Welcome Physicians and Healthcare Professionals!

Thank you for working with Clear Spring Health to help give our members a clear path to healthy aging.

Your relationship with your patients is important in protecting their health and well-being. Clear Spring Health has tools and resources to help support you in their care. The strength of our provider and physician networks give your patients the freedom to achieve their healthy aging goals, while saving money.

As a participant in our network, you join a vast group of providers dedicated to providing quality Medicare Advantage Plan options to seniors in select counties of Colorado, Illinois, North Carolina and Virginia

Join Our Network

If you are interested in joining our network, please complete the form below and a representative will be in touch.

Provider Resources
Referrals and precertification apply to benefit plans that include those requirements. Please review the attached document to learn more about our guidelines.

Please submit your appeal request, including all applicable documentation to:

Clear Spring Health
Appeals and Grievances
P.O. Box 4048
Scranton, PA 18505-9875

Clear Spring Health values the quality care that you give to our members and it is our goal to provide prompt reimbursement for those services. A key factor in timely claim processing is correct submission. We are committed to helping you submit a claim correctly the first time which will increases your cash flow, prevents costly follow-up by your staff and reduces unresolved claims for members.

Clear Spring can accept claims electronically through Change Healthcare. Clear Spring encourages practitioners to take advantage of our electronic claims processing capabilities. Submitting claims electronically offers the following benefits:

  • Faster Claims Submission and Processing
  • Reduced Paperwork
  • Increased Claims Accuracy
  • Time and Cost Savings

For submission of professional or institutional electronic claims for Clear Spring Health, the Clear Spring Health Payer ID is 66009.

Paper claims can be mailed to:

Clear Spring Health
Attn: Claims
P.O. Box 4048
Scranton, PA 18505

You need to stay “in-the-know” with the latest news in this constantly changing world of health care. Clear Spring Health is here to provide you with news and updates from us as well as the latest breaking stories from the health care industry, Centers for Medicare (CMS), and the Centers for Disease Control (CDC). We are here to keep you informed.

First Tier, Downstream and Related Entities (FDR) Annual Attestation Form

Centers for Medicare and Medicaid Services (CMS) and other federal and state entities require Clear Spring Health (CSH) to have oversight and monitoring of the First Tier, Downstream, and Related Entities (FDR). Clear Spring Health is committed to ensure the FDRs are in compliance with applicable laws and regulations as published in the Title 42 of the Code of Federal Regulations, Parts 422 and 423 and sub-regulatory guidance published in both Pub. 100-18, Medicare Prescription Drug Benefit Manual Chapter 9, and in Pub. 100-16, Medicare Managed Care Manual Chapter 21.

This attestation form is to facilitate the oversight and monitoring for FDR compliance with CMS and other federal and state regulators program requirements. The annual attestation must be signed by an individual with the authority to attest the accuracy and completeness of the information provided.

Please complete and submit the attestation form to Clear Spring Health Compliance Department
Contact Us

  • Customer Service Phone
    • Phone: 877-384-1241
  • Vendor Contact Information
    • Dental
      • Phone: CO 855-225-1731
      • Phone: IL 800-508-6780
      • Phone: NC 844-831-9098
      • Phone: VA 844-822-8109
    • Vision
      • Phone: IL 844-254-9491
      • Phone: CO, NC, VA 844-824-2014
    • Hearing
      • Phone: 877-234-4761
    • Fitness
      • Phone: 888-423-4632