The Alterwood Advantage Provider Portal represents a critical digital platform designed to streamline healthcare provider interactions and administrative processes. This portal offers healthcare professionals a centralized system for managing patient-related tasks, claims, and essential documentation.
Official Links
- Website: https://www.alterwoodadvantage.com/for-providers/
- Contact: 1-866-550-0560 (TTY: 711)
What Providers Can Do
Claims Submission
Providers have two primary methods for submitting claims:
-
Electronic Claims (Preferred Method)
- Payor ID: RP016
- Platform: Availity
-
Mailed Claims
- Address: Alterwood Advantage, PO Box 981832, El Paso, TX 79998-1832
- Accepted Forms: CMS 1500 or UB04
- Submission Deadline: 180 calendar days from date of service
Key Portal Resources
Provider Documents
The portal provides access to critical documents including:
- 2025 Provider Manual
- 2025 Quick Reference Guide
- Transition of Care Form
- Clinical Practice Guidelines
- PCP Change Request Forms
Authorization Management
Providers can manage various authorization requests:
- Inpatient Services Prior Authorization
- Outpatient Services Prior Authorization
- Rehabilitation Prior Authorization
- Part B Medication Prior Authorization
Access and Requirements
Eligibility
The portal is designed for:
- Healthcare providers
- Medical practices
- Clinics working with Alterwood Advantage
Network Participation
Providers interested in joining the Alterwood Advantage network can explore network details directly through the portal.
Privacy and Security
Compliance Features
- HIPAA-compliant platform
- Secure document transmission
- Protected claims processing
Support Resources
Contact Information
- Provider Support: 1-866-550-0560
- TTY: 711
- Hours of Operation: Not specifically detailed in available documentation
Important Considerations
Claim Submission Guidelines
- Submit claims within 180 calendar days
- Use only designated submission methods
- Avoid sending paper claims to alternative addresses
Unprovided Information
Some details were not explicitly available in the source documents:
- Exact login process
- Specific portal URL
- Detailed app download instructions
- Precise hours of operation
The Alterwood Advantage Provider Portal offers a comprehensive digital solution for healthcare providers, facilitating efficient claims management, authorization processes, and administrative tasks.
Disclaimer
Portal features and availability are subject to change. Providers should always refer to the most current documentation and contact Alterwood Advantage directly for the most up-to-date information.
Compliance Note
Alterwood Advantage is an HMO and HMO-SNP plan with Medicare and Maryland Medicaid contracts. Enrollment depends on contract renewal.
Last Updated: 10/01/2024
FAQ
What kind of insurance is Alterwood Advantage?Alterwood Advantage is an HMO and HMO-SNP plan with a Medicare contract and a State of Maryland Medicaid contract. Enrollment in Alterwood Advantage depends on contract renewal. Our plan(s) may offer supplemental benefits in addition to Part C benefits and Part D benefits.
What is the payer ID for Alterwood Medicare Advantage?Payer ID # RP016.
How do I contact Alterwood Advantage?Please contact Alterwood Advantage at 1-866-675-3944 if you need information in an accessible format or language other than what is listed above. Our office hours are 8 am – 8 pm ET, 7 days a week, October 1 – March 31; 8 am – 8 pm ET, Monday – Friday, April 1 – September 30. TTY users should call 711. 7.
How do I appeal Alterwood Advantage?You may also ask us for an appeal through our website at www.AlterwoodAdvantage.com. Expedited appeal requests can be made by phone at 667-261-8050 or toll free at 866-267- 3144.
https://www.alterwoodadvantage.com/for-providers/
Medicare beneficiaries may also enroll in Alterwood Advantage through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov. Dismiss.
https://www.alterwoodadvantage.com/
Alterwood Advantage has core principles focused on ensuring the provider experience is positive. Explore how to join the Alterwood Advantage network today!