Bright HealthCare Provider Resources

Find everything you need in order to see Bright HealthCare members.

Need to look up a member ID?

Use our Member Lookup Tool for Individual & Family plan members.

For Medicare Advantage plan members call 844-223-8380.

Provider Finder Member Hub

Provider Finder

Provider Finder Member Hub

Helping your Bright HealthCare patients stay in-network is easy! Find in-network care for your patients.

Bright HealthCare Provider Finder

Downloadable Resources

Download or share resources with your practice staff:

2022 Welcome Guide

English

Spanish

2021 Welcome Guide

English

Spanish

2021 Quick Reference Guide

English

Spanish

Pharmacy Resources

Additional Provider Resources

Member ID Lookup

Individual and Family Members

Medicare Advantage Members - Call 844-223-8380

Claims and Payment

Learn how to set up payment accounts and how to submit, track and manage claims.

Claims and Payment

Provider Disputes Form

Utilization Management

Find more information on Bright HealthCare's clinical programs, including prior authorizations and how to refer your patients for case management.

Utilization Management

Sharing or Updating Provider Data

After contracting with Bright HealthCare, completion of the Provider Roster Template is the next step in adding your providers to the Bright HealthCare network.

Any changes to your practice (providers or service locations) should be submitted on the standard roster template, when appropriate. Below is a pdf with instructions and links to the appropriate roster templates for your region. Please review the Provider Resource Guide located on Availity for more information.

Roster Submissions

SNP Model of Care Training

CMS requires providers who serve Bright Health Special Needs Plan (SNP) members to complete annual training on the SNP Model of Care (MOC). The MOC describes how Bright Health identifies and addresses the unique needs of its SNP members. Annual MOC training ensures providers are educated about and able to leverage the services and supports available to SNP members. Please click below to complete the SNP MOC training and attestation.

SNP Training and Attestation

NEW PAYER ID Effective 1/1/22

Claims news!  Bright Health is making life easier by changing from multiple payer IDs to one payer ID when you file a claim!

Effective 1/1 please use Payer ID BRGHT for all submissions

In order to avoid rejected claims, please ensure you share this information with your IT department to update EDI, clearinghouse and other software processes.

Policies

Find New Policies and FAQs here:

In-Office Laboratory Testing Payment Policy (Effective 10/1/2021)

New Transplant Policy FAQ

To search additional policies, please visit .