Our Mailing Address for Providers

APWU Health Plan's claims mailing address may have changed for 2008. Current information is on the 2008 APWU Health Plan Member ID Card and Sleeve. Be sure to check the address for claims submission information on visits from APWU Health Plan members.

APWU Health Plan claims are mailed to different addresses based on the state of residency of the APWU Health Plan member:

• For states where the APWU Health Plan member's local PPO network is CIGNA HealthCare (Click here for CIGNA states), and APWU Health Plan is the primary payer, submit all medical claims, whether you are a participating or non-participating provider, to:

  CIGNA Healthcare
  P.O. Box 5909
  Scranton, PA 18505
  or Payer ID 62308

• For states where the APWU Health Plan member's local PPO network is Coventry Health Care (Click here for Coventry states), and APWU Health Plan is the primary payer, submit in-network hospital claims to:

  Coventry Health Care
  APWUHP
  P.O. Box 10398
  Scottsdale, AZ 85271-0398

  For all other medical claims in a Coventry state, whether you are a participating or non-participating provider, submit to:

  APWU Health Plan
  P.O. Box 1358
  Glen Burnie, MD 21060-1358
  or Payor ID 44444

• For the state of Minnesota, where the APWU Health Plan member's local PPO network is PreferredOne and APWU Health Plan is the primary payer, submit all medical claims, whether you are a participating or non-participating provider, to:

  PreferredOne
  P.O. Box 1527
  Minneapolis, MN 55440-1527
  or Payor ID 41147

• For states where the APWU Health Plan member's local PPO network is PHCS (Click here for PHCS states), and APWU Health Plan is the primary payer, submit all medical claims, whether you are a participating or non-participating provider, to:

  APWU Health Plan
  P.O. Box 1358
  Glen Burnie, MD 21060-1358
  or Payor ID 44444

• In the Virgin Islands, where the APWU Health Plan member's local PPO network is VI Equicare, and the APWU Health Plan is the primary payer, submit all medical claims, whether you are a participating or non-participating provider, to:

  APWU Health Plan
  P.O. Box 1358
  Glen Burnie, MD 21060-1358
  or Payor ID 44444

WHEN APWU HEALTH PLAN IS THE SECONDARY PAYER:

• For medical claims where APWU Health Plan is the secondary payer, submit all medical claims along with Other Insurance Carrier's Explanation of Benefits to:

  APWU Health Plan
  P.O. Box 1358
  Glen Burnie, MD 21060-1358

FOR ALL STATES:

• When the APWU Health Plan member is traveling outside of their state of residence, submit all medical claims, whether you are a participating or non-participating provider, to:

  CIGNA Healthcare
  P.O. Box 5909
  Scranton, PA 18505
  CIGNA Payer ID 62308

• Mail correspondence or appeals to:

  APWU Health Plan
  799 Cromwell Park Drive, Suites K-Z
  Glen Burnie, MD 21061

Claims Status Information

To receive information about the status of your claim, providers may either:

• Submit a claim status form via the Internet
• Call the Automated Phone System on a touch-tone phone at 1-800/222-APWU (2798) - 7 a.m. to 8 p.m. EST, Monday-Friday
• Call Customer Service at 1-800/222-APWU (2798) - 8:30 a.m. to 8 p.m. EST, Monday-Friday

Patient Eligibility/Verification

To verify or determine patient eligibility, call 1-800/222-APWU (2798). The patient eligibility/verification form for submittal over the internet is under construction.

Precertification

Inpatient stays must be precertified to avoid a $500 penalty. The exceptions are: if the patient has other health insurance, including Medicare Part A, which is primary to the APWU Health Plan, or if the stay is outside the United States or Puerto Rico.

For emergency or maternity admissions, precertification must take place within 48 hours of the admission, even if the patient has been discharged. If a newborn remains in the hospital past the mother's discharge, these extra days must be precertified. Planned stays must be precertified at least 48 hours prior to the admission.

Durable medical equipment, rehabilitative therapy and nursing services must also be precertified. All therapies and nursing must be preauthorized by the provider of service.

PROVIDER PRECERTIFICATION NUMBERS:
To precertify, call the precertification vendor for your area - click here.

Coverage Information

To receive information about coverage, providers may either:

• Submit a coverage information form via the Internet
• Call the Automated Phone System on a touch-tone phone at 1-800/222-APWU (2798) - 7 a.m. to 8 p.m. EST, Monday-Friday
• Call Customer Service at 1-800/222-APWU (2798) - 8:30 a.m. to 8 p.m. EST, Monday-Friday