Member Files & Forms
In order to view some of these materials, you will have to have a copy of Adobe Acrobat Reader installed on your computer. If you do not, you can download and install the latest Acrobat Reader software free. Download Adobe Reader.
- Make a Request
Members may use this form to request a new ID card, make a change in your address, add or change a physician or send us a comment.
We encourage you to let us know right away if you hvae question, concerns, or problems related to your covered services or the care you receive. If you have a grievance, call Member Services at 1.877.847.7907 (TTY: 1.880.622.3925) in the Ohio Valley or Mountaineer Region or 1.800.426.9013 (TTY: 1.877.236.2291) in the HomeTown Region.
Categories
Privacy of Your Health Information
The privacy and security of your health information is very important to The Health Plan. For that reason, we have procedures in place to ensure that your information is well protected. The following notice, describe in detail the processes in place to ensure the privacy of your health information.
Our Customer Services Department is available to assist you with any questions or concerns. You can call Member Services at 1.877.847.7907 (TTY: 1.800.622.3925) in the Ohio Valley or Mountaineer Region or 1.800.426.9013 (TTY: 1.877.236.2291) in the HomeTown Region.
We have also developed a number of forms for you to utilize for reporting and/or requesting information pertaining to the Privacy of Your Health Information. The following forms are available for your use:
Provider Directories
Listed are printed directories we currently have available online for you to download and print at your convenience. In addition to these directories, which are somewhat large, we have a provider look-up feature to facilitate searching for providers by specialty and location.
Access the Provider Search.
*Provider lists are printed by Region. To determine which regional list is appropriate, review our The Health Plan Service Area Reference Map below. *
If you reside or are looking for providers in any of the regions highlighted in grey -- please contact the The Health Plan Customer Service in St. Clairsville at 740.695.7902/1.888.847.7902 and in Massillon at 330.837.6880/1.800.426.9013.
Every effort is made to ensure the accuracy of all Health Plan Directories at publication. However, there may be changes at any time. When you require medical services, we recommend that you verify the participation status of the provider by contacting our Member Relations Department or the provider's office.
Documents
Accident Report
| Date added: | 10/16/2007 |
| Filesize: | 253.85 kB |
| Downloads: | 39 |
This form is to be filled out if Health Contract contains a subrogation clause. The Health Plan is obligated to recover any claim payments made on your behalf from the third party's insurance carrier or from you if you received that claim payment. Contact our Funds Recovery Department at 1.800.624.6961, ext. 7903 if you have any questions, or to give the information by phone.
Users will need to have the most recent version of Adobe Acrobat or Adobe Reader (7.0 or greater). Users will then be able to fill out the form ONLINE and click "Print Form" when finished.
Baby Keepsake Booklet
| Date added: | 07/23/2009 |
| Filesize: | 2.29 MB |
| Downloads: | 85 |
Case Management Program
| Date added: | 09/18/2009 |
| Filesize: | 40.42 kB |
| Downloads: | 44 |
(further explanation can be found in the Practitioner Procedural Manual, Section 7)
For members experiencing a critical illness or injury, The Health Plan provides specially trained registered nurses in case management to assist in coordinating care and services. If you believe you could benefit from this program, fill out the form below or you can contact the case managers by calling the Medical Department at 740.695.7644 or 740.695.7643 and toll-free at 1.800.624.6961, ext. 7644 or 7643.
You can also submit a Member Case Management Referral Form online.
Emergency Medical Information (EMI)
| Date added: | 03/17/2009 |
| Filesize: | 820.83 kB |
| Downloads: | 56 |
Emergency Medical Information (EMI)
| Date added: | 01/28/2009 |
| Filesize: | 820.44 kB |
| Downloads: | 54 |
Guide to HP Services
| Date added: | 03/01/2010 |
| Filesize: | 657.52 kB |
| Downloads: | 25 |
Member Rights & Responsibilities
| Date added: | 09/18/2009 |
| Filesize: | 35.58 kB |
| Downloads: | 55 |
Services Requiring PreAuthorization
| Date added: | 01/27/2010 |
| Filesize: | 14.52 kB |
| Downloads: | 54 |
The Health Plan Service Area
| Date added: | 09/18/2009 |
| Filesize: | 89.04 kB |
| Downloads: | 64 |
The Health Plan geographic area covers a large portion of Eastern Ohio and Northern and Central West Virginia as shown on this map of the plan service area regions.
Resources for Members
I want to . . .
- Request a new ID card, change my information
- Sign up for important screening test reminders (brought to you by the College of American Pathologists)
- Get a FREE Online Personal Health Record
Improve your quality of care with your Personal Health Record. Please take a moment to visit this important site.
- Find the Average Cost of Medical Procedures
This is information from a third party and may NOT reflect actual costs and/or charges at The Health Plan facilities but rather is averaged based on this companies analysis of the cost of medical procedures annually.
- Find What Services Require PreAuthorization
- Visit Vision Services Plan (VSP)
Questions concerning your Vision Services can be found here.