Claim Submission
Claims for Alterwood Advantage members are accepted two ways:
Electronic claims (preferred method)
- Change Healthcare – Payor ID: RP016
- Availity – Payor ID: RP016
Mailed (CMS 1500 or UB04 claim forms only) to-
Alterwood Advantage
PO Box 981832
El Paso, TX 79998-1832
Please do not send paper claims to any other address, as this will only delay the processing of your claim.
For additional information, please see our Provider Manual.
Provider Documents
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2022 Provider Manual
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2024 Quick Reference Guide
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Transition of Care Form
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Waiver of Liability
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Clinical Practice Guidelines
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2023 Part B Preferred Drug List
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2024 Part B Preferred Drug List
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PCP Change Request Form
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PCP Closed Panel Acceptance Form
Prior Authorization Documents
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2023 Prior Authorization Summary & Code List
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2024 Prior Authorization Summary & Code List
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Prior Authorization Changes - January 2024
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Prior Authorization Changes - April 2024
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Inpatient Services Prior Authorization Form
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Outpatient Services Prior Authorization Form
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Outpatient Rehab Prior Authorization Form
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Part B Medication Prior Authorization Form
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Authorization Request Guidance