Member Resources
Eligibility, Benefits & Claims Assistance
Performance Health
Claims Administrator
P.O. Box 450978
Westlake, OH 44145
Our Customer Service Team is available Monday – Friday 8:00 am – 6:00 pm ET
Finding a Provider
Refer to your ID card for applicable provider network you have access to through your plan.
First Health Network www.myfirsthealth.com
MPCN www.mpcn-ms.com
Health Link of MS www.healthlinkppo.com
Member Portal
Your benefits, claims and/or eligibility are available 24/7 via our member portal. Use the “My Plan” tab on the main website page to register for online access to your claims, plan document, EOB’s and additional items.
- To register you will need your ID card.
- From www.myperformancehlth.com, go to My Plan, Web Access Login, Register & Enroll, Select Member, Complete the Registration form. Your Registration Code is the Alternate ID number on your ID card plus a suffix of 01 for the subscriber, 02, 03, 04, 05, etc for spouse and/or dependents.
- Once you have completed the Registration form you will be emailed a link to confirm your Registration.
- Click on the link and you will then have immediate access to the Member portal. Remember you will only need your registration code this one time to set up your account.
- Once your account has been created you will only need your login and password.
Healthcare Pricing Comparison Tool
As of January 1, 2023, the Transparency in Coverage Rule mandates member access to a healthcare price comparison tool.
We have partnered with TALON to bring you access to MyMedicalShopper™; which provides you the ability to shop for healthcare services based on price, quality, and location. Just like we shop for everything else! Use your member subscriber ID to access the pricing tool using the link below.
If you need assistance with the shopping tool or with obtaining pricing please contact our Customer Service Team at 877-585-8480
View the video below for additional information on the MyMedicalShopper pricing tool:
Member Resource Documents
- Your Privacy
- Women’s Health and Cancer Rights Act
- The Newborns’ and Mothers’ Health Protection Act
- Mental Health Parity & Addiction Equity Act
- Notice of Extended Coverage to Participants Covered Under a Group Health Plan
- Medicaid and the Children’s Health Insurance Program
- Your Rights and Protections Against Surprise Medical Bills
- Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA)
Precertification
Your plan does require precertification on certain services.
You can reference your plan document for the complete list. To begin the precertification process, your provider(s) should contact Performance Health at 877-585-8480.
Transition of Care/Continuity of Care
What does Transition of Care and Continuity of Care mean?
Transition of Care allows new members and/or members whose plan has experienced a recent provider network change to continue to receive services for specified medical and behavioral conditions, with health care professionals that are not participating in the plan’s designated provider network, until the safe transfer of care to a participating provider and/or facility can be arranged. The provider must agree to accept network rates for the defined period of time. Examples of qualifying medical conditions can be found below. You must apply for Transition of Care no later than 30 days after the date your coverage becomes effective or after the effective date of the network change using the request form below.
Continuity of Care allows members the option to apply to receive services at in-network coverage levels for specified medical and behavioral conditions, from their current health care provider if the provider is or is soon to be out-of-network. This arrangement will be allowed until the safe transfer of care to a participating provider and/or facility can be arranged. The provider must agree to accept network rates for the defined period of time. Examples of covered medical conditions can be found below. You must apply for Continuity of Care within 30 days of your health care provider’s termination date (this is the date your provider is leaving the network) using the request form below.
Performance Health Open Negotiation Notice
Reference the below Performance Health Open Negotiation Notice for details on the process your provider must follow for disputing the allowable rate used on your claim.
Who is Performance Health
How to manage the front desk when they ask who you are insured with?
How to use your ID card?
Do I have any Out of Network benefits and what happens when doctor says we do not take your insurance?
Provider Searches
What services are available to me that could save me money?
What is Reference Based Pricing
What should I do if I get a bill from a healthcare provider? Balance Bill defense is available for all members with a Reference Based Pricing Plan.
Health Coaching
Check with our Customer Service Team to find out if your plan accesses Health Coaching
