Welcome to NEMS MSO's EZ-NET Provider Portal. The EZ-NET Provider Portal provides real-time response from the NEMS MSO Managed Care system. It is a web-based administrative tool for provider resources, which allows providers to communicate with NEMS MSO and perform tasks via the internet without compromising security. Providers may use the EZ-NET Provider Portal to submit Treatment Authorization Requests, authorization status inquiries, claims status inquiries, and download Explanation of Benefits (EOB).

UPDATES

EZ-NET Compatibility

NEMS Provider Portal is compatible with the following browsers: Google Chrome, Microsoft Edge, Firefox, and Safari


Utilization Management (UM) Affirmative Statement

Decision to approve or deny a service is based only on appropriateness of care, services, and existence of coverage. NEMS does not reward practitioners or other individuals for issuing denials of coverage or service care. Financial incentives for decision makers do not encourage decisions that result in underutilization. Members and providers may request a copy of the policies, procedures, and criteria used to make a determination for a specific procedure or condition by contacting NEMS UM at 1(415) 352-5186, option 1


UM Staff Availability

NEMS UM Staff is available to members and providers during regular business hours (Monday Through Friday, 8:00am - 5:30pm) to discuss UM issues, including denial decisions, request a copy of the policies, procedures and UM criteria, by calling 1(415) 352-5186,  option 1. TTY services 1(800) 735-2929 is available for the hearing impaired. NEMS provides language assistance for members whose primary language is not English. After normal business hours, UM staff can receive secure voicemail and fax. Our fax number is 1(415) 398-2895. Messages received are returned within one (1) business day. Our staff identifies by name, title and organization name when initiating or returning calls regarding UM issues.


Links

Need Access to the Provider Portal?


Click Here to download the Provider Portal Form to obtain access to the NEMS secure provider portal.


New to the Provider Portal?

Click Here to watch a tutorial on how to submit/inquire authorization online

Click Here to watch a tutorial on how to inquire claims status online

Click Here to watch a tutorial on how to submit retro authorization request online


Provider Resources

Click Here to review the DHCS Timely Access Standards

Click Here for the latest updates/newsletters from NEMS MSO 

Click Here to be directed to the NEMS MSO website. Providers can view our provider network, treatment & referral authorization requirements, download the claims dispute form, and more....


Contact










Provider Relations
        Email: Provider.Relations@nems.org
        Phone: (415) 352-5186 * Press Option 3
        Fax: (415) 233-4892

Utilization Management (Authorization)
        Phone: (415) 352-5186 * Press Option 1
        Fax: (415) 398-2895

Claims 
        Phone: (415) 352-5186 * Press Option 2
        Fax: (866) 930-2290
        Mailing Address: PO Box 1548, San Leandro, CA 94577


General Inquiries

Email: MSO-info@nems.org


EZ-NET Provider Portal Support

Email: MSOEDI@nems.org