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  • Appointment Of Representative Form - Geisinger Health Plan

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Department of Health and Human Services Centers for Medicare & Medicaid Services Form Approved OMB No. 0938-0950 Appointment of Representative Name of Party Medicare or National Provider Identifier.

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Flex card “This is available for one of our Geisinger Gold Medicare Advantage plans this year and is a great benefit that members should take advantage of if they have it,” says Kolb. “It can be used to help pay for dental, vision and hearing devices.”

(800) 883-6355 or (570) 271-8763 Fax: (570) 271-7860 Monday – Friday, 8 a.m.- 4:30 p.m.

The initial submission of any claim must be received by GHP within 4 months of the date of service for outpatient claims and/or 4 months of the date of discharge for inpatient claims, as applicable.

Geisinger comprises ten hospital campuses, two research centers, a college of medicine and a 550,000-member health plan serving more than three million residents in central, south-central and northeast Pennsylvania and beyond.

Can I request a new one? You can request a new card and print a temporary ID card if you have a Member Portal account. Log in here. Or call our customer service team at 570-214-0003.

Geisinger Health Plan offers quality, comprehensive coverage for all eligible Medical Assistance recipients. Each year, more than 500,000 members throughout Pennsylvania choose GHP Family for our high-quality Medicaid plan.

Geisinger Provider Choice — Features a multilevel network where a member's out-of-pocket costs, such as copays, deductibles and coinsurance, are determined by the network group to which the provider they choose to see is designated. Members can see any provider from any group at any time.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232