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Contact National Health Administrators

You can contact NHAI in a number of ways.



NHAI OFFICES RESPONSIBILITIES CONTACT NUMBERS
National Health Administrators, Claims Dept.
425 Eagle Rock Avenue, Suite 105
Roseland, NJ 07068
Questions on Benefits, Claims, Membership, or Provider verification of benefits.
See also Compliance Office for Claims Appeals below.
Hotline: (888) 679-2400 Ext.1
Phone: (888) 335-0133
Fax: (973)228-4240
claims@nhai.net
Behavioral Health Solutions
PO Box 1237
Laurence Harbor, NJ 08879
All claims for mental health and substance abuse must be filed directly with the NHAI Behavioral Claims Office.

NBHS is the Exclusive Provider for Mental Health & Addictive Treatment. Non-approved providers or services will not be covered.

Hotline: (888) 679-2400, Ext.3
Phone: (888) 838-8874,
Fax: 732-441-9866
E-mail: behavioral@nhai.net
National Health Administrators , Inc. PPO
1200 Brown Street Suite 12
Peekskill, NY 10566

Normal Business Hours, except for Holidays: 9 a.m. - 5 p.m.
PPO providers are available at the following Web Site For Information Packet on NHAI PPO, or to Find local providers & other general questions.
www.nhai.net

PPO Provider Relations, PPO Negotiations, and all PPO Contracting and pricing. Problems with providers.
Hotline: (888) 679-2400, Ext.0
Fax: (914) 739-8341
OUT OF STATE PPO PROVIDERS RESPONSIBILITIES CONTACT NUMBERS
NHAI has a number of providers in Florida, Connecticut and other states. Please check the provider listing at our web site. OOA or traveling members call Multiplan or TRPN PPO for Physicians or facility referrals (800) 557-6794. For emergencies, go to the nearest hospital. Go to web site to see if there are PPO Providers in area. PPO directories are available from Trust Office. Non-OOA members must get precertification to use Multiplan or TRPN when traveling. Contact PPO Office for InformationHotline: (888) 679-2400, Ext.4
Fax: (914-739-8341
PRE-CERTIFICATION RESPONSIBILITIES CONTACT NUMBERS

Pre-Cert Department
(Medical and Mental Health or Substance Abuse)

IN AN EMERGENCY GO TO NEAREST HOSPITAL IMMEDIATELY !!

For Pre-certification, Utilization Review, Case Management for Medical, Mental Health TreatmentPre-certification decisions are independent from payment or benefit decisions. Hotline: (888) 679-2400, Ext.2
Phone: (866) 844-8244
Fax: (785) 233-3149
E-mail: precert@nhai.net
NHAI Behavioral (NHAB)(Exclusive Provider for all behavioral treatment) NHAB must authorize all mental health and substance abuse services. Benefits must also be pre-certified by our pre-certification department. IN CASE OF EMERGENCY, GO TO THE NEAREST HOSPITAL! Hotline: (888) 679-2400, Ext.3
Phone: (888) 838-8874
Fax: (732) 441-9866
PRESCRIPTIONS - Rx RESPONSIBILITIES CONTACT NUMBERS
Your group health id card is also your rx card to purchase retail drugs

For retail and mail order programs or to find a local network pharmacy.For special Rx requests, problems, or vacation override on medication, contact the Compliance Office or the Executive Offices of NHAI, Extension 6, than Extension 5. Catamaran Member Service& Rx Card: (855) 577-6312
Mail Order Rx: (888) 637-5121
Fax: (888) 637-5191
Group # 1533N
CLAIMS APPEALS RESPONSIBILITIES CONTACT NUMBERS
Claims Appeals (including complaints and/or questions about plan interpretation. )
Normal Business Hours:
Mon -Thurs.: 7:00 a.m. - 5:00 p.m.
Fridays: 7:00 a.m. - 12:00 noon
Please submit all appeals in writing by regular mail, fax or E-mail and allow 10-30 days for processing. For complaints or questions on the plan, contact the Compliance Office. Hotline: (888) 679-2400 Ext.5
Fax: (770) 874-1097
E Mail: compliance@nhai.net
Mail Address - Do not send Certified. If you want a receipt send priority mailing with proof of mailing.
Compliance Office
Attn: Andrea Henry
416 Creekstone Ridge
Woodstock, GA. 30188-1753
Phone: (800) 645-1195
Claims Appeals concerning Pre-certification and/or Medical Necessity - call the Pre-certification Office immediately. Emergency situations will be processed within 24 hours during normal business hours. The patient or member must file appeals concerning benefit payments or plan interpretation with the compliance office. Please allow a minimum of 10 to 30 days to review your claim once all information is submitted including a copy of the claim in question and the EOB. This may be sent via e-mail, fax, or regular mail.
ENROLLMENT & COBRA INFORMATION CHANGE OF STATUS WHERE TO ENROLL/FILECHANGES/ FORMS
COBRA, Enrollment, Change of Status, Student Verification Normal Business Hours, except for Holidays: 9:30 a.m. - 4:30 p.m. Forms, PPO directories, general information and COBRA. You must notify Trust within 60 days of any change in family status. Failure to notify us of a change may result in ineligibility for COBRA benefits. Compliance Office Phone: (800) 645-1195 fax: (770) 874-1097 e-mail: compliance@nhai.net

We look forward to hearing from you!

 
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