Claim Submission
Claims for Alterwood Advantage members are accepted two ways:
Electronic claims (preferred method)
Availity – Payor ID: RP016
Mailed (CMS 1500 or UB04 claim forms only) to-
Alterwood Advantage
PO Box 981832
El Paso, TX 79998-1832
Claims must be submitted within one hundred eighty (180) calendar days of the date of service.
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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2025 Provider Manual
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2025 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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2025 Part B Preferred Drug List
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PCP Change Request Form
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PCP Closed Panel Acceptance Form
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Transportation Benefit Overview
Prior Authorization Documents
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2025 Prior Authorization Summary & Code List – Eff 4/14/2025
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2025 Prior Authorization Summary & Code List – Eff 7/23/2025
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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
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Organization Determination Guideline & Review Transparency
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Q4 2024 Prior Authorization Notice of Change