You manage their care. We manage their coverage.
Gravie is a third-party administrator (TPA). We partner with Aetna Signature Administrators, the Cigna Healthcare® Open Access Plus Network, the Cigna Healthcare® LocalPlus® Network and Health Payment Systems (HPS) networks to administer your patient’s health plan.
Your patients. Our members.
This page explains how Gravie works with healthcare providers like you. Our goal is to ensure your patients’ benefits perform precisely how we’ve designed them, and that you and your team are compensated for your care.
Gravie, your network, and your patient’s health plan
If a patient’s ID card features a logo for one of the networks mentioned above, your first instinct might be to check eligibility with that network. For Gravie members, that will always return a false “not covered” eligibility status. Here’s why, and what to do instead.
Provides the contracted providers and negotiated rates. If you’re contracted with one of these networks, you’re in-network for Gravie members too. Your contract and rates don’t change.
Deliver care at your contracted rates. Where you verify coverage, request authorization, and submit claims depends on the task and your network. We’ve laid out each one below.
We run the plan on behalf of the employer. That means we:
- Hold the member’s plan details
- Verify eligibility and benefits
- Handle prior authorization and utilization management
What brings you to Gravie?
I would like to:
Confirm a Gravie patient’s coverage before their visit. Search by Gravie, not the network.
Find the right payer ID, submission method, and where to check claim status and payment.
Search a medication, procedure, or therapy to find its precertification requirement and where to submit.
Submitting a claim?
The right way depends on the network.
Gravie partners with four provider networks: Aetna Signature Administrators, the Cigna Healthcare® OAP Network, the Cigna Healthcare® LocalPlus® Network, and HPS. Each network routes claims differently. Select your patient’s network below to find the right payer ID and submission method.
Submit claims to Cigna for plans using the Cigna Healthcare® Open Access Plus Network or LocalPlus® Network.
If your patient has a Cigna logo on their ID card, submit claims to:
Cigna
PO Box 188061
Chattanooga, TN 37422-8061
Payer ID: 62308
Prior authorization, case management, utilization management:
Contact Gravie at the provider services number on the back of the card.
Submit claims to Gravie for plans using the Aetna network.
If your patient has an Aetna Signature Administrators logo on their ID card and a 5-digit Group # (eg. EHDLK), submit claims electronically through the Smart Data Stream Portal, or mail to:
Gravie Administrative Services
PO Box 211543
Eagan, MN 55121
Payer ID: GRV01
For prior authorization and medical necessity, contact American Health Holdings:
Fax: (866) 881-9643
Phone: (833) 462-0102
For case management:
Fax: (866) 353-6508
Phone: (800) 641-3224
Submit claims to HPS for plans using the HPS/Paymedix or FirstHealth networks.
If your patient has a HPS/Paymedix logo on their ID card, submit claims to:
Health Payment Systems, INC.
P.O. Box 510620
Milwaukee, WI 53203
Payer ID: 20270
To obtain precertification:
Phone: (833) 462-0102
Visit: gravie.mednecessity.com
Precertification must be obtained for services as specified in the member’s plan.
Confirm your network status
To confirm you’re is in-network with Gravie, search the directory for the network on your patient’s ID card:
Chances are, you already accept Gravie.
If you see a network logo that you accept on our ID card, then your patient is covered by Gravie.
Looking for more?
Submitting an appeal on a member’s behalf?
Providers may submit an appeal for a member only after obtaining the member’s written authorization. Appeals submitted without authorization cannot be accepted. Please have the signed authorization on hand before you submit the form, and attach it with your submission.
Log into your provider portal.
Track a claim, including payment status, by logging into your Gravie Provider portal. If you haven’t created an account yet, you’ll need to do so in order to access details about your claim.
Frequently Asked Questions
No. Gravie is a third-party administrator (TPA). We lease the Aetna, Cigna, and HPS networks to administer self-funded and level-funded health plans, and we pay claims directly.
Search by the payer ID on the card (see Claims) rather than the plan name. Clearinghouse listings vary.
Gravie leases these networks; your contract and rates come from the network, but claims and eligibility are administered by Gravie.
That registration doesn’t automatically give you Gravie claim status. See Claims for the correct portal.
Please call Gravie Care: (877) 684-3984.
