Address
What is the claims mailing address for medical claims?
PO Box 21631 Eagan, MN 55121
What is Troy Medicare's Customer Support phone number?
1-888-494-TROY (8769)
What are the two phone numbers for Perform RX?
Provider Services - 866-560-6052
Where can member's go to check their balance for their Healthy Benefits OTC/OTC & Meal?
Members can go to the benefit portal or the app to view their balance details.
Or by phone - Self Service Line - 877-909-2486
What does PHI stand for?
Protected Health Information
What is the RX Mailing Address?
PO Box 516 Essington, PA 19029
What is the phone number for Utilization Management?
704-275-8900 x181
What is the name of the outside vendor for our Fitness Program?
Silver & Fit
What's the name of the non-emergency transportation service vendor?
SafeRide
If the member is calling in, what 3 things do you have to verify?
First & Last Name (Usually they will provide this to you right away)
Member's date of birth (DOB)
Member's address
What is the address for Vision reimbursement?
PO Box 30516 Charlotte, NC 28230
What is Zelis "Provider Client Services" phone number?
What is Perform RX?
Our outside pharmacy vendor
What is Liberty Dental?
Our outside Dental Vendor
If a non-member is calling in and the member is available, what would you need to do?
If the member is available, ask to speak with the member. Verify two of the following and then ask for verbal authorization to disclose information to "name of caller/relationship"
- Member's DOB
- Member's address
- Member ID
What is Troy Medicare's Corporate Office address?
615 S. College St. FL 9 Charlotte, NC 28202
What is Care Management's phone number?
704-275-8900 x180
When a member goes to the dentist, what network should they be asking if the dentist is part of/in network with?
Liberty Dental, not Troy Medicare
What network does a member have to utilize for vision benefits?
There is not a network, they can go to any vision provider in the state of NC.
If a Provider is calling in, what would you need to do?
Verify the member's first and last name and two of the following:
- Member's date of birth
- Member's address
- Member's Troy ID
- Member traditional Medicare ID
What is the OON appeals address? What is the INN appeals address?
OON - PO Box 30667 PMB 36507 Charlotte, NC 28230
INN - PO Box 30516 Charlotte, NC 28230
What is the phone number for Lighthouse? What is Lighthouse?
1-866-704-8769
Broker Agent Services
What are the Healthy Benefits for HMO & DSNP? (Asking about both the OTC and the Meal, there should be 3 amounts provided)
HMO OTC - $40 per quarter
DSNP OTC - $325 per quarter
DSNP Meal - $50 per month
What outside vendor must a member go through to receive hearing aid benefits? What's their phone number?
Hearing Care Solutions
866-344-7756
If a non-member is calling in and the member is NOT available, what would you need to do?
If the member is unavailable, verify the following:
- Written consent on file that is signed and dated by the member or Power of Attorney (If no AOR, POA or verbal auth is given, we cannot release any details regarding the member's plan)
AND
Verify two of the following:
- Member’s date of birth
- Member’s address
- Last 4 digits of the member’s social security number