Provider Resources
You care for patients every day, and we believe your network partner should make that work easier—not more complicated. HealthSmart Network Solutions brings more than 50 years of network experience, millions of members, proven client growth, and broad market expertise to help connect providers with patients.
Whether you are a hospital, health system, large provider group, independent practice, individual practitioner, managed care organization, or any other type of provider, we offer flexible network options designed to support your goals, expand your reach, and help you stay focused on delivering excellent care.
When you join our provider networks, you gain a trusted partner committed to fast, accurate claims processing, a dedicated provider relations support team, and operational excellence that reduces administrative friction.
Comprehensive Provider Services
With flexible contracting and 24/7 online claim status access, HealthSmart Network Solutions helps make participation simpler, more transparent, and more valuable—so together, we can improve access, support healthier communities, and create a better experience for everyone.
Our online services enable you to:
To request a client list please Contact Us
For questions about benefits, eligibility or claims, please contact the number on the member’s ID card.
Fast, Accurate Claims Processing that You can Count On
Our partnerships with our network providers is a testament to our mission and our values. Every provider who joins our network(s) can expect an increase in patient volume, a stable member base and an expedited claim turnaround time. When you become a HealthSmart Network Solutions provider, we provide an array of seamless services to help you.
EDI Overview
HealthSmart Network Solutions offers a full-service healthcare EDI Clearinghouse, which is open to all providers in the healthcare community. Our goal is to give our network providers the highest level of service possible. Engineered with the latest cutting-edge technology, we are committed to meeting all HIPAA requirements and leading the way in EDI services.
EDI Services Include:
EDI Benefits:
Online Claim Status
Contracted network providers can use our free Online Claim Status tool to quickly check the status of their claims. For more information, please contact Customer Service at 1-800-687-0500.
Online Credentialing and Recredentialing
We are pleased to participate in the Universal Credentialing DataSource, a project of the Council for Affordable Quality Healthcare (CAQH). This web-based solution allows you to store and manage your credentialing information online and share it with insurance carriers electronically.
Fraud, Waste & Abuse
By reporting suspected fraud, waste, or abuse (FWA), you help protect patients, reduce health care costs, and prevent financial harm to others. Submitting a report is an important first step. Once received, HealthSmart Network Solutions works to detect, correct, and prevent FWA across the health care system.