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Providers

Effective Immediately

To better serve our Members and Providers, SWHP has implemented an new phone system. The system will request the Member or Provider enter the 11 digit Member Number (or SSN) being addressed. The call will then route to the appropriate Advocate specifically trained to address the issue.

Benefits and Eligibility

Claims and Billing

Medical Management

*Primary Care Physician - Member Selections 

Complaints and Appeals 

Quality Improvement 

Medical Policies 

Reimbursement Policies

Provider Directory 

Provider Manual 

Pharmacy Services - Prior Auth/Formularies 

General Information

Provider Contract Requests 

Out of Network Providers 

Claims Processing

Frequently Asked Questions

How to Become a Pharmacy Provider

Tutorials