PROVIDER UPDATE: In response to the temporary CHC service interruption, Simpra has contracted with Availity for claims submission. Continue to use codes SIM-01 and SIM-02. Contact your clearinghouse to determine if previously submitted claims need to be resubmitted.

Contact Information

Hours of Operation

Member Services: 8am – 8pm LOCAL TIME, 7 days a week from October 1st – March 31st, 5 days a week from April 1st – September 30th.
- Note: Member Services is closed on the following Holidays: Memorial Day, Independence Day, Thanksgiving, and Christmas
Provider Services: 8am – 6pm LOCAL TIME
Utilization Management: 8am – 5pm Central Time, Monday-Friday

TTY/TDD numbers are listed in the directories below.

Member Services

Phone: 1-844-637-4770 (TTY/TDD 1-833-312-0044)
Email: [email protected]
Mailing Address:Simpra Advantage
PO Box 981843
El Paso, TX 79998-1843

Enrollment Services

Phone: 1-844-637-4770 (TTY/TDD 1-833-312-0044)
Email: [email protected]
Mailing Address: Simpra Advantage
PO Box 981843
El Paso, TX 79998-1843

Compliance

Contact: Celeste Panaro, Chief Compliance Officer
Email: [email protected]
Phone: 832-278-3988
General Email: [email protected]
Mailing Address:Simpra Advantage
Attn: Compliance Department
PO Box 1847
Birmingham, AL 35201
Hotline: 1-833-416-5035 (toll free)
Fax:205-994-7028

Appeals and Grievances

Phone:1-844-637-4770 (TTY/TDD 1-833-312-0044)
Email:[email protected]
Mailing Address: Simpra Advantage
Appeals and Grievances Department
PO Box 981842
El Paso, TX 79998-1842

Medicare

URL: www.medicare.gov
Phone: 1-800-MEDICARE (1-800-633-4277)
TTY/TDD users can call 1-877-486-2048

Privacy or HIPAA

Phone:1-833-416-5035 (toll free)
Email:[email protected]
Mailing Address: Simpra Advantage
Attn: Compliance Department
PO Box 1847
Birmingham, AL 35201

General Provider Inquiries

Phone:1-844-637-4770 (TTY/TDD 1-833-312-0044)

Provider Portal

Phone:1-844-637-4770 (TTY/TDD 1-833-312-0044)
Web Address: https://ehealth-smp.healthsuiteadvantage.com

Claims Helpdesk

Phone:1-844-637-4770 (TTY/TDD 1-833-312-0044)
Mailing Address: Simpra Advantage
Attn: Claims Department
PO Box 981843
El Paso, TX 79998-1843

Utilization Management

Phone:1-844-637-4770 (TTY/TDD 1-833-312-0044)
Fax: 251-725-5099
Call to start an authorization, check the status of an authorization, provide clinical information over the phone, or get referrals for specialists.

Navitus Pharmacy Helpdesk

Web Address: www.Navitus.com
Phone: 1-866-270-3877 (TTY/TDD 711)

Network Support

Phone:1-844-637-4770 (TTY/TDD 1-833-312-0044)
Email: [email protected]

Compliance

Contact: Celeste Panaro, Chief Compliance Officer
Email: [email protected]
Phone: 832-278-3988
General Email:[email protected]
Mailing Address:Simpra Advantage
Attn: Compliance Department
PO Box 1847
Birmingham, AL 35201
Hotline:1-833-416-5035 (toll free)
Fax: 205-994-7028

How to fill out the enrollment form

Who can use this form?

People with Medicare who want to join a Medicare Advantage Plan

To join a plan, you must:

Be a United States citizen or be lawfully present in the U.S.
Live in the plan’s service area

Important: To join a Medicare Advantage Plan, you must also have both:

Medicare Part A (Hospital Insurance)
Medicare Part B (Medical Insurance)

When do I use this form?

You can join plan:

Between October 15–December 7 each year (for coverage starting January 1)
Within 3 months of first getting Medicare
In certain situations where you’re allowed to join or switch plans

Visit Medicare.gov to learn more about when you can sign up for a plan.

What do I need to complete this form?

Your Medicare Number (the number on your red, white, and blue Medicare card)
Your permanent address and phone number

Note: You must complete all items in Section 1. The items in Section 2 are optional — you can’t be denied coverage because you don’t fill them out.

Reminders:

If you want to join a plan during fall open enrollment (October 15–December 7), the plan must get your completed form by December 7.
Your plan will send you a bill for the plan’s premium. You can choose to sign up to have your premium payments deducted from your monthly Social Security (or Railroad Retirement Board) benefit.

What happens next?

Once we process your request to join, we’ll contact you.

How do I get help with this form?

Call Simpra Advantage at 1-844-637-4770 (TTY/TDD 1-833-312-0044).

Or, call Medicare at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

En español: Llame a Simpra Advantage al 1-844-637-4770 (TTY/TDD 1-833-312-0044) o a Medicare gratis al 1-800-633-4227 y oprima el 2 para asistencia en español y un representante estará disponible para asistirle.

Individuals experiencing homelessness

If you want to join a plan but have no permanent residence, a Post Office Box, an address of a shelter or clinic, or the address where you receive mail (e.g., social security checks) may be considered your permanent residence address.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-1378. The time required to complete this information is estimated to average 20 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850.

IMPORTANT Do not send this form or any items with your personal information (such as claims, payments, medical records, etc.) to the PRA Reports Clearance Office. Any items we get that aren’t about how to improve this form or its collection burden (outlined in OMB 0938-1378) will be destroyed. It will not be kept, reviewed, or forwarded to the plan. See “What happens next?” on this page to send your completed form to the plan.