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Advantage Health Solution Claims and Medical Management Update

Suburban Health Organization has moved the administration of Advantage Health Solution claims and medical management from ProHealth to CMCS effective 12/15/2014.

The following information will need to be shared with your office and billing staff and your records updated in order for you to receive reimbursements:

CMCS Electronic Claims Submission:
EDI Payer ID: EMDEON 35199

Paper Claims:
Suburban Health Organization
P.O. Box 50830
Indianapolis, IN 46250

Claims Inquiries & Customer Service Information:
Ph: 1.866.873.4516 or 1.317.596.5929
Fax:  1.317.570.6822

Medical Management (including all authorizations and precertification-related calls):
1.317.570.9999
Fax: 1.800.747.3693

The Prior Authorization process, including forms listed below, will remain the same. For any questions, please call Bryce Conway at 317.692.5222 or brycec@suburbanhealth.com.

Providers may also go online to www.cmcs-indy.com to check on their claims status.  This tool provides real-time access to the CMCS processing system, and reduces the need to call customer service for routine questions.

Risk Services Resources

Used for Advantage Membership. These PDF forms require Adobe Reader to view.

Prior Authorization Forms

For any questions related to Medical Management or Prior Authorization, please contact CMCS directly at:
Ph: 1.866.482.5254 or 1.317.570.9999
Fax: 1.800.747.3693

For claims inquiries or disputes and for all customer service questions, please contact CMCS directly at:
Ph: 1.866.873.4516 or 1.317.596.5929
Fax:  1.317.570.6822