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Lovelace's Network Operations Department provides prompt responses to your questions. Our Provider Services Representatives are well trained and have expert knowledge and advice. Also, to enhance the customer service to our provider partners, we now have a dedicated Provider Response Team to answer all of your claims, benefits, and eligibility questions.

 

Provider Resources
 

Lovelace Commercial & Senior Plan Products

Lovelace Community Health Plan (Salud and SCI) products

CIGNA products

Health Services

Prior Authorization-Medical Only

Albuquerque:
(505)-262-3100
Statewide:
(800)-336-5078

Albuquerque: (505)-816-6601
Statewide: (888)-232-2750

Albuquerque: (505)-262-3100
Statewide: (800)-336-5078

Prior Authorization-Behavioral Health

Albuquerque: (505)-816-6605
Statewide: (888)-684-0461
*For SALUD, please contact Value Options at (800)-397-1630.

CIGNA Behavioral Health:
(800)-926-2273

Case Management

Albuquerque:
(505)-262-3100
Statewide:
(800)-336-5078

Albuquerque: (505)-816-6608
Statewide: (877)-894-4783

Albuquerque: (505)-262-3100
Statewide: (800)-336-5078

Network Operations

Main Number

Albuquerque: (505)-262-7363
Statewide:(800)-808-7363
Fax: (505)-262-3806

Claims Help Line

Albuquerque: (505)-262-3856
Statewide:(800)-808-7363
Fax: (505)-262-3806

(800)-CIGNA24
(800-244-6224)

Claims Mailing Address

Lovelace Health Plan
PO Box 760
Pueblo, CO  81002-0760

*Please check the back of the Member’s Identification Card for the claims mailing address.

Electronic Claims Routing Number

90328

SX159

*Please check the back of the Member’s Identification Card for the electronic routing number.

Interactive Voice Response

Eligibility and Co-pay Verification

Albuquerque:
(505)-232-1894
Statewide:
(888)-525-4437

Albuquerque: (505)-232-1878
Statewide: (877)-480-9371

(800)-CIGNA24
(800-244-6224)

Central Territory Providers:

Network Manager:

Michelle Marquez (505)-262-3095

sylvia.marquez@lovelace.com

Provider Service Rep:

Gilbert Gallegos (505)-232-1700

gilbert.gallegos@lovelace.com

Statewide Behaviorial Health

Provider Service Rep:

Digby Henry (505)-816-6668

john.henry@lovelace.com

Northern Territory Providers:

Network Manager:

Angela Sanchez-Caldwell (505)-232-1820

angela.sanchez-caldwell@lovelace.com

Provider Service Rep:

 

Sonia Gonzales (505) 232-1793

sonia.gonzales@lovelace.com

Provider Service Rep (UNM/LHS/Transportation):

Valerie Jimenez (505)-262-3736

valerie.jimenez@lovelace.com

Southwest Territory Providers:

Network Manager:

Angela Sanchez-Caldwell (505)-232-1820

angela.sanchez-caldwell@lovelace.com

Provider Service Rep:

Christina Bustamante (505)-262-3818

christina.bustamante@lovelace.com

Southeast Territory Providers:

Network Manager:

Patricia Briggs (505)-262-3852

patricia.briggs@lovelace.com

Provider Service Rep:

Doreen Renna (505)-232-1853

doreen.renna@lovelace.com

Forms/Directories/Formularies

Visit our website at lovelacehealthplan.com or call (505)-232-1812

Provider Appeals

For contract reimbursement disputes, please include a copy of the original claim and the Explanation of Payment and forward to your provider service representative.  Provider Appeals must be submitted in within 180 calendar days from the date of the Explanation of Payment.  When submitting a request for review, please make sure to include a cover letter requesting the review and indicate the reason for the appeal.  For reviews with a clinical component, additional documentation should include supporting narrative, operative report(s) and medical records, as applicable.  Written requests should be sent to:

Lovelace Health Plan
Attn: Appeal Coordinator
PO Box 27107
Albuquerque, NM  87125-7107

CIGNA Healthcare
Central Appeals Unit
PO Box 5225
Scranton, PA 18505-5225

MEMBER RESOURCES

Customer Care Center

Albuquerque: (505)-262-7363
Statewide: (800)-808-7363

(800)-CIGNA24
(800-244-6224)


*Please refer benefit questions from members to the Customer Care Center

 

 

 
 

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