Patrius Health 101: FAQs for Providers
We’re thankful that you are a provider in the Patrius Health Network. Here are some commonly asked questions to assist new providers. Review these topics and become familiar with the many online resources that can help you navigate Patrius Health and deliver the care your patients need.
Getting Started with Patrius Health
I just joined the Patrius Health Network—now what?
We recommend you become familiar with our Patrius Health provider education website, which offers many resources to help you. Here are some resources that can help you get started:
I have questions about how to access or navigate myBlue Provider. Whom can I contact?
Blue Cross & Blue Shield of Mississippi’s provider website is called myBlue Provider. If you have issues accessing or navigating myBlue Provider, Mississippi providers should call Blue Cross & Blue Shield of Mississippi’s EDI Services at 1-601-664-4357.
Where can I find the Patrius Health Provider Manual?
The Provider Manual is one of the many resources available on the Patrius Health provider website, which is accessible by logging in to myBlue Provider and clicking the link to Blue Advantage® Resources.
Verifying Benefits for Blue Advantage Patients
Where can I verify benefits online for my Blue Advantage patients?
Providers can verify their patients’ coverage and plan via Eligibility and Benefits on myBlue Provider.
Whom do I contact if I have questions about benefits?
For questions about your Blue Advantage patients' eligibility and benefits, call Patrius Health provider services at 1-888-949-2352.
Conducting Pre-Service Reviews
How do I know if my patient needs a pre-service review?
Certain services may require precertification for your Blue Advantage patients. The Pre-Service Review webpage on the Patrius Health provider website contains details to help you get started. Another resource is the Pre-Service Review Provider Guide.
How can I verify if a service requires a precertification or initiate this process online?
The Pre-Service Review Provider Guide shows the steps to determine if a pre-service review is needed and how to initiate that process. Start this process by logging in to myBlue Provider. Under Prior Authorization in the left menu, select Blue Advantage Pre-Service Review. You will be directed to the Blue Advantage Pre-Service Review portal for Patrius Health.
Who can I contact for questions about pre-service reviews?
For website support related to a review, contact Blue Cross & Blue Shield of Mississippi EDI at 1-800-826-4068. For other questions related to a review, contact Patrius Health provider services at 1-888-949-2352.
Is there a guide available to help me navigate the pre-service review process?
Yes, the Pre-Service Review Provider Guide is available on the Patrius Health provider website.
Claims-Related Topics
Where can I send claims?
Claims for Patrius Health Blue Advantage members should be filed to Blue Cross and Blue Shield of Mississippi. All providers should bill for services rendered using their National Provider Identifier (NPI). Do not file claims to Medicare with the exception of the following:
- Services related to hospice care
- Services related to clinical trials
► Quick Tip: To ensure accurate claims processing, it is critical that providers capture all ID card data. If the information is not captured correctly, providers may experience a delay in claims processing. Providers should make a copy of the front and back of the member’s ID card, and provide the key information to their billing staff.
Whom can I contact if I have claims-related questions?
For inquiries or requests to have claims reviewed if you believe there was an error in processing, please contact Patrius Health provider services at 1-888-949-2352.
Whom can I contact for eClaims support for front-end rejects, etc.
For Blue Advantage services rendered in MS, call Blue Cross & Blue Shield of Mississippi EDI Support at 1-601-664-4357.
Whom can I contact for accepted claims/denied claims reports?
For accepted claims questions, call Patrius Health provider services at 1-888-949-2352.
Information About Provider Online Tools
What online tools are available for providers?
Patrius Health offers valuable online tools to assist providers with their patient population and determining care that may be needed. They include:
Patrius Health also offers the online AutoHR360 application that gives providers a convenient option for completing and submitting the Health Risk 360 (HR360) patient assessment. Review the HR360 webpage for more information about this assessment and a related incentive.
How can I get our practice’s health risk assessment template approved in lieu of using the Patrius Health HR360 form?
There are many eConnectivity options available to enhance data sharing and minimize administrative burden. Send us a Contact Blue message mentioning your desire to get your practice eConnected. Our Patrius Health team will reach out to discuss options.