Check Eligibility Status

Welcome to the healthcare provider portal!

This portal is exclusively for healthcare providers to check the status of eligibility for benefits for our members/your patients.

In order to check the eligibility status for one or more of our members, you will need to first create an account.

In setting-up your account you will need:

  • Your Tax Identification Number (TIN)
  • Your National Provider Identifier (NPI)
  • A valid email address

Once you have created your online account, you will need our member’s OE ID number that can be found on their insurance ID card.

Click here to log in or create an account.

 

Calendar Year Deductible – Medical
Active and Retiree Plans (not Medicare primary)

Network Providers $250 per person calendar year deductible with a maximum of $750 per family.
Non-Network Providers  $500 per person with a maximum of $1,500 per family.

To locate a Network Provider, click here .

 

Calendar Year Deductible – Dental
Active and Retiree Plans

For those members enrolled in the fee-for-service or United Concordia Preferred dental plans, there is a $25 per individual/$75 family maximum calendar year deductible.  Prior authorization is required for all dental work in excess of $600.  There is no deductible or prior authorization required for members enrolled in United Concordia Plus or Delta Care USA DHMOs (dental HMO).