1, 2022, please register. Online access to benefits, eligibility and claims information for ConnectiCare members, as well as referrals for Passage plans. Spouse of active employee is under 65 and eligible for Medicare due to total disability. Find benefit summaries, lists of covered drugs, and all necessary forms to get the most out of your ConnectiCare coverage. 1-800-829-0696 Computer Innovations | 203-272-1554 |salfusco40@aol.com P.O. Certain changes in a practitioners status may require review by the Credentialing Department, such as completely moving into a new service area or a specialty change. To begin using EDI, an electronic connection must be established between your office and ConnectiCare. Health plan/insurer of the parent whom the court has care ordered to provide coverage for the child. 3. Medicare premium payments Refunds/overpayments by members: New Century Health - Medical Oncology Policies, Provider resource: 2020 changes to Medicare Advantage plans, Dual special needs plan member information available through provider website, Reminders about caring for our Medicare Advantage members, Changes to claims payment for Medicare Advantage inpatient stays, Update on Medicare Beneficiary Identifiers (MBIs). Note: Pursuant to Connecticut COB rules and federal law, ConnectiCare does not coordinate benefits under a ConnectiCare SOLO individual plan or Exchange plan, with other group plans or other individual plans with the exception of Medicare. Web authorizations are available atradmd.com. Paper claim submission Please enter a valid phone number. The electronic remittance advice (ERA) is sent out to our clearinghouses within one day of claims reimbursement. Hours are Mon. To sign up for ERA, contact PNT Data (formerly Post-n-Track) at860-257-2030orpntdata.comor Change Healthcare (formerly Emdeon) at877-363-3666orchangehealthcare.com. Medicare and Medicaid-eligible members designated as Qualified Medicare Beneficiary Electronic vendor report (Acceptance Report by Providers) showing that the data was successfully transmitted to ConnectiCare (i.e., #R022) Find a ConnectiCare Center Near You Make an appointment at any of our convenient locations. In the event that we notify you in writing that ConnectiCare has identified a payment error in an amount exceeding the amount due to you, you will be responsible for making the applicable refund. Tricare for life Phone Number. Our plans are designed to provide you with personalized health care at prices you can afford. For example, under the first ConnectiCare plan the patient is responsible for a copayment and under the second plan, that copayment and/or any applicable balance will be paid, providing policy limitations/guidelines are followed. Dr. Paul P. Arellano, M.D. Please check the privacy statement of the website where this link takes you. It belongs to the New York-based healthcare group EmblemHealth, which is one of the largest nonprofit healthcare providers in the U.S. Plans are available for individuals. Note: In any case, the member is only responsible for one copayment per day, per billing provider/group in the same specialty, for applicable services provided. CT & MA Members: We require that you submit your changes in writing attention to Network Operations, 175 Scott Swamp Road, Farmington, CT 06032-3124. Change Healthcare | 877-363-3666 | changehealthcare.com ConnectiCare providers listed on Doctor.com have been practicing for an average of: 29.7 year(s) Average ProfilePoints score for Providers who take ConnectiCare: 42/80: For claim status inquiries, please sign in to our secure portal. Check our provider directory to make sure we have the right information for you and your practice. Adjustments and corrected claimsmay notbe submitted electronically. The filing limit for claims where ConnectiCare is secondary is 180 days after the issue date of the last Claim Summary or EOB received from the primary carrier. Dual ConnectiCare Coverage: ConnectiCare will coordinate benefits under the secondary plan, after the first ConnectiCare plan has paid. Read! This is a protected messaging feature available only after you sign in to your secure ConnectiCare account. If you have any concerns about your health, please contact your health care provider's office. Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. You may receive an acceptance or rejection report, highlighting any problems encountered. 1-888-946-4658 Gives you access to the provider manual, our onlineProvider Directory, downloadable forms, Pharmacy Central, and more. If you submit procedure codes which are not on your contract/fee schedule, the claim will be denied. Who should a provider contact if Offers innovative programs to support members with specific conditions, including members with asthma, chronic obstructive pulmonary disease (COPD), diabetes, heart failure, coronary artery disease (CAD), and other complex conditions. How to login easier? Lumbar, cervical, and thoracic spine surgery (open, closed, or minimally invasive). (The copayment amount/applicable services, as stated on the ID card, are governed by the membersEvidence of Coverageor other legal documents, as applicable.) If you receive an overpayment from a member that exceeds the cost-share for which they are responsible according to their benefit plan, we request that you refund the appropriate amount back to the member in a timely manner. Claims are not coordinated for workers compensation. ConnectiCare commercial plan is primary and Medicare is secondary, Other insurance (for internal routing purposes only), Diagnosis code(s) (accurate to the 4th or 5th digit), Indication of dual payers (so that claims are appropriately routed through the Coordination of Benefits workflow), ConnectiCare provider ID number (6 or 10 digits). If you have questions, call provider services at 1-800-828-3407 . You must submit the procedure codes which are required per your contract with ConnectiCare. Office Visit Newsletter. ConnectiCare Also responds to inquiries from members who require more information. You must submit the procedure codes which are required per your contract with ConnectiCare. We will identify and request reimbursement of overpayments within 18 months of the date the claim was paid. Welcome to the ConnectiCare member portal, where you can find doctors, compare costs, and view claims. Box 4000 You must bill the other health plan insurance/insurer first, when ConnectiCare is secondary carrier. Find information on a variety of support resources, contact information, as well as online and automated tools to help simplify transactions. changehealthcare.com, The SSI Group, Inc. Login. The ConnectiCare Provider Portal provides health providers with personalized access to patient ConnectiCare records online. You are now leavinga ConnectiCare website. Coronavirus (COVID-19) Updates for Providers Register for Secure Provider Portal Provider Login Register for a Webinar CarePartners of Connecticut distributes its Provider Update newsletter by email. Maintains provider records in ConnectiCares automated claims payment system and makes necessary changes to provider information, such as address, tax ID number, etc. New Century Health - Medical Oncology Policies, Provider resource: 2020 changes to Medicare Advantage plans, Dual special needs plan member information available through provider website, Reminders about caring for our Medicare Advantage members, Changes to claims payment for Medicare Advantage inpatient stays, Update on Medicare Beneficiary Identifiers (MBIs). If you have any concerns about your health, please contact your health care provider's office. You are in the right place. What impact does the American Rescue Plan Act (ARP) have on health insurance coverage? To speak with a representative about programs for chronic conditions. Available 8:30 a.m. to 5 p.m., Monday Thursday, 9 a.m. through 5 p.m. on Friday. When submitting theProvider Appeal Request Form, you must provide proof of timely filing. You are now leavinga ConnectiCare website. Submitting. Manage Spine Surgery and Interventional Pain Management Program. Find company research, competitor information, contact details & financial data for Connecticare, Inc. of Farmington, CT. Get the latest business insights from Dun & Bradstreet. P.O. 1-800-723-2986 P.O. From information to tools to important updates, find the most frequently used resources for providers, in one convenient spot. Last Name *. Go to Pay My Premium for details. To accomplish this you will need some basic equipment, including a: Computer Welcome to the ConnectiCare member portal, where you can find doctors, compare costs, and view claims. The Group ID only allows numerical digits 0 through 9. To sign up for electronic claims submission, contact one of the following clearinghouses listed below: PNT Data (formerly Post-n-Track) Health insurance. All providers will be paid in accordance with payment arrangements for Medicare beneficiaries as set forth in the Medicare Advantage Schedule of Payments for Medicare Advantage plan members, and incentive arrangements (if any) as set forth therein. is an Internist (Primary Care Doctor) in Deerfield Beach, FL. SOLO Intake1-860-678-5274 It is not medical advice and should not be substituted for regular consultation with your health care provider. Relevant changes include your: The medical directors of participating IPAs and PHOs may consult with practitioners for the first line of appeal for any clinical decisions. Fax: 860-674-2849. Please consult your IPA or PHO. Provide an explanation of why you are sending the refund. Entitlement of member If you dispute the overpayment amount, you must notify ConnectiCare in writing within fifteen (15) days of the initial overpayment notice. Practice Management System Software. You are now leavinga ConnectiCare website. Available 8 a.m. to 6 p.m. Monday - Friday ConnectiCare offers plans that have coinsurance requirements. Please see below for a list of clearinghouses with connectivity to ConnectiCare. . 877-469-3263 For additional information about any of the features described in this section, please contact your Network Account Manager or Provider Services at800-828-3407, unless otherwise noted. Available 8 a.m. to 8 p.m. Monday - Friday, 9 a.m. to 2 p.m.Saturday. Nothing in this section is intended to restrict or prohibit providers from billing a member for any applicable copayment, coinsurance, or deductible for certain covered services, as required under the members plan. Compare plans, find a doctor, get forms, and more. Order of benefit determination Send the refund to: ConnectiCare VIP Medicare Advantage Claims Refund If you have any concerns about your health, please contact your health care provider's office. Commissions/Licensing1-860-678-5224 Participating providers may not bill members for any service that is covered under the members ConnectiCare plan. Or Call Now (888) 666-8161. . 1-800-333-1733 Please follow thesesafety guidelinesif you plan to visit one of our locations. Please check the privacy statement of the website where this link takes you. Medicare Provider Services 1-877-224-8230 Available 8 a.m. to 6 p.m. Monday - Friday Claim address: . Coordinates preauthorization of services and procedures that require prior review by ConnectiCare. No requests for refunds beyond this time limit will be requested, unless the overpayment is due to fraudulent billing activity. Members can send general questions to this email address. The primary focus is on assessment, triage, and follow up. . Inspired by our commitment to community care? If received beyond this time frame, the denial will be upheld and the request will be closed. While the paper statement generally follows 3-5 days following remittance of your check, you'll receive your ERA within a day or two of claims reimbursement. Note: Prior to initiating services that are not covered under a members plan, the physician or other health care provider must advise the member that the service is not covered, that the member will be held responsible for the associated costs, and the member must agree to be financially liable for those costs prior to receiving the services. We . Generally, the remittance and checks are mailed first class within 48 hours following the day on which they are produced. 1-877-224-8230 Looking to pay your bill? Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage. Conducts new office orientations, educational and problem-solving visits, and general and specialty workshops for participating providers. - Fri. 8 a.m. - 5 p.m. 1-800-562-6833 Modem Our portals may only be accessed using a supported browser such as the latest versions of Google Chrome or Microsoft Edge. Home; Individual & Family; Medicare Advantage; Medicare Supplement All claims are entered into the data processing system where an online claims history is maintained for twenty-four (24) months. Automate your patient account reconciliation process. (TTY: 711) Welcome to the new myConnectiCare portal. ConnectiCare as Secondary Carrier: Payment will not be made until we receive a copy of the Claim Summary or Explanation of Benefits (EOB) indicating the amount paid by the primary carrier. From the provider page on our website, access our radiology program atradmd.comto view clinical guidelines, begin the authorization process, track pended pre-authorization requests, or verify authorizations. . If you're new, and have a registration code, click Register below to begin. Any information provided on this Website is for informational purposes only. Find benefit summaries, lists of covered drugs, and all necessary forms to get the most out of your ConnectiCare coverage. If you have any concerns about your health, please contact your health care provider's office. 175 Scott Swamp Road, Farmington, CT 06032-3124, Email: Send directly to your Network Account Manager. If you are looking for the services below, choose an option to begin your search; for all other services or specialties, please sign in or continue as a guest. Available 8 a.m. to 5 p.m. Monday - Friday (after hours you may leave a voicemail message). Please include the effective date of the change and contact Provider Services to notify them of the change. Box 4000 * Birthday rule: Primary carrier is the health plan/insurer of the parent whosemonth and day of birthoccurs earlier in the calendar year. LoginAsk is here to help you access Connecticare Login quickly and handle each specific case you encounter. Providers may also use PNT Data for online services (realtime claim and eligibility transactions). salfusco40@aol.com. Mental Health and Substance Use. (SeeFormsfor applicable registration form.). 4. is a Surgeon in El Paso, TX. Most balance billing occurs when the member has a deductible that needs to be satisfied, such as a Medicare Part B deductible, or a commercial carrier deductible. Do I have to submit claims electronically in order to receive EFT? Farmington, CT 06032-3124. Note: Pursuant to Connecticut COB rules and federal law, ConnectiCare does not coordinate benefits under a ConnectiCareSOLO individual plan with other group plans or other individual plans. We've made great strides to improve your member experience. Parent with legal custody is remarried. ConnectiCare commercial plan is primary (as long as the employer group has over 100 employees); Medicare is primary if the employer has less than 100 employees. ConnectiCare commercial plan is primary (as long as the employer group has over 100 employees); Medicare is primary if the employer has less than 100 employees. When forwarding a refund please be sure to: Complete aStandard Provider Refund Form * Birthday Rule: Primary carrier is the health plan/insurer of the parent whosemonth and day of birthoccurs earlier in the calendar year. 877-224-5995 TTY: (711) Assignments are divided geographically as we recognize that representatives are an important link between providers and ConnectiCare. Read the latest news and updates for ConnectiCare providers. Submit claims electronically. Secure Messaging plan. In order to appeal, you must provide a letter explaining why payment is warranted and one of the following examples of acceptable documentation: ConnectiCares Claims Status Report, showing the claim was filed timely Providers should check claims status through ConnectiCare's website, connecticare.com. If you apply to a job, you will be treated as a referral from me. You are now leavinga ConnectiCare website. Currently, ConnectiCare has relationships with several different clearinghouses. We receive claims from the following clearinghouses: Change Healthcare Box 494 Canton, MA 02021-0494. Fax: 860-674-7035. Contact Us - Solidarity HealthShare How Sharing Works Why Solidarity Resources Get a Quote Enroll Now (844) 313-4999 Member Login Contact Us Frequently Asked Questions Sharing Guidelines Blog Contact Us Are you a member of Solidarity HealthShare? Services that require a copayment include, but are not limited to, office visits, pain management services, and diagnostic/therapeutic procedures. Our members rely on our provider directory to find doctors like you quickly and easily. Let us know. For questions, please reach out to the clearing house to whom you submitted your claims. When you choose EFT, you accelerate the cash collection process for your office because the funds go directly into your account, not in the mail. Group ID *. EFT is a quick and easy way for participating providers to receive payment for the claims submitted to ConnectiCare. Find a doctor, dentist, specialty service, hospital, lab, and more. Looking for a health plan? Shall never be liable for more than their applicable cost-share (e.g., copayments, coinsurance, deductibles, etc.) . (ConnectiCare may also ask that you provide us with a spec sheet from your bank or a copy of a voided check.) Find resources, credentialing information, documents, forms, and additional support to help you provide excellent patient care. Following are some generally applicable rules for determining which plan is primary or secondary. Member Services: CarePartners of Connecticut Attn: Member Services P.O. Assists you in reaching a department or specific employee within ConnectiCare. Send a copy of the Explanation of Payment . Denied Services: Medical record reviews to start this month Administrative appeals The provider requests reconsideration of a claim denied for administrative purposes (e.g., filing limit, coding edits). Or Call Now (888) 666-8161. Administers preauthorization of imaging and radiation oncology services, as appropriate, for all product lines. ConnectiCare reserves the right to charge providers a $15 per claim fee for high-volume (20 or more claims) bulk billing errors for electronically submitted claims. Through your secure provider website account, your EOP is available online 3 days following the claims payment date. If all the information outlined below is not present and correct on the claim form, it will be returned to you for the required information. ConnectiCare 860-257-2030, Change Healthcare (formerly Emdeon) No. It is not medical advice and should not be substituted for regular consultation with your health care provider. Our Portals will not work well, or not work at all, with other browsers. Find information about how to choose one of ConnectiCares contracted skilled nursing facilities for yourself, a family member, or your patient using the Centers for Medicare & Medicaid Services Five-Star Quality Rating System. Please see below for a list of clearinghouses with connectivity to ConnectiCare. Make an appointment at any of our convenient locations. If you are interested, click this link. A confidential and anonymous hotline for reporting suspected fraudulent or abusive billing activities. EFT is not dependent upon electronic claims submission. To find out more, contact PNT Data directly at 1-860-257-2030. All providers acknowledge that ConnectiCare is receiving federal funds and that payments to providers for covered services are in whole or in part, from federal funds. Or Call Now (888) 666-8161. When you receive your remittance from us, you may then bill the member for the portion of the bill for which he/she is responsible, as indicated on the EOP. Find a doctor, specialist, or medical office through your ConnectiCare plan. 800-881-2739 ConnectiCare has a fraud and abuse hotline that is available to members, providers, employees, and government officials. You may direct any questions regarding claims to Provider Services at 877-224-8230. Step 1. 5. You can also request a printed copy of the ConnectiCare provider directory by sending an email to: info@connecticare.com. Claims which are submitted in paper format may also be reimbursed via EFT. Administers preauthorization of imaging services, as appropriate, for all product lines. 175 Scott Swamp Road Hartford, Connecticut Area. The line is available 24 hours a day to members, providers, employees, and government officials. You may submit paper claims by completing a CMS 1500 form or UB-04 form, as appropriate. under their ConnectiCare plan. Email: kofraud@emblemhealth.com. Claims are adjudicated according to the providers contractual agreement and the members benefits. Dr. Robert Reiter, MD is an Urologist (Genitourinary Doctor) in Los Angeles, CA. Case managers are available for other management questions, 8 a.m. 5 p.m., Monday through Friday (Please leave a voicemail message ater hours). Child whose parents are divorced, legally separated, or whose health coverage has been ordered by the courts. A hub for resources to help you care for our Medicare members. In the event that we notify you in writing that ConnectiCare has identified a payment error in an amount exceeding the amount due to you, you will be responsible for making the applicable refund. Manages ConnectiCares pharmacy benefit, preauthorization program, and drug list. Coinsurance: Providers should continue to send claims to the address indicated on the back of the ConnectiCare member ID card. ConnectiCares 180-day filing limit (from date of service) applies. Thank you! Order of benefit determination Note: If the member has medical coverage under their auto carrier, the auto carrier would be primary for claims related to the auto accident, up to the policy maximum. Can get help understanding and using your plan been ordered by the primary. 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