The Senior Whole Health (SWH) Provider Portal represents a comprehensive digital platform designed to streamline healthcare provider interactions, offering efficient tools for managing patient care, claims, and administrative tasks across multiple states including Massachusetts and New York.
Official Links
- Massachusetts Provider Portal: https://www.molinahealthcare.com/providers/ma/swh/home.aspx
- New York Provider Portal: https://www.molinahealthcare.com/providers/ny/swh/home.aspx
What is the Provider Portal?
The Availity Provider Portal is a robust digital platform that enables healthcare professionals to perform critical administrative and clinical tasks efficiently. Specifically for Senior Whole Health providers, the portal offers real-time transaction capabilities across multiple service areas.
Key Portal Features
Provider Capabilities
Providers can:
- Check member eligibility and benefits
- Submit claims and supporting documentation
- Check claim status
- View remittance and explanation of benefits (EOBs)
- Request prior authorizations and referrals
- Access SWH-specific resources and news
Access and Registration
New Users
Providers can register for the Availity Portal to access:
- Newest tools
- Resources
- Customized training opportunities
Existing Users
Providers with credentials from another payer can directly log in and start working with SWH on Availity.
Important Provider Responsibilities
Senior Whole Health requires providers to:
- Maintain accurate directory demographics
- Update provider information at least 30 days in advance for:
- Office location changes
- Contact information updates
- Provider additions/terminations
- Tax ID or NPI modifications
- Practice status changes
Privacy and Security
The portal emphasizes:
- HIPAA compliance
- Secure data transactions
- Confidential member information handling
Support and Contact
Provider Services
- Massachusetts: (855) 838-7999
- Email: [email protected]
- New York: Provider Relations at 1-877-353-9819
Additional Resources
Mental Health Support
- Providers can explore evidence-based education opportunities through Psych Hub
- Molina Help Finder assists in referring patients to low-cost resources
Technological Integration
DirectAssure Collaboration
- SWH collaborates with DirectAssure for accurate provider directories
- Providers encouraged to use CAQH ProView for profile management
Unprovided Information
Some specific details were not explicitly mentioned in the source documents, such as:
- Exact app download instructions
- Detailed billing process through the portal
- Comprehensive step-by-step login procedures
The Senior Whole Health Provider Portal offers a comprehensive, secure platform enabling healthcare providers to efficiently manage patient care, administrative tasks, and critical healthcare interactions.
Note: Information is current as of the website’s last update in July 2024.
FAQ
Is senior whole health part of MassHealth?Senior Whole Health (SWH) HMO-SNP is a Medicare Advantage health plan for seniors 65 years and older that combines your MassHealth Standard and Medicare benefits. It’s simple to join. Have both Medicare Part A and B, and MassHealth Standard Eligible individuals may enroll at any time of year.
Who is the parent company of senior whole health?M&A Details. Senior Whole Health was acquired by Magellan Health Services on Jul 13, 2017 .
Does senior whole health require referrals?Call 911 for help or go to the nearest emergency room, hospital, or urgent care center. You don’t need to get approval or a referral first from your doctor or other network provider. “Urgent Care” is when you need medical help for an unforeseen illness, injury, or condition, but your health is not in serious danger.
What is senior whole health of New York MLT?Senior Whole Health of New York Medicaid Managed Long Term Care Plan provides care and services, along with assistance with daily activities, to Medicaid-eligible adults 21 years or older who are also eligible for long-term care.
https://www.molinahealthcare.com/providers/ma/swh/home.aspx
On the Provider Portal you can: Check member eligibility and benefits, Request prior authorizations and referrals, Submit claims, send supporting documentation
https://www.molinahealthcare.com/providers/ny/swh/home.aspx
On the Provider Portal you can: Check member eligibility and benefits; Submit claims, send supporting documentation and check status; View