Provider Resources


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FAQ


You've got questions and we've got answers. View our Frequently Asked Questions page.


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Health Library


The Health Library is a free resource exclusively for MeridianComplete providers where you can get tips to help you manage your health.


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FAQS


 

You’ve got questions, we’ve got answers. If there’s a question you can’t find the answer to on our website, call

Provider

Services at

1-855-580-1689 (TTY 711), Monday - Friday from 8 a.m. – 8 p.m.

Who do I call with billing or claims questions?

Visit our Billing and Payment page for more information. If you still have questions, please call

1-855-580-1689

and we will connect you with our Claims Department.

How do I request claim status?

MeridianComplete is happy to assist providers with claim status!

Providers are able to check claims status using our self-service tool by calling Member Services at 866-606-3700. Please have the NPI, claim number, and member information available when using this tool.

What are the advantages of becoming a Meridian Provider?

Learn more about what Meridian can do for you on our Why Meridian? page.

How can I join the MeridianComplete Provider Network?

Meridian contracts with Primary Care Providers, Specialists, Hospitals, and Ancillary Providers. To become a contracted Meridian provider, call Provider Services at

1-855-580-1689

.

In order to ensure and maintain a high level of medical care, all providers are credentialed by

MeridianComplete

.

Do PCPs need a referral to see a

MeridianComplete

member not assigned to their panel?

Yes, members must choose an in-network PCP to provide their care.  In most situations, the member's in-network PCP or our plan must provide a referral before the member can use other providers in the plan’s network, such as specialists, hospitals, skilled nursing facilities, or home health care agencies.

 

Referrals from the member's PCP are not required for emergency care or urgently needed care.

Do Specialists need a referral to provide services to

MeridianComplete

members in the office?

Yes, members must choose an in-network PCP to provide their care.  In most situations, the member's in-network PCP or our plan must provide a referral before the member can use other providers in the plan’s network, such as specialists, hospitals, skilled nursing facilities, or home health care agencies.

 

Referrals from the member's PCP are not required for emergency care or urgently needed care.

I have patients who speak other languages, are hard of hearing or have other cognitive limitations. Can you help me communicate with them?

Yes, Meridian helps providers meet the individual needs of members by providing interpreters for those who are deaf or hard of hearing, accommodations for those with cognitive limitations, and interpreters for those who do not speak English. Call

MeridianComplete

at

1-855-580-1689

to access these services.

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QUICKLINKS

MEDICARE DISCLAIMER

MeridianComplete is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees.

 

You can get this document in Spanish, or speak with someone about this information in other languages for free. Call

1-855-580-1689 (TTY users should call 711)

,

Monday - Sunday, 8 a.m. to 8 p.m.

  The call is free.

 

Usted puede obtener gratuitamente este documento en español o hablar con alguien sobre esta información en otros idiomas. Llame al

1-855-580-1689

(los usuarios de TTY deben llamar al 711), lunes a domingo, de 8 a.m. a 8 p.m. La llamada es gratuita.

 

Limitations, copays, and restrictions may apply. For more information, call MeridianComplete Member Services or read the MeridianComplete Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year

The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. We will send you a notice before we make a change that affects you.

 

Copays for prescription drugs may vary based on the level of Extra Help you receive. Please contact the plan for more details.

 

For certain kinds of drugs, you can use the plan’s network mail-order services. We also have an optional automatic mail-order delivery program under which we will automatically fill all new prescriptions your health care provider sends to us, as well as refills for prescriptions that have already been filled but are running out. Usually a mail-order pharmacy order will get to you in no more than 5 days. If you experience any problems receiving your mail order prescription, call Member Services at

1-855-580-1689 (TTY users should call 711)

.

Page Last Modified: 4/5/2022 2:50:09 PM