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Provider Manual

Northwood to manage DMEPOS services

Last Updated on August 28, 2018

Effective July 1, 2015, Security Health Plan is partnering with Northwood, Inc. (Northwood) to manage DMEPOS services provided by the following provider types for all Plan members:

  • Durable medical equipment providers
  • Medical supply providers
  • Oxygen/respiratory equipment providers                           
  • Mobility providers
  • Orthotics/prosthetics providers
  • Wig providers
  • Breast prosthesis providers
  • Ocular prosthetic providers
  • Pharmacy providers who distribute/dispense DMEPOS
  • Speech generating device providers
  • Sleep study providers*

* Exception: When this provider type bills for professional studies supporting sleep services, Security Health Plan is responsible to manage/pay those services/claims.

Northwood’s policies will apply to all DMEPOS services and providers managed by Northwood. For Security Health Plan-managed services, the Plan’s policies will apply.  Under this new partnership, Northwood will be responsible for administering a full range of services, including:

  • Prior authorization of DMEPOS and services
  • Claims processing and adjudication
  • Member and provider services related to DMEPOS requests
  • Data reporting
  • Provider contracting, credentialing and management
  • Provider inquiries, grievances and appeals

 How to request authorizations

  • Regular business hours – All providers may submit prior authorization requests by fax (866-483-9988) or phone (866-532-1344) Northwood will be available Monday through Friday, 8:30 a.m. to 5 p.m.
  • After-hours – Providers are required to obtain authorizations for urgent/emergent requests occurring after-hours and on weekends and holidays within 2 business days following the date of service.  Northwood has designated on-call Benefit Coordinators to provide members and providers 24/7 access for emergent/urgent after-hours and/or weekend and holiday services.
  • Online – Northwood contracted providers may submit prior authorization requests online via Northwood’s provider portal https://provider.northwoodinc.com  Please contact Northwood at 866-532-1344 to obtain information on how to sign-up.

Resources

Northwood Provider Materials
Northwood prior authorization procedure code list

Northwood Contact Information:

Phone:  866-532-1344
Fax:  866-483-9988
www.northwoodinc.com