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Submitted URL: http://www.provaccess.com/
Effective URL: https://www31.mutualofomaha.com/ProviderAccess/
Submission: On February 20 via manual from US — Scanned from DE
Effective URL: https://www31.mutualofomaha.com/ProviderAccess/
Submission: On February 20 via manual from US — Scanned from DE
Form analysis
1 forms found in the DOMPOST /ProviderAccess/verifyTin
<form action="/ProviderAccess/verifyTin" method="post">
<div class="u-size1of2">
<div class="Field Field--lg" id="tinInput">
<label class="Field-label" for="tin">Tax Identification Number (TIN)</label>
<input type="text" name="tin" maxlength="9" size="12" id="tin" onchange="return validateTin();" class="Input" value="">
<span class="Field-error" id="tinMessage">Please enter a valid tax identification number. Tax identification numbers will be 9 digits with no spaces or dashes.</span>
<span class="Field-detail">Enter the 9-digit TIN with no spaces or dashes.</span>
</div>
<div class="Field" id="termsInput">
<label>
<input type="checkbox" name="terms" value="on" id="terms" onchange="return validateTerms();"><input type="hidden" name="_terms" value="on">
<span class="Checkbox-label">I agree to the <a id="terms-popup" href="#termsPopUp" data-openable="" data-overlay-trigger="open">terms and conditions</a></span>
</label>
<span class="Field-error" id="termsMessage">Please accept the terms and conditions to continue.</span>
</div>
<div class="Field u-cf">
<input type="submit" value="Sign In" onclick="return validateLogin(); analytics.track({category: 'Index', action: 'Login', nonint: true });" id="sign-in" class="Button Button--blue Button--lg">
</div>
</div>
<div class="mb10">
<p data-tid="SiteInformationStatement" class="u-fontSansSerif" style="font-size: 15px; color: #a8a8a8;">Provider Access is an information center for health care providers to access Medicare Supplement policy information regarding patient
eligibility and benefits as well as claim status detail. <strong>Information available on Provider Access will not be shared over the phone</strong>. Notice: <a href="//mooitg.mutualofomaha.com/medicare-supplement-claim-notice.php" id="claimLink" target="_blank">Important Medicare Supplement Claim Filing
Information</a>
</p>
</div>
</form>
Text Content
PROVIDER ACCESS For Medicare Supplement Eligibility, Benefits and Claims Information SIGN IN -------------------------------------------------------------------------------- Tax Identification Number (TIN) Please enter a valid tax identification number. Tax identification numbers will be 9 digits with no spaces or dashes. Enter the 9-digit TIN with no spaces or dashes. I agree to the terms and conditions Please accept the terms and conditions to continue. Provider Access is an information center for health care providers to access Medicare Supplement policy information regarding patient eligibility and benefits as well as claim status detail. Information available on Provider Access will not be shared over the phone. Notice: Important Medicare Supplement Claim Filing Information Mutual of Omaha recently introduced its partnership with Zelis Payments to help improve our providers' payment experience. Who is Zelis Payments? Zelis Payments is a provider-focused electronic healthcare payments technology company that delivers payments to medical providers nationwide, saving practices time and shortening the revenue cycle. Learn More Are you ready to accelerate and simplify your claims and payments? Call 855.774.4395 and mention code MOO2020 for a special offer. TERMS AND CONDITIONS MUTUAL OF OMAHA INSURANCE COMPANY USER AGREEMENT FOR HEALTH CARE PROVIDER ACCESS ONLINE SERVICE PLEASE READ THE FOLLOWING TERMS AND CONDITIONS CAREFULLY BEFORE CHECKING "I AGREE" BELOW. YOU ARE ABOUT TO ENTER INTO A USER AGREEMENT (THIS "AGREEMENT"). BY CHECKING "I AGREE" BELOW. THIS AGREEMENT IS INTENDED TO SET FORTH THE BASIC TERMS AND CONDITIONS BETWEEN YOU AND MUTUAL OF OMAHA INSURANCE COMPANY AND ITS AFFILIATES (COLLECTIVELY, "MUTUAL"). BY INDICATING YOUR ACCEPTANCE OF THIS AGREEMENT AND ACCESSING THE SERVICE, YOU AGREE TO BE BOUND BY THE TERMS OF THIS AGREEMENT. YOU AGREE THAT MUTUAL MAY MAKE AGREEMENTS WITH YOU BY ELECTRONIC MEANS AND THAT SUCH AGREEMENTS HAVE THE SAME LEGAL EFFECT AS AGREEMENTS ENTERED INTO ON PAPER AND ARE AUTHENTIC AND VALID. Please review this Agreement. Mutual owns this web site. By accessing, viewing, or using the systems, services or materials on any of Mutual's web sites (e.g., "mutualofomaha.com", "Provider Access", or other sites, which are collectively known as the "Site"), you indicate your understanding of the terms and conditions of this Agreement, and further agree to accept such terms and conditions and to be legally bound by them. A. AVAILABILITY AND USE OF MATERIALS ON THE SITE "Materials" include information, forms, documents, software and other content present on or available to you from the Site. "Software" means any computer software accessible to you on the Site. Mutual may revise, enhance or update the Materials at any time. You must use the Materials in accordance with the procedures established by Mutual. B. COPYRIGHT AND PROPRIETARY RIGHTS IN MARKS, LOGOS AND MATERIALS All service marks and logos located on the Site are owned by Mutual unless otherwise indicated. All Materials are Mutual's property, unless otherwise indicated. All Materials are protected by United States copyright laws and all other applicable laws. Removal or reproduction, by any means, of any Materials, logo, trademark, service mark, or the name of Mutual or its affiliates, is expressly prohibited without the prior written consent of Mutual. C. LICENSE TO USE MATERIALS Mutual grants you a non-exclusive, non-transferable, temporary license to use Materials other than the Software. Mutual may revoke your license to use any Material (including Software) at any time if you fail to comply with this Agreement, or for any other reason. In no event shall the Materials be used in any manner which Mutual deems to be directly or indirectly in competition with Mutual or contrary to Mutual's best interests. D. LICENSE TO USE SOFTWARE Mutual grants you a non-exclusive, non-transferable, temporary license to use the Software. The Software is the sole and exclusive property of Mutual, or Mutual's third party vendor, as identified by the Software. If Mutual's authorization to use third party Software expires or terminates, your license to use the Software is immediately and automatically revoked. You agree to use the Software exclusively in conjunction with Mutual's products and in accordance with procedures established by Mutual. Under no circumstances other than for backup or archival copying purposes may you copy the Software or any portion thereof without Mutual's prior written consent. You are not otherwise authorized to copy, reverse engineer, decompile, or use the Software in any manner other than as expressly authorized in this Agreement. E. COMMUNICATIONS WITH THE SITE Except as required by privacy laws, if you elect to communicate with Mutual via the Site or e-mail, you acknowledge that the information contained in your message may not be considered confidential and that Mutual shall be free to disclose or otherwise use such information contained therein without any liability or limitation. Mutual is not responsible and shall not be liable for the contents of information, messages or other content posted to the Site by visitors or persons other than Mutual employees. Opinions or comments contained in such items reflect the views of the author and not of Mutual unless Mutual expressly states to the contrary. F. LINKS TO OTHER WEB SITES The Site may, from time to time, contain links to other Internet web sites for the convenience of users in locating information and services that may be of interest. You acknowledge that these third-party sites are maintained by persons or organizations which Mutual does not control, and Mutual expressly disclaims any responsibility for the content, the accuracy of the information and/or quality of products or services provided by or advertised on these third-party sites. Mutual does not control, endorse, promote, or have any affiliation with any other web site unless expressly stated in the Site or in the other web site. G. USE OF THE INTERNET Use of the Internet is solely at your own risk and is subject to all applicable state, national and international laws and regulations. While Mutual endeavors to apply security protocols which are necessary and appropriate to the types of electronic communications which occur through use of the Site, the confidentiality of any communication or material transmitted to or from Mutual via the Site, other web sites or Internet electronic mail cannot be guaranteed, including personal information such as your address or social security number. Mutual will not be liable for any loss resulting from a cause over which we have no direct control, including but not limited to, failure of electronic or mechanical equipment or communication lines, telephone or other interconnect problems, computer viruses, unauthorized access, theft, operator errors, severe weather, earthquakes, natural disasters, strikes or other labor problems, wars, or governmental restrictions. H. DISCLAIMER OF WARRANTY AND LIMITATION OF LIABILITY USE OF THIS SITE IS ENTIRELY AT YOUR OWN RISK. IN NO EVENT SHALL MUTUAL BE LIABLE TO YOU, OR TO ANY THIRD PARTIES, FOR ANY DAMAGES YOU OR A THIRD PARTY MAY SUSTAIN DUE TO YOUR USE OR INABILITY TO USE THE SITE OR ANY MATERIALS, EVEN IF MUTUAL HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGE. MUTUAL SHALL NOT BE LIABLE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, INCLUDING WITHOUT LIMITATION, LOST REVENUES OR LOST PROFITS, WHICH MAY RESULT FROM THE USE OF, ACCESS TO, OR INABILITY TO USE THESE MATERIALS. UNDER NO CIRCUMSTANCES WILL THE TOTAL LIABILITY OF MUTUAL TO YOU EXCEED THE PRICE PAID FOR USE OF THE SITE. THE SITE AND MATERIALS ARE PROVIDED "AS IS." TO THE MAXIMUM EXTENT PERMITTED BY LAW, MUTUAL DISCLAIMS ALL WARRANTIES OF ANY KIND, EITHER EXPRESSED OR IMPLIED, INCLUDING, WITHOUT LIMITATION, IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, OR NON-INFRINGEMENT. MUTUAL DOES NOT WARRANT THAT THE FUNCTIONS CONTAINED IN THE SITE OR ANY MATERIALS WILL MEET ANY REQUIREMENTS OR NEEDS YOU MAY HAVE, OR THAT THE SITE OR ANY MATERIALS WILL OPERATE IN AN ERROR FREE OR UNINTERRUPTED FASHION, OR THAT ANY DEFECTS OR ERRORS IN THE SITE OR MATERIALS WILL BE CORRECTED, OR THAT THE SOFTWARE IS COMPATIBLE WITH ANY PARTICULAR PLATFORM. SOME JURISDICTIONS DO NOT ALLOW THE WAIVER OR EXCLUSION OF IMPLIED WARRANTIES SO THEY MAY NOT APPLY TO YOU. I. INDEMNIFICATION AND INJUNCTION You agree to defend, indemnify, and hold harmless Mutual, its affiliates and subsidiaries, and all of their respective directors, officers, employees, representatives, proprietors, partners, shareholders, servants, principals, agents, predecessors, successors, assigns, and attorneys from and against any and all claims, proceedings, damages, injuries, liabilities, losses, costs, and expenses (including attorneys' fees and litigation expenses) relating to or arising from your use of the Site, any breach by you of this Agreement, your negligent or intentional acts, errors or omissions in regard to the subject matter of this Agreement, or your failure to comply with applicable laws. J. GOVERNING LAW AND JURISDICTION This Agreement is governed by the laws of the State of Nebraska without regard to that state's principles of conflicts of laws. Your consent to the jurisdiction of the federal and state courts presiding in Omaha, Nebraska, and agree to accept service of process by mail and hereby waive any and all jurisdictional and venue defenses otherwise available. This Site is controlled and operated by Mutual from its offices within the United States. Mutual makes no representation that materials in the Site are appropriate or available for use in other locations, and access to them from territories where their contents are illegal is prohibited. Those who choose to access this Site from other locations do so on their own volition and are responsible for compliance with applicable local laws. K. ENTIRE AGREEMENT This Agreement represents your entire agreement with Mutual with regard to the use of its Site. You agree that this Agreement is not intended to confer and does not confer any rights or remedies upon any person other than the parties to this Agreement. 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