 (12/14) Page 2 of 2 Consent ID #: My consent will expire on the following date, event or condition unless I withdraw my consent. (If expiration date is left blank or is longer than one year, the consent will expire 1 year from the signature date) TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PAY NOW | TOTAL HEALTH CARE All Healthcare.gov Enrollees and Individuals: To pay your premium, you need to have your Exchange Subscriber ID.. If you do not have your Exchange Subscriber ID, you can search for it by clicking on the “Where do I find this?” link next to the Exchange Subscriber ID field in the Payment Center.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
MEMBER CENTRAL
Get full access to your account. Once logged in, you will have access to the following features and more: Benefit Summary. Certificate of Coverage. Member Handbooks. Your Drug Coverage. Eligibility. Authorization Status. Claim Status.PHARMACY PROVIDERS
Elixir pharmacy staff are available 24 hours a day at 1-844-222-5584 Formularies – Updated as of 06/03/2021. A formulary is a list of guidelines for coverage ofSIGN UP NOW
Your Total Health Care Subscriber ID and suffix are located on your Total Health Care member ID card, which you should receive in the mail after your enrollment has been processed. TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
PAY NOW | TOTAL HEALTH CARE All Healthcare.gov Enrollees and Individuals: To pay your premium, you need to have your Exchange Subscriber ID.. If you do not have your Exchange Subscriber ID, you can search for it by clicking on the “Where do I find this?” link next to the Exchange Subscriber ID field in the Payment Center.MEMBER CENTRAL
Get full access to your account. Once logged in, you will have access to the following features and more: Benefit Summary. Certificate of Coverage. Member Handbooks. Your Drug Coverage. Eligibility. Authorization Status. Claim Status.PHARMACY PROVIDERS
Elixir pharmacy staff are available 24 hours a day at 1-844-222-5584 Formularies – Updated as of 06/03/2021. A formulary is a list of guidelines for coverage ofSIGN UP NOW
Your Total Health Care Subscriber ID and suffix are located on your Total Health Care member ID card, which you should receive in the mail after your enrollment has been processed.PHARMACY GENERIC
Pharmacy Benefit Information. Members may obtain the following information through Elixir:. Determine their pharmacy benefit financial responsibility; Order a refill for an existing mail order prescription (Applies only to Commercial, 3 – Tier & Qualified Health Plan Approved Drug Lists)SIGN UP NOW
Your Total Health Care Subscriber ID and suffix are located on your Total Health Care member ID card, which you should receive in the mail after your enrollment has been processed. CONTACT US | TOTAL HEALTH CARE Contact us with your general inquires or to request health information. Total Health Care. 3011 W. Grand Blvd. Suite 1600 Detroit, MI 48202 (313) 871-2000 or (800) 826-2862 TTY# 7-1-1 PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion. PROVIDER – BEHAVIORAL HEALTH Beacon Health Options Referral/Scheduling Line: 877-564-8517. Access to a clinical care manager – dedicated line. Perform additional risk assessment & triage. Provider referral and scheduling of BH appointment. Available 24/7. Behavioral Health Referral Form. Claims Questions: 855-377-2416. Total Health Care Behavioral Health MemberServices.
MEDICAID HMO
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PRIOR AUTHORIZATION
Prior Authorization From THC. PCP must FAX clinical information to THC Utilization Department at 313-748-1312. Authorization Grid. Specialty Drugs. Home Care Prior Authorization Form. Home Care IV Prior Authorization Form. Abortion – (Medicaid only) Admissions: InpatientHospital –
CYBERSECURITY
Total Health Care experienced a cybersecurity incident that involved unauthorized access to several employee email accounts. Those email accounts contained sensitive personal information about the company’s members and physician partners. After conducting an extensive forensic investigation, the company found no evidence that information was viewed or misused in any way. PROVIDER – REFERRAL AND AUTHORIZATION The benefit maximum for referrals is 30 visits. Therefore, a total of 4 referrals are allowed. •If additional visits beyond 30 are clinically indicated, clinical review and approval is required through Total Health Care’s Utilization Department. The provider of service may fax clinical information to 313-748-1312 to request visits beyond30.
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PAY NOW | TOTAL HEALTH CARE All Healthcare.gov Enrollees and Individuals: To pay your premium, you need to have your Exchange Subscriber ID.. If you do not have your Exchange Subscriber ID, you can search for it by clicking on the “Where do I find this?” link next to the Exchange Subscriber ID field in the Payment Center.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
MEMBER CENTRAL
Get full access to your account. Once logged in, you will have access to the following features and more: Benefit Summary. Certificate of Coverage. Member Handbooks. Your Drug Coverage. Eligibility. Authorization Status. Claim Status.PHARMACY PROVIDERS
Elixir pharmacy staff are available 24 hours a day at 1-844-222-5584 Formularies – Updated as of 06/03/2021. A formulary is a list of guidelines for coverage ofSIGN UP NOW
Your Total Health Care Subscriber ID and suffix are located on your Total Health Care member ID card, which you should receive in the mail after your enrollment has been processed. TOTAL HEALTH CAREMEMBERPROVIDEREMPLOYERAGENTPHARMACYPRIORAUTHORIZATION
Extended $0 Cost Share. for COVID-19 Coverage! No copays, deductibles, or coinsurance through. June 30, 2021 for medically necessary COVID-19. treatment at in-network providers. Schedule your. COVID-19. vaccine today. Register for an appointment* to get your.THCMI LOGIN
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans. PAY NOW | TOTAL HEALTH CARE All Healthcare.gov Enrollees and Individuals: To pay your premium, you need to have your Exchange Subscriber ID.. If you do not have your Exchange Subscriber ID, you can search for it by clicking on the “Where do I find this?” link next to the Exchange Subscriber ID field in the Payment Center.PROVIDER CENTRAL
THC has partnered with the following vendors to provide services to our membership: Pharmacy: EnvisionRxOptions , Specialty Pharmacy: EnvisonRxOptions. Durable Medical Equipment : Binsons , Weight Management : Weight Watchers, Diabetic Supplies: J & B Medical Supply , Transportation Services: Veyo. Behavioral Health Network: BeaconHealth Options.
MEMBER CENTRAL
Get full access to your account. Once logged in, you will have access to the following features and more: Benefit Summary. Certificate of Coverage. Member Handbooks. Your Drug Coverage. Eligibility. Authorization Status. Claim Status.PHARMACY PROVIDERS
Elixir pharmacy staff are available 24 hours a day at 1-844-222-5584 Formularies – Updated as of 06/03/2021. A formulary is a list of guidelines for coverage ofSIGN UP NOW
Your Total Health Care Subscriber ID and suffix are located on your Total Health Care member ID card, which you should receive in the mail after your enrollment has been processed.PHARMACY GENERIC
Pharmacy Benefit Information. Members may obtain the following information through Elixir:. Determine their pharmacy benefit financial responsibility; Order a refill for an existing mail order prescription (Applies only to Commercial, 3 – Tier & Qualified Health Plan Approved Drug Lists)SIGN UP NOW
Your Total Health Care Subscriber ID and suffix are located on your Total Health Care member ID card, which you should receive in the mail after your enrollment has been processed. CONTACT US | TOTAL HEALTH CARE Contact us with your general inquires or to request health information. Total Health Care. 3011 W. Grand Blvd. Suite 1600 Detroit, MI 48202 (313) 871-2000 or (800) 826-2862 TTY# 7-1-1 PROVIDER – FORMS AND DOCUMENTS Medical Services Administration Forms. > MSA-1550 Beneficiary Verification of Coverage. > MSA-1959 Informed Consent to Sterilization. > MSA-2218 Acknowledgement of Receipt of Hysterectomy Information. > MSA-4240 Certification for Induced Abortion. PROVIDER – BEHAVIORAL HEALTH Beacon Health Options Referral/Scheduling Line: 877-564-8517. Access to a clinical care manager – dedicated line. Perform additional risk assessment & triage. Provider referral and scheduling of BH appointment. Available 24/7. Behavioral Health Referral Form. Claims Questions: 855-377-2416. Total Health Care Behavioral Health MemberServices.
MEDICAID HMO
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.PRIOR AUTHORIZATION
Prior Authorization From THC. PCP must FAX clinical information to THC Utilization Department at 313-748-1312. Authorization Grid. Specialty Drugs. Home Care Prior Authorization Form. Home Care IV Prior Authorization Form. Abortion – (Medicaid only) Admissions: InpatientHospital –
CYBERSECURITY
Total Health Care experienced a cybersecurity incident that involved unauthorized access to several employee email accounts. Those email accounts contained sensitive personal information about the company’s members and physician partners. After conducting an extensive forensic investigation, the company found no evidence that information was viewed or misused in any way. PROVIDER – REFERRAL AND AUTHORIZATION The benefit maximum for referrals is 30 visits. Therefore, a total of 4 referrals are allowed. •If additional visits beyond 30 are clinically indicated, clinical review and approval is required through Total Health Care’s Utilization Department. The provider of service may fax clinical information to 313-748-1312 to request visits beyond30.
PRIOR AUTHORIZATION FROM THC PRESERVICE ONLY Prior Authorization from THC PCP Initiated Referral for HMO only Preservice only FAX clinical information to THC Utilization Departmentat 313
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Members – at this time PCP changes cannot be done through the portal. We are diligently working to get this feature back up in running. In the meantime, please contact customer service at 800-826-2862 x3350 to update your Primary Care Physician. Looking for health care plan coverage? INDIVIDUAL AND FAMILY PLANLearn More >>
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INTERESTED IN BECOMING A MEMBER? Find a Plan Now. Need more information about our plans? If you can't find the information you need below, please contact us. Go TOTAL HEALTH CARE WANTS YOU TO MAKE THE SMART CHOICE. CLICK HERE TO FIND THE BEST OPTIONS AVAILABLE FOR YOU.SMALL BUSINESSES
Businesses with 50 or fewer employees can also select a plan directly through Total Health Care. However, the Small Business Health Care Tax Credit is not available through these plans.Go
LARGE BUSINESSES
We have a variety of Total Health Care Group Plans from which to choose. Find one that best fits your healthcare needs and budget. GoMEDICAID
Medicaid is a comprehensive health plan that covers low-income adults and children. Find out if you qualify.HEALTHY
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The Healthy Michigan Plan provides health care coverage for low-income adults and children who make too much to qualify for Medicaid and Medicare. Find out if you qualify.Details
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