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Provider Information

The Provider web page(s) are available to provide an efficient means for NARBHA's provider network to access specific information that NARBHA feels is necessary to manage member care and monitor provider performance.


These consist of :


*  A Claim Query process that allows direct service providers to look up information on their claims submitted to NARBHA for adjudication.   This information is updated after every NARBHA claim cycle.  This process is located on the secure portion of the NARBHA web site.

*  An Enrollment Verification process that allows direct service providers and other stakeholders to determine if the members are enrolled at NARBHA.   This information is refreshed daily.  This process is located on the secure portion of the NARBHA web site.

*  Provider Monitoring page(s) that identify the provider's performance against the standard set of performance measures applied to all like providers.  This information is refreshed daily.  This process is located on the secure portion of the NARBHA web site.

*  Links to various other web sites that will assist the provider.

*  Provider Orientation materials addressing several specific needs/requirements in the Management Information System (MIS) area.

As noted above some of these processes are located on secure portion(s) of the NARBHA web site and require that staff at the provider request a NARBHA User ID to allow them to access the information.

NARBHA Enrollment Verification
Direct service providers and other stakeholders can now verify NARBHA enrollment information through the NARBHA web site.   This process is limited to provider/stakeholder staff that have been issued a User ID/ password.  

 

NARBHA Claims Query
Direct service providers can look up information on their claims submitted to NARBHA by using the Claims Query web application located under the Provider Information tab.   This process is limited to provider staff that have been issued a User ID/ password.  

 

Requesting Access/ User ID 
Want to access secure portions of the NARBHA website?  Download and complete the Web Site User Access Application form located on this page.  The form contains instructions on completion and submission.

 

Prior Authorization Requests

Emergency services are never prior authorized. Please, provide the clinically appropriate service, and then contact NARBHA Medical Management Department for additional instructions at 1-928-774-7128.

For non-emergency inpatient psychiatric hospitalizations, Level I Residential Treatment Center (RTC) admissions, Level II, Level III, and Home Care Training (HCTC), prior to admission, see DBHS/NARBHA Policy 3.14 Securing Services and Prior Authorization for instructions and forms that must be faxed to the NARBHA Utilization Care Management Department at (928) 214-1166). 24 hour assistance is available by contacting NARBHA Utilization Care Manager at 1-928-774-7128.

Acute Health Plan & Provider Coordination Assistance

For assistance with coordination of care between primary care providers, Health Plans and other stakeholders, call 928-774-7128 or Member Services 1-800-640-2123.