What a Health Plan Should Be

To better serve our Health Plan Select physicians and providers, we have compiled some of the most frequently asked questions. If you do not see your question listed below, please let us know and we will address it for you.

Question:
How can I determine if a member is active with Health Plan Select?
Answer:
Confirming eligibility is easy by using HPS Provider Tool (ePower). From HPS’s home web page, click on Providers, then click on ePower and sign-in with your assigned ePower User ID, then click on Eligibility verification to access member eligibility information. If you have not registered for access, please contact Provider Relations at 706-549-0549, Ext. 5 for more information on what options are available to you with this too or click Register Today to download a registration packet.
You can also determine if a member is active by contacting HPS’s Member Services department directly at 706-549-0549 Ext.

Question:
Who should I contact if I have questions about my fee schedule or contract?
Answer:
You may contact the Provider Relations Department directly at (706) 549-0549, Ext. 5 and you will be able to speak with a Provider Relations Representative who will be able to assist you with your inquiries.

Question:
Can I submit my claims electronic?
Answer:
Yes, HPS accepts claims electronically through the following method:
1) Claims may be submitted electronically via a clearinghouse. To submit claims using this method, your office will need to enroll with a clearinghouse. Upon enrollment, you should submit your claims data through your chosen clearinghouse. The clearinghouse will pass your claim data through the standard data specifications and send it directly to HPS’s claim payment system.

Question:
Who should I contact if I have questions about a claim?
Answer:
You may contact Health Plan Select at (706) 549-0549 Ext. 2 to speak with a representative about a claim.

Question:
How do I appeal a claim?
Answer:
You have the right to an appeal if you do not agree with a determination made by HPS. All requests related to timely filing, lack of medical necessity, or prior authorization must be submitted within 120 days from the original date of the Remittance or initial denial. All appeals must be submitted in writing and include all pertinent information to substantiate your request. The written appeal should be mailed to: