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  • Paramount Negative Balance Report Fax Inquiry Form 2020

Get Paramount Negative Balance Report Fax Inquiry Form 2020-2025

Negative Balance Report Fax Inquiry Form Attn. Provider Inquiry Phone Number: 4198872564 Toll Free: 8888912564 Fax: 4198872014 Toll Free: 8554484705ADVANTAGE ELITE HMO PROMEDICA MEDICARE.

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CT AU-463 2021 NJ CN 10792 2014 CT H-13B 2021 NJ CN 10952 2006

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Complete all information requested below and fax or email with a copy of complete medical records, itemized bills and a copy of the HCFA-1500 or UB-04 to (908) 658-3511 or billreview.integrity@zelis.com.

Provider Appeals | Fax Submission Now you have the option of submitting Paramount's Clinical Authorization Appeal form via fax. Fax the form to Paramount Provider Appeals at 567-585-9500.

Fax: 1.866. 404.1771// Mail: Attn: Clinical PA Department- 411 Bienville St. Natchitoches, LA 71457 Be certain to keep copies of this form, your denial notice, and all documents and correspondence related to this claim. Liviniti is a service mark of Southern Scripts Holdings, LLC.

Fax request to 1-888-541-3829.

Requests can be submitted in writing, via fax to 904-539-4090, or via the Part B South QIC Appeals Portal at https://.c2cinc.com/QIC-Part-B-South. Requests can be submitted in writing, via the DME QIC Appeals Portal at https://qicappeals.cms.gov/, or by fax to 585-869-3314.

Your MyParamount.org account is where you can access deductible counters, claims information, your ID card and more. Or, if you prefer to speak with your personal call center representative, call Paramount Member Services at 419-887-2525 (toll-free 800-462-3589) or TTY at 419-887-2526 (toll-free 888-740-5670).

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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