Care Improvement Plus! This provider manual

More documents

Recommendations

Info

Care Improvement Plus Contact Information PROVIDER SELF-SERVICE CENTER……………………………..…... www.careimprovementplus.com For eligibility verification, claims status and payment information PROVIDER RELATIONS……………………………………………………………………1-866-679-3119 Claims Questions………………………………………………………... provider@careimprovementplus.com Credentialing……………………………………………………….. credentialing@careimprovementplus.com Contract/Address Updates Non-delegated and Delegated groups………………... cipcontractupdates@careimprovementplus.com Contracting…………………………………………….. providerrelations@careimprovementplus.com ELIGIBILITY VERIFICATION………………………………………………….……….....1-866-679-3119 Secure Provider Portal………………………………..https://providerportal.careimprovementplus.com UTILIZATION MANAGEMENT……………………….…………………………………...1-888-625-2204 For services requiring authorization or prior authorization MEDICAL CLAIMS…………………………………………………………………………. 1-866-679-3119 Non-Par Provider Dispute Resolution……..www.careimprovementplus.com/providers/nonparpayment.aspx EDI claims via Emdeon: Payor ID 77082 Paper Medical Claims: Care Improvement Plus P.O. Box 488 Linthicum, MD 21090-0488 Attention: Claims Department Provider@careimprovementplus.com Medical Claim Appeals....................................................................................................1-800-213-0672 PHARMACY BENEFITS SERVICES……………………………………………………….1-866-673-3561 Provided by Medco Health Solutions Pharmacy Claims: Medco Health Solutions, Inc. P.O. Box 14718 Lexington, KY 40512 1
Pharmacy Appeals……....................................................................................................1-866-683-3275 Vision and Dental Claims…..………………………………….................................................1-800-828-9341 Provided by Avesis Third Party Administrators P.O. Box 7777 Phoenix, AZ 85011 Attention: Claims Department or electronically www.avesis.com Mental Health Claims………………………………………………………………………….1-888-751-1235 Optum P.O. Box 30760 Salt Lake City, UT 84130-0760 or electronically: payor ID is 87726 CASE MANAGEMENT………………………………………………………………………1-866-272-2945 TELEPHONE FOR HEARING IMPAIRED (TTY)……………………………………………………..711 2
Page 1: 2012 Care Improvement Plus Provider
Page 5 and 6: SECTION A - INTRODUCTION Welcome We
Page 7 and 8: qualify for programs that they may
Page 9 and 10: • Providers must render service a
Page 11 and 12: and data may be submitted to CMS. B
Page 13 and 14: • Obtain authorizations as approp
Page 15 and 16: mailing may highlight the providers
Page 17 and 18: Little Rock, AR 72203 http://www.ar
Page 19 and 20: Care Improvement Plus maintains a c
Page 21 and 22: (Clinical and/or coverage determina
Page 23 and 24: initial ninety (90) day period. SEC
Page 25 and 26: The Chief Medical Officer (CMO) and
Page 27 and 28: line, or going online at www.careim
Page 29 and 30: Other HIPAA Administrative Simplifi
Page 31 and 32: named transactions. Code sets are i
Page 33 and 34: As outlined in the Federal Regulati
Page 35 and 36: APPENDIX A - Sample Care Improvemen
Page 37 and 38: APPENDIX C - Utilization Management
Page 53 and 54:
APPENDIX C - Utilization Management
Page 55 and 56:
APPENDIX D - Part B Drug Authorizat
Page 57 and 58:
Notice of Privacy Practices Effecti
Page 59 and 60:
■ Other uses and disclosures of y
Page 61 and 62:
an insurance policy or claim or for
Page 63 and 64:
APPENDIX G - Filing Claims with CIP
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
APPENDIX H - Filing Claims with CIP
Page 71:
Address 351 W. Camden Street, Suite
show all

Care Improvement Plus! This provider manual

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?