Providers

Welcome from RiverSpring Health Plans. We have provided below some basic information and materials. Please feel free to reach out to us with any questions.

Billing, Claims and Payment Information
How to Submit a Claim

Claims can be submitted via paper or electronically, although processing and payment of electronically submitted claims will be quicker.

Paper Claims:
Providers must submit the applicable, completed and legible forms to:

ElderServe Health, Inc. d/b/a RiverSpring Health Plans
PO Box 211465
Eagan, MN  55121

Providers may also submit and track paper claims through Smart Data Stream at no cost. To use this option, providers must register on the site with the following link:

https://portal.smartdatastream.us/quickclaim/servlet/quickclaim/template/ClearingHouse,Login.vm

 Electronic Claims:
RiverSpring has partnered with Change Healthcare, as our electronic claim submission gateway. Change Healthcare is a cost‐ effective, long‐term solution for managing HIPAA‐compliant 837 EDI transactions for claim submissions. RiverSpring Payer ID: 05178

To sign up with Change Healthcare Clearinghouse:

 Provider Portal

Providers may verify member eligibility, review authorizations, set up electronic payments, and download Explanation of Payments through our Provider Portal: riverspring.ppi.com.

To request access to our provider portal, you will need to send an email to Providerportalrequest@elderservehealth.org with the following information:

  • Provider NPI#
  • Provider TIN# (Tax ID)
  • Provider/Facility Name, Address and Telephone Number
  • Requester Name & Email (MUST be a business email; gmail, yahoo etc. NOT accepted)
  • Affiliation with Provider if 3rd party biller

Once access has been granted you will receive an email with your log-in information.

Provider Portal Link: https://riverspring.ppi.com/provider/sign_in

For Claim Inquiries or Disputes, please contact:

Provider Participation

If you are interested in joining the RiverSpring network, please email Providerrelations@elderservehealth.org and include the following information in your request:

  • Provider Name and Services
  • National Provider Identifier(NPI)
  • Contact Information

 Provider Materials & Compliance

Important Message: Effective January 1, 2023, coverage of Adult Vaccines Recommended by the Advisory Committee on Immunization Practices Under Medicare Part D and Cost-Sharing for Covered Insulin Products Under Medicare Part D of the Inflation Reduction Act of 2022 are required.

  • Important Message About What our members Pay for Vaccines – Our plan covers most Part D vaccines at no cost. Call us for more information.
  • Important Message About What our Members Pay for Insulin – Members won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on, even if they haven’t paid their deductible.
  • Important Message About What You Pay for certain Prescriptions – Beginning April 1, 2023 you will not pay more than the co-insurance amount for Chemotherapy administration services including chemotherapy/radiation drugs or Other drugs covered under Part B of original Medicare.
  • Important Message About What You Pay for Insulin – Beginning July 1, 2023, you will not pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter the cost-sharing tier it’s on, even if you have not paid your deductible.

Please visit the CMS link for more information: https://www.cms.gov/newsroom/fact-sheets/inflation-reduction-act-lowers-health-care-costs-millions-americans

 

Last updated on May 3, 2024