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      • General Contact Information

        Mailing Information:
        Passport Health Plan
        5100 Commerce Crossings Drive
        Louisville, KY 40229

        Email
        You can contact us using our email form.

        Main Office Number

        (502) 585-7900

        Compliance Team

        1-855-512-8500 email here

      • Member Contact Information

        Member Services
        1-844-859-6152
        Available from April 1 to September 30,
        Mon - Fri, 8 a.m. to 9 p.m. EST (8pm CST)
        from October 1 to March 31
        7 days a week, 8 a.m. to 9 p.m. EST (8pm CST)

        If You Are Interested in this Plan:
        Call Toll-Free 1-844-643-2780
        Available from January 1 to September 30,
        Mon - Fri, 8 a.m. to 8 p.m. (EST/CST)
        from October 1 to December 31
        Mon - Fri, 8 a.m. to 8 p.m. (EST/CST) and Saturdays from 10 am to 6 pm EST/CST

        TTY/TDD
        711


      • Provider Contact Information



        Provider Services
        1-844-859-6152
        Available from April 1 to September 30,
        Mon - Fri, 8 a.m. to 8 p.m. (EST/CST)
        from October 1 to March 31
        7 days a week, 8 a.m. to 8 p.m. (EST/CST)

Passport has customer service representatives ready to serve you. You can call us:

Member Services: 1-844-859-6152 | TTY/TDD 711

April 1 - September 30 | Mon - Fri | 8am - 9pm EST (8pm CST) and October 1 - March 31 | 7 days a week | 8am - 9pm EST (8pm CST)

If You Are Interested In This Plan, Call Toll-Free 1-844-643-2780 | TTY/TDD 711

January 1 - September 30 | Mon - Fri | 8am - 8pm EST/CST and October 1 - December 31 | Mon - Fri | 8am - 8pm EST/CST and Saturdays from 10 am to 6 pm EST/CST

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    • General Contact Information

      Mailing Information
      Passport Health Plan
      5100 Commerce Crossings Drive
      Louisville, KY 40229

      Email
      You can contact us using our email form.

      Main Office Number

      1-502-585-7900

      Compliance Team

      1-855-512-8500
      Email Compliance Team

      To report Fraud, Waste, or Abuse
      click here

    • Member Contact Information

      Member Services
      1-844-859-6152
      Available from April 1 - September 30,
      Mon - Fri, 8 a.m. to 9 p.m. EST (8pm CST)
      from October 1 to March 31
      7 days a week, 8 a.m. to 9 p.m. EST (8pm CST)

      TTY/TDD
      711

      If you are not a member of this plan, call toll-free 1-844-643-2780
      Available from January 1 - September 30,
      Mon - Fri, 8 a.m. to 8 p.m. (EST/CST)
      from October 1 to December 31
      Mon - Fri, 8 a.m. to 8 p.m. (EST/CST) and Saturdays from 10 am to 6 pm EST/CST

      TTY/TDD
      711

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      Main Office Number

      1-502-585-7900

      Compliance Team

      1-855-512-8500
      Email Compliance Team

    • Provider Contact Information

      Provider Services
      1-844-859-6152
      Available from April 1 - September 30,
      Mon - Fri, 8 a.m. to 8 p.m. (EST/CST)
      from October 1 to March 31
      7 days a week, 8 a.m. to 8 p.m. (EST/CST)

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      Provider Services
      1-844-859-6152
      Available from April 1 - September 30,
      Mon - Fri, 8 a.m. to 8 p.m. (EST/CST)
      from October 1 to March 31
      7 days a week, 8 a.m. to 8 p.m. (EST/CST)

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    • Contact Us

      General Contact Information

      Mailing Information
      Passport Health Plan
      5100 Commerce Crossings Drive
      Louisville, KY 40229

      Email
      You can contact us using our secure email form.

      Main Office Number

      (502) 585-7900

      Compliance Team

      1-855-512-8500 email here

      Main Office Number

      1-502-585-7900

      Compliance Team

      1-855-512-8500
      passportlistens@getintouch.com

      Member Contact Information

      Member Services
      1-800-578-0603
      Available Monday through Friday,
      between 7 a.m. and 7 p.m. (ET)
      TDD/TTY
      1-800-691-5566
      For information about
      Transportation,
      Call Toll-Free
      1-888-941-7433 (Voice and TTY)

      Provider Contact Information

      Provider Services
      1-800-578-0775
      Available Monday through Friday, between 8 a.m. and 6 p.m. (ET)

      Provider Relations Specialists
      Provider Claims Services Unit (PCSU)

      1-800-578-0775, Select Option 2, then Option 1
      Available Monday through Friday, between 8 a.m. and 6 p.m. (ET)

      Utilization Management
      Attn: Appeals Department
      5100 Commerce Crossings Dr.
      Louisville, KY 40229
      1-877-903-0082

      Case Management
      Attn: Case Management
      5100 Commerce Crossings Dr.
      Louisville, KY 40229
      1-877-903-0082

      Electronic Claims Submission
      Emdeon (formely WebMD)
      1-800-845-6592
      Passport Health Plan
      electronic payer
      identification number is
      61129.

      Claims Submission
      Passport Health Plan
      P.O. Box 7114
      London, KY 40742

      Family Planning Claims Submission
      AmeriHealth Family Planning
      Attn: Claims
      P.O. Box 42476
      1901 Market Street, 29th Floor
      Philadelphia, PA 19101-2476

      Vision Claim Submission
      Block Vision
      120 West Fayette Street,
      Suite 700
      Baltimore, MD 21201

      Submission of Medical Records
      (when requested from
      claims processing)
      Passport Health Plan
      200 Stevens Drive
      Philadelphia, PA 19114

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Passport has customer service representatives ready to serve you. You can call us:

Member Services: 1-844-859-6152 | TTY/TDD 711

April 1 - September 30 | Mon - Fri | 8am - 9pm EST (8pm CST) and October 1 - March 31 | 7 days a week | 8am - 9pm EST (8pm CST)

If You Are Interested In This Plan, Call Toll-Free 1-844-643-2780 | TTY/TDD 711

January 1 - September 30 | Mon - Fri | 8am - 8pm EST/CST and October 1 - December 31 | Mon - Fri | 8am - 8pm EST/CST and Saturdays from 10 am to 6 pm EST/CST
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  • Claims Issue Form
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Provider Network Forms
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Non-Participating Provider Forms
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Utilization Management Forms
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Behavioral Health Forms
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Pharmacy Forms
  • 2019 Step Therapy Criteria | 2020 Step Therapy Criteria
  • 2019 Prior Authorization Criteria | 2020 Prior Authorization Criteria
  • Coverage Determination Request Form
  • Request for Redetermination Form

 

Last Modified: December 11, 2019

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  • AHIP

5100 Commerce Crossings Drive
Louisville, Kentucky 40229

Member: 1-844-859-6152 Provider: 1-844-859-6152

Passport Advantage (HMO SNP) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-844-859-6152 (TTY: 711). 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-844-859-6152 (TTY: 711).

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