Welcome, Providers

This is the exclusive partnership between Providence Health Plan and Collective Health, serving as the new third-party administrator (TPA) for Providence Health Plan’s ASO/self-funded business, effective September 1, 2025.

This change is continuing to roll out by employer group, so it is essential to check the member’s most current ID card to verify their plan and see if the “Providence Health Plan Powered by Collective Health” logo is there.

For a full set of resources and our comprehensive Provider Support Manual, please visit the Availity Essentials™ Portal.

Visit Availity Essentials™ to check eligibility and benefits. Remember to search for the “Providence Health Plan Powered by Collective Health” payer in the menu.

DO NOT use the ProvLink portal (phpprovider.providence.org) for these members.


ProvLink remains in place only for other Providence Health Plan members (e.g., fully-insured, Medicare).


Always check the member ID card first to determine which payer to use.

Submit digital claims for Providence Health Plan Powered by Collective Health members via Availity Essentials™ or your existing clearinghouse connection to Optum, using Optum Payer ID: 36481.

Submit paper claims on a standard Professional services: CMS-1500 or Institutional services: UB-04 form with all required fields and send to this address:

Collective Health
PO Box 23055
Tampa, FL 33623

Submit a PA request over the phone

• For faster service, please refer to the number on the back of the patient’s medical ID card.
• Otherwise please call (855) 383-3585 and select “Medical Authorizations”.
• Follow the prompts to be connected with the right entity to submit your request, which will be either American Health Holding or Cigna.

The following steps require you to know the patient’s wrap network and whether you are in-area or out-of-area.

If Cigna is the wrap network on the patient’s plan, please follow these instructions:
Providers who are in-area with Providence Health Plan:

• Please submit PA requests to American Health Holding:
  • Fax: 866-881-9643
  • Online: collectivehealth.getprecert.com  
• Providers who are out-of-area with Providence Health Plan:
  • Please submit PA requests to Cigna by referring to their website: https://www.cigna.com/health-care-providers/coverage-and-claims/precertification

If Cigna is not the wrap network, then please submit PA requests to American Health Holding (AHH) through either of the following methods:

• Fax: 866-881-9643
• Online: collectivehealth.getprecert.com 
• PA list for AHH

Required documentation for Prior Authorization requests to American Health Holding

• Member ID, Group Number, Member Name, Employer, Member DOB, Network, Member Address
• Patient Name, Patient DOB, Relationship to Member
• Case Type (Inpatient or Outpatient), Urgency (Elective or Emergent)
• Admission Date/Estimated Date of Confinement (EDC), Procedure Date
• Facility Name, Address, Phone Number, and National Provider Identifier (NPI) or Taxpayer Identification Number (TIN)
• Provider Name, Address, Phone Number, Specialty, and National Provider Identifier (NPI) or Taxpayer Identification Number (TIN)
• Diagnosis Code(s) (i.e. ICD-10 code(s))
• Procedure Code(s) (i.e. CPT/HCPCS code(s))
• Priority of the PA (Urgent/Standard)

This list may be subject to exclusions based on benefit and contract terms.

• All Inpatient Hospital Admissions, including:
• Observation stays exceeding 47 hours.
• Acute Inpatient hospital admissions, including Obstetric admissions that exceed federal mandate (2 days for Vaginal, 4 days for C-section births)
• Long-Term Acute hospital admissions
• Inpatient Mental Health and/or Substance Use Disorder admissions
• Inpatient Rehabilitation facility admissions 
• Residential Treatment Facility admissions
• Skilled Nursing Facility (SNF) admissions 

For the current list of additional services requiring prior authorization, required documentation, clinical criteria, please refer to any of the following resources:

• The Resources tab on the Providence Health Plan Powered by Collective Health Payer Space in Availity.
• Call the Prior Authorization phone number on the back of the patient’s member ID card.
• Medical Policy, Reimbursement Policy, Pharmacy Policy, & Provider Information
• Self-funded Pharmacy Resources | Providence Health Plan
• Precertifications and Prior Authorizations | Cigna Healthcare   

For additional resources, please refer to the links and documents below:

For PAs submitted to American Health Holding refer to the following:  

• Providence Health Plans (except for PEBB) use the PHP Standard PA List
• PEBB – Providence Health Plan Combined PA List – see PEBB-specific services.   Refer PHP Standard PA List for additional medication prior authorization requirements.
• Intel – Prior Authorization is required for out-of-network providers only.

For PAs submitted to Cigna refer to this PDF.

For questions related to “Providence Health Plan Powered by Collective Health” members, please call the number on the back of the member’s ID card.

Please find our comprehensive Provider Support Manual on the Availity Essentials™ site for “Providence Health Plan Powered by Collective Health”. 

We are actively working to enhance your self-service options through the Availity Essentials™ portal. Before January 1, 2026, additional capabilities will be added to the portal, including enhanced eligibility and benefits information (including accumulators), claims status inquiries, and claims attachments. Please check there soon for more information!

No. This is an administrative change only. Your contract, network status, rates, and credentialing with Providence Health Plan are not affected by this change.