Call us at 1-833-CL-CARES  |  1-833-252-2737
8AM-8PM Monday-Friday (TTY 711)

Call us at 1-833-252-2737
8AM-8PM Monday-Friday (TTY 711)
Refer a Participant | For Providers | Provider Portal
For Participants | For Caregivers
CenterLight Healthcare

Information for Providers

In this issue of our PROVIDER ENGAGEMENT NEWSLETTER:

A welcome message from our CEO, meet our team, learn how to more conveniently submit claims and read about Elyse and Betty’s story. Download newsletter

At CenterLight Healthcare, we are committed to delivering high quality health and health-related services to our participants in the diverse communities we serve. This commitment is only possible through our relationship with you -- our network of caring and compassionate Providers dedicated to enhancing our participants' quality of life.

This section of our website affords our participating Providers access to a variety of useful tools and documents. Use the quick links below to obtain directories, forms and more.

Provider Resources

How to Submit a Claim

Referral Form

If you need assistance or have any questions, please call our Customer Service department at 1-800-761-5602.






Provider Resources

Please click on the links below to access Provider information in pdf format.

Electronic Funds Transfer Request Form

Prescription Drug Coverage Determination Form (CenterLight Healthcare Direct) (PDF, 25KB)

Prescription Drug Coverage Determination Form (CenterLight Teamcare) (PDF, 25KB)

Prescription Drug Coverage Determination Form (Online)

Prior Authorization Criteria (CenterLight Teamcare) (PDF, 396KB) (Last Updated October 2018)

CenterLight Healthcare Quick Reference Guide (PDF, 39KB)

Provider Manual (PDF, 11MB)

Participant Bill of Rights (PDF, 371.2KB)

Fraud, Waste and Abuse Policy (PDF, 304KB)

Provider Directories

Please click on the links below to access Provider Directories in pdf format.

Dental Provider Directory (PDF) (Coming Soon)

CenterLight Teamcare (PACE) Provider Directory (PDF, 4.5MB) (Last Updated November 2017)

CenterLight Healthcare Direct Provider Directory (PDF, 3.1MB) (Last Updated October 2018)

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How to Submit a Claim

We understand that getting paid quickly and accurately is important to you and encourage our participating providers to file claims online. Online claims processing saves time and paper.


Electronic Claims Submission

Electronic claim submission provides an easier and faster way to submit claims. For all electronic claims, please register with one of the following clearinghouses:

Clearinghouse Payer ID
Emdeon/ Change Healthcare 13360
MDOnline/ Ability Network 13360

Paper Claims Submission

If you submit paper claims, please be sure to submit claims on a CMS 1500 or a UB 04 form and always include:

  1. The service facility location information.
  2. The pay to group or individual name.
  3. The National Provider Identifier (NPI).
  4. The name of the rendering provider and rendering provider NPI

Always include the NPI and Tax Identification Number (TIN) on claims. Please refer to these sample forms (PDF, 569.9KB) which indicate the fields required to properly process a claim

Submit paper claims to:

CenterLight Healthcare
P.O. Box 21546
Eagan, MN 55121

Providers should submit all claims within ninety (90) days of the date of service for prompt adjudication and payment.

For any questions regarding claims status, please call Provider Services at 1-800-761-5602, Monday through Friday, from 9 AM to 5 PM.

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