For member eligibility, benefit verification, or claim status, please call Members Health Insurance (MHI)
Claims Service toll-free at:
Member Line: 1-844-708-7950
Provider Line: 1-844-708-7951
Our hours of operation are Monday through Friday, 7:30 a.m. to 4:30 p.m. CST.
You may also correspond with us via fax or email.
MHI Claims Service Fax: 931-490-0424
MHI Claims Service Email: firstname.lastname@example.org
To submit a claim:
Please note: claims for MHI members are set up for an electronic Medicare crossover. If you wish to submit a paper claim, you may mail it to:
Members Health Insurance Company
P.O. Box 1424
Columbia, TN 38402
To update your information with us:
You may send any updates to your information, including updated W-9 forms, to us at email@example.com.
Click here to update your information with MHI by completing the MHI Provider Profile form.
FREQUENTLY ASKED QUESTIONS
What type of coverage does MHI offer?
Members Health Insurance offers Medicare Supplement plans A-G, M and N. Since these are Medicare Supplement plans, benefits are based on Medicare guidelines. If Medicare denies, no benefits will be available unless otherwise specified in the member’s contract.
Is Prior Authorization required?
Since this is a Medicare Supplement, no prior authorization is required from MHI.
What are MHI’s timely filing guidelines?
The MHI timely filing limit is one year plus 90 days from the date of service.
Is there a provider portal?
Please click here to access the One Connection portal where you can securely view member benefit details.
How does MHI determine if a claim should be denied for a pre-existing medical condition?
Some members will have a pre-existing condition waiting period. For MHI, a pre-existing condition is defined as: a condition for which medical advice was given or treatment was recommended by or received from a physician within six (6) months prior to a member’s effective date. For members who have a pre-existing condition waiting period, the MHI Claims Processing Department will review claims and relevant medical information to determine if the claims submitted are for a condition that was treated or had been advised to be treated within the 6 months prior to the member’s effective date.
What steps do I take to appeal a claim?
Call MHI at 1-844-708-7950 and ask for a reconsideration. You will need to have your ID number available along with the claim number in question or date of service. The provider can also submit an appeal for you. The appeal must be submitted within 60 days of the denial of the claim.