Quick Reference Guide

Key information all in one place.
Click here to download a copy of the Quick Reference Guide.  Or, view them below.
Please note that the Riverside Health Quick Reference Guide is still in effect. 
2017 Quick Reference Guide with UM Health Partners Member ID Card Images Coming Soon

MEMBER IDENTIFICATION CARD

IMPORTANT PHONE NUMBERS

Provider Services: 410-779-9359 or 800-730-8543   |   Member Services: 410-779-9369 or 800-730-8530

Health Services | Utilization Management
Case Management | Disease Management:1-410-779-9359 or 1-800-730-8543

Newborn Coordinator: 1-410-779-9371

State of Maryland EVS: 1-866-710-1447

For PA (Prior Authorization), QL (Quantity Limit), ST (Step Therapy) review, or Non Formulary Exceptions:
Call CVS/Caremark at 1-877-418-4133

For Mental Health/HIV Pharmacy Authorizations:
Call the State of Maryland’s Specialty Mental Health System at 1-800-932-3918
or the Anti-Psychotic Peer Review Line for children 0-9 years old at 1-855-283-0876

Routine Vision Services: Superior Vision 1-800-879-6901

Adult Dental Services: DentaQuest 1-800-341-8478

Child Dental Services: Maryland Healthy Smiles
Phone: 844-275-8753 | Email: providerservices@sciondental.com
Web Portal: provider.mdhealthysmiles.com

CLAIMS SUBMISSION

Riverside Health of Maryland, Inc.

P.O. Box 1572

Bowie, MD 20717-1572

Claims must be submitted on CMS-1500 or UB-04 forms.

Claims must be filed within 180 days of the date of service.

ELECTRONIC DATA INTERCHANGE (EDI)

Claims may be submitted to Riverside through the following clearinghouse

EMDEON: PAYOR ID 45281

CLAIMS ADJUSTMENTS

Riverside Health of Maryland, Inc.

Attn: Claim Adjustments

1966 Greenspring Drive, Suite 100

Timonium, MD 21093

Reconsideration of claims must be submitted within 180 days of the date of remittance, and must include a written description of the issue and a reference to the initial claim.

MEDICAL APPEALS

Riverside Health members and their representative(s),including a member’s provider with written authorization, may submit a medical appeal relating to an adverse action within 90 calendar days of the decision. Medical appeals can be filed to the following address:

Riverside Health of Maryland, Inc.

Attn: Appeals and Grievances Department

1966 Greenspring Drive, Suite 100

Timonium, MD 21093

LAB SERVICES

Quest Diagnostics: 866-MYQUEST (866-697-8373)   |   Labcorp: www.labcorp.com