Providers are credentialed by location, so it is important to notify us in writing of any upcoming changes or additions. Our easy-to-use online Provider Information Updates on our website at https://www.herayahealth.com/provider-information-updates will collect the required information for a relocation or additional office request. You will be notified by Heraya in writing of the effective date for the new location.
Provider Services FAQ
What should I do if I want to relocate or add an additional office?
Can I notify Heraya of any changes via your website?
Yes! Our our online Provider Information Updates for on our website at https://www.herayahealth.com/provider-information-updates can be used to submit many kinds of information changes including updating your e-mail address, requesting a relocation or additional office, and name/e-mail/phone number updates.
How can I obtain a copy of the fee schedule for the lines of business I am participating in?
A copy of each fee schedule was sent to the provider at the time of initial credentialing, as well as any time a contract is amended. If you have misplaced a fee schedule(s) or need a copy for your billing staff, please contact the Provider Services department.
What if I want to change my payment information?
To update any payment information, please mail or fax an updated IRS W-9 form to Heraya. W-9 forms are available on the IRS website at https://www.irs.gov/pub/irs-pdf/fw9.pdf or can be requested for our Provider Services Department.
Can a non-contracted provider in my office treat Heraya members in my absence?
If there are no other contracted providers of your discipline in your office, you can request call coverage. Call coverage may be approved for a non-contracted provider to treat Heraya members for a time period up to 60 days. Beyond 60 days is considered a Leave of Absence and Heraya patients should be referred to another Heraya contracted provider. You can find the Leave of Absence or Call Coverage request forms on Frequently Used Forms page or you can contact our Provider Service Department for more information.
Can a call coverage provider treat KP Direct PCP-referred patients?
Only Heraya contracted providers may treat a PCP-referred patient. The patient will present with a KP Direct PCP referral authorization form indicating the Heraya provider. If that provider is not available to treat the member, please refer the patient back to the Community Medicine Integration Center for further direction. Contact information is contained with Heraya’s Billing Manual.
How do Heraya patients find me?
Most patients will find your information through our website using “Find a Provider” search option or the applicable payer provider directory. Patients can search for a provider by name or by location. Remember, providers are credentialed by location so please inform us of any location changes or updates. We updates our website daily and contracted clients regularly.
How do I obtain a copy of Heraya’s current Billing and Provider Operations Manuals?
To obtain a current copy of either Heraya’s Billing Manual or Provider Operations Manual, please visit our website at www.chpgroup.com. The manuals are behind our secure Provider Log-in, on the Manuals and Policies tab.
What if a service a provider recommends is not covered?
Heraya does not interfere with recommended services by our qualified providers. However, as outlined in your Professional Services Agreement, we do require that the member agrees in writing prior to services rendered to pay out-of-pocket for non-covered services. For your convenience, Heraya has created a form for this purpose that meets the minimum requirements. You can find a Patient Consent for Non-covered Services form behind the secure Provider Login on our website under the Frequently Used Forms tab.
How can I contact Heraya’s Provider Services Department?
E-mail – ps@herayahealth.com
Phone – 503-203-8333 or toll-free at 800-449-9479
Fax – 877-482-2856