Apostrophe

Apostrophe administers your health plan. This means we work for you. When you make smart healthcare choices, you get better health outcomes and lower costs. To get started, here are some exciting changes that you will see:

First things, first
As soon as you get your Apostrophe ID Card and welcome packet, go to ​my.apostrophe.health​ to register your card. During registration we will ask important questions like whether or not you are in the middle of long term care, if you have secondary insurance, and provide important reminders about Apostrophe.

Member Care Team
Tired of long waits and not getting your questions answered? Apostrophe’s dedicated Member Care team is available to help you anytime you need help- without the long waits and confusion that you normally get when you call into your health plan. Our Member Care team is available from 8am-6pm MST and is on call on weekends and holidays!

When to Call us:
If you have a procedure or surgery scheduled, we can connect you to the highest quality physicians and give you incentives for making smart healthcare choices.

  • Anytime your doctor says “We don’t take Apostrophe”
  • If you are in the middle of long term care (chronic illness, pregnancy, cancer, etc)
  • A doctor tries to charge you for care – even copays
  • Anytime you get a bill

Member Bill Pay
Never pay your doctor again – not even your copay! Apostrophe takes the confusion and chaos out of billing. You get one fully audited bill from Apostrophe. If you ever get a bill from your provider, don’t pay it! Take a picture of your bill and email it to ​hi@apostrophe.health​. We will handle it for you. If you have any questions about any of your bills, just call our member care team! We’ve got your back!

Telemedicine
Feeling sick late at night or don’t have time to go to your doctor? Call our partner MeMD (866-810-7766) and press extension 1. You can talk to a doctor, get a diagnosis, and have an RX called in, all from the comfort of your couch for no charge. You can also use our other telemedicine partner, Sherpaa, for all your ongoing care needs. They can help manage your conditions and prescriptions all from the convenience of your home, on your time! To talk to a Sherpaa doctor, just log in via your Apostrophe Member Center

Information for Your Doctor

About Apostrophe
Apostrophe is the claims administrator for employers in your community who self-fund their health benefits. Maintaining patient-provider relationships is our top priority.​ Please call 855-999-2146 if you, or the patient, need immediate payment assistance.
In-Network Providers
Apostrophe treats all providers as in-network and does not use a rental network. There is no credentialing ​or contracting required — and there are no surprise out-of-network costs for the patient.​
Eligibility

You can check eligibility online at provider.apostrophe.health​ or you can call us at ​855-999-2146.

Patient Collections
You do not have to collect money from patients at the point of care. Providers receive payment from Apostrophe for both the patient’s and the employer’s share of the cost. Apostrophe eliminates your accounts receivable.
Claims Submission

We accept paper and electronic claims:

  • EDI Payer ID: 81312
  • Submit paper claims to PO Box 99012, Lubbock, TX 79490
Reimbursement
Apostrophe reimburses at 140% of your current CMS-Medicare pricing for physicians and 150% for hospital services. If those rates are acceptable, we don’t need to have a contract. We will reimburse you at those rates. ​Where no Medicare reimbursement exists, a crosswalk will be utilized.

99203 Initial Office Visit Example
Medicare Pays $107.52
Apostrophe pays 140% or $153.53

99213 Established Visit Example
Medicare Pays $73.81

Apostrophe pays 140% or $103.33

If these payment rates do not work for you, we are happy to consider reasonable alternative rates and enter into an agreement. Just give us a call or send us an email!

Pre-Authorizations

A list of procedures that require a pre-authorization is available here. You can also call our Provider Care team at 855-999-2146​ and they can connect you to the pre-authorization department.