If you missed our Live trainings the following link will take you to the recorded training: Preauthorization & Referral System Conversion Training(specialists can skip to the 9min15sec mark for information on retrieving referrals and entering treatment), Preauthorization & Referral Training Manual. Providers; O4 Main Nav Items. A supported web browser such as Google Chrome (recommended) or Microsoft Edge. Find a Plan Call Toll-Free 866-7040109 TTY 711 Call Center Hours October 1-March 31 Seven (7) days a week from 8 a.m.-8 p.m. April 1-September 31 Monday-Friday from 8 a.m.-8 p.m. $0 monthly premium Refer to our Provider Manual for more detailed information. Facility/ancillary providers must also complete the common facility application. You can no longer share email addresses with other users. The Real Time Transactions and Responses applications (Eligibility 270-271 and Claim Status 276-277) will be unavailable on the following days. Designed by Elegant Themes | Powered by WordPress. LoginAsk is here to help you access Www Archcare Org Login quickly and handle each specific case you encounter. You will also need your email if you ever need to retrieve or reset your username and password. The most relevant archcare provider portal pages are listed below: Table of contents Provider | ArchCare If you are a provider contracted with ArchCare Advantage HMO Special Needs Plan, please call: 1-800-373-3177. Mercy Cares network is closed to most medical and behavioral health care providers. If you missed one of our Lunch & Learns you can still view the recorded webinars here! The claims management workflow allows providers to submit and track claims electronically, reducing calls to your call center and eliminating the need for fax and mail. Be sure to upload all supporting documents and that re-attestation is required every 120 days(reminders are sent out in the form of an email prior to expiration). Contracted providers can find reimbursement information in their Mercy Care contracts. If you do not want to leave our website, please click the X. Shop for a health plan that fits your needs. Currently, our network meets the needs of our membership and our letter of interest, contracting and credentialing processes help us achieve that goal. It is not medical advice and should not be substituted for regular consultation with your health care provider. See What happens next? on this page to send your completed form to the plan. Please remember that adequately completing your CAQH application will help reduce credentialing timelines. TTY users can call1-877-486-2048. You can save time and money by completing tasks through the secure, online Provider Portal's tools. 2021 ProCare Advantage. Call ProCare Advantage at 1-844-206-3719 (TTY 711). As long as you require a nursing home level of care, our plan can help you with your very special needs, regardless of where you reside. Available to Medicare Beneficiaries who meet the requirements for long-term care eligibility. Search from our database of doctors, hospitals and other healthcare facilities. Get answers to Frequently Asked Questions such as appeals address, payer ID, etc. Its Committed to Excellence philosophy emphasizes compassion, service and a commitment to realizing the best possible health outcomes for its patients, including its ProCare Advantage Medicare beneficiaries. Support for You:Learning how to use our portals features will be the key to your success. If you are a practitioner that requires a site visit as part of the initial credentialing event (Primary Care Provider or Obstetrician) or a facility that requires a site visit as part of the initial credentialing event (facilities that are not accredited or surveyed), the participating plan(s) that you are requesting to contract with will have access to any site visit already performed under the alliance. Our extensive expertise in TPA means your organization can focus on providing care . Registration is quick and easy. PeakTPA offers a full suite of health plan management and back office services that optimize financial management and fulfill financial management and regulatory requirements. If no site visit has been performed by a participating plan in the AzAHP credentialing alliance, a single site visit will be performed as part of the initial credentialing event and made available to all participating plans. Formed in 1978 and now operating 37 nursing facilities in Texas and New Mexico, Cantex is an established and respected industry leader in the provision of exemplary skilled nursing care. Call ProCare Advantage at 1-844-206-3719 (TTY 711). We Www Archcare Org Login will sometimes glitch and take you a long time to try different solutions. From here, you will select the name of the member you are seeking an ID card for and which plan (medical, dental, vision, etc.) Were phasing in all providers over the new few weeks. Registered providers agree to abide by state laws and agree to accept the state Medicaid payment as payment in full. With 330 payers instead of just one, we have an ever-growing network to help you get your money fast. You may receive timeouts on your 271 and 277 response transactions. Under our Medicare contract, MCA is required to implement a MOC and must provide ongoing training to health plan staff and network providers who contribute to the effectiveness of the MOC. Additionally, specialty Behavioral Health providers should include a summary description of programs, including target populations and age categories, specific models of care/therapies used, along with frequency of programming treatment. Copyright document.write(new Date().getFullYear()) Mercy Care, All Rights Reserved. Click here to register Each portal account user must have their own email address. If you dont see an immediate change, please be patient. The valid OMB control number for this information collection is 0938-1378. We submit data both to the Centers for Medicare and Medicaid services (CMS) and many State Administering Agencies (SAAs) for accurate reimbursement. Deployment activity: October 21st (8:30 pm to 11:30 pm) Important: To join a Medicare Advantage Plan, you must also have both: VisitMedicare.govto learn more about when you can sign up for a plan. You can even print your chat history to reference later! You can: We appreciate your interest in joining Mercy Cares network. Note: You must complete all items in Section 1. If it is determined the network need has changed and services provided by your organization are warranted, a Network Management Representative will contact you directly. Our Companies, Lines of Business, Networks, and Benefit Plans (PDF), Medicaid, HARP, and CHPlus (State-Sponsored Programs), Cultural Competency Continuing Education and Resources, Medicaid Cultural Competency Certification, Find a center near you, view classes and events, and more, EmblemHealth Neighborhood Care Physician Referral Form (PDF), Vendor-Managed Utilization Management Programs, Physical and Occupational Therapy Program, Radiology-Related Programs and Privileging Rules for Non-Radiologists, New Century Health Medical Oncology Policies, UM and Medical Management Pharmacy Services, COVID-19 Updates and Key Information You Need to Know, EmblemHealth Guide for Electronic Claims Submissions, Payment processes unique to our health plans, EmblemHealth Guide for NPIs and Taxonomy Codes, 2022 Provider Networks and Member Benefit Plans, EmblemHealth Spine Surgery and Pain Management Therapies Program, Outpatient Diagnostic Imaging Privileging, Benefits to Participation in Dental Network. Furthermore, you can find the "Troubleshooting Login Issues" section which can answer your unresolved problems and equip you with a . O4 Breadcrumbs < Home > < Section ; O4 Detail Hero Banner O4 Simple Cards. Network providers are required to complete the MOC Training within 90 days of contracting and annually thereafter. Notify us of any updates needed by emailing networksupport@procareadvdev.com. Contact your Network Management representative to schedule an appointment, or to learn when your representative will visit your office. Sessions via Webinar for the office staff of our Medicaid providers. See What happens next? on this page to send your completed form to the plan. You may submit a potential future provider letter of interest andW-9 Form for review. To support you, we createdportal training materials(with instructional videos) andFrequently Asked Questions. If you are a provider contracted with ArchCare Community Life (MLTCP), please call: 1-855-467-9351. If you are having difficulties registering please . ProCare Advantage (HMO I-SNP) is a division of Cantex Continuing Care Network, LLC. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850. About PeakTPA. Be a United States citizen or be lawfully present in the U.S. Aperture performs the PSV once and shares the results with each participating plan that you authorize to receive it. Deployment activity: October 21st (8:30 pm to 11:30 pm) Get a head start by preparing for your transition now. If you want to join a plan during fall open enrollment (October 15December 7), the plan must get your completed form by December 7. The first change will be moving our Preauthorization & Referral system from ADIN to the secure Advantage Dental Provider Portal effective July 19th. Maintaining complete and correct provider records in the Interactive Provider Directory is a priority for ProCare Advantage as the directory provides an important source of provider information to our members. All Rights Reserved. If you're not a provider or a practice, choose an option below to continue. The time required to complete this information is estimated to average 20 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. Select a login based on your location. Overview; Social responsibility; Leadership; News; O4 Utility Nav. TTY users can call1-877-486-2048. If you are a provider contracted with ArchCare Senior Life (PACE), please call: 1-866-263-9083.. For practitioner groups that are adding a new practitioner, you simply complete the common Practitioner Data Form once and send to each of the participating plans your group is contracted with. ArchCare Advantage List of Employees: 1992-2019 There's an exhaustive list of past and present employees! If you are a provider contracted with ArchCare Advantage HMO Special Needs Plan, please call: 1-800-373-3177. our team will be ready to assist with any questions. Or, call Medicare at 1-800-MEDICARE (1-800-633- 4227). By providing this information promptly, you will ensure your practice is listed correctly in the ProCare Advantage Provider Directory and that members are able to reach your practice for services needed. Visit our site to learn about the best ways to use ProviderPortal, . ArchCare at Home also provides a range of community-based charitable programs for individuals on Medicaid. Contact us O4 Utility Nav Items. The partially-capitated managed long-term care plans provide long-term care services, ancillary, and ambulatory services. Our Portals will not work well, or not work at all, with other browsers. Once they process your request to join, theyll contact you. Managed Long Term Care (MLTC) www.health.ny.gov Providers should not schedule or see Mercy Care members until they are notified of the participation effective date. If you need to check on the status of a claim, please use our secure web portal. IMPORTANT Do not send this form or any items with your personal information (such as claims, payments, medical records, etc.) The Credentialing Alliance uses Aperture Credentialing for primary source verification (PSV) services for the alliance. When you are at the checkout section, you need to choose a Gift Card as your payment method. For Provider Services (866) 386-4447. EZ NET Provider Portal offers Providers secure, web-based access to health care information, including claims, eligibility, and benefits. Your plan will send you a bill for the plans premium. is unable to make it, these will be recorded and posted here, to our provider portal. Able to live safely in the community when you enroll Have a nursing assessment to determine eligibility We believe everyone should have a say in how and where they receive care Our trusted and caring teams help seniors and those with physical, cognitive and developmental disabilities articulate care goals and desires. very similar to ADIN so that additional training will be minimal. administrative burden for your office. IMPORTANT Do not send this form or any items with your personal information (such as claims, payments, medical records, etc.) You can: Access member benefits and eligibility information Get answers to Frequently Asked Questions such as appeals address, payer ID, etc. You may accessthe portal by clicking on the link in the top upper right hand corner of this web page under Find A Provider. O4 Utility Nav Items. Below is the process for submitting your letter of interest for network participation consideration. Following the initial alliance recredentialing event, your next recredentialing date will be set three (3) years out. Providers must register with the AHCCCS program to be eligible for payment reimbursement. ArchCare Advantage has formed a network of doctors, specialists and hospitals to provide care for our members. you have any questions regarding the conversion please contact preauth@advantagedental.com and to the PRA Reports Clearance Office. Available to Medicare beneficiaries with a diagnosis of dementia. The Provider Portal application will be unavailable Sundays between 12:30 PM CST - 6:00 PM CST for regularly scheduled maintenance. 1. to the PRA Reports Clearance Office. You can fax directly to Provider Relations at 860-975-3201 the following information: Please feel free to contact our Network Management department for the following: You can reach our Network Management department by calling 602-263-3000 or 1-800-624-3879, Express Service Code 631. A unique email address is needed to set up each accounts password the first time. To support you, see the new portal training materials and Frequently Asked Questions. Plan Code Plan ID# PCP Provider Name Telephone Number Plan Type 82 00477156 Affinity Health Plan, Inc. (800) 553-8247 Mainstream 92 00894519 Metroplus Health Plan, Inc. (800) 597-3380 Mainstream AA 04004537 Healthplus HP LLC (800) 454-3730 HARP AC 03114514 ArchCare Senior Life (Catholic Managed Long Term Care Inc) Between October 15December 7 each year (for coverage starting January 1), Within 3 months of first getting Medicare, In certain situations where youre allowed to join or switch plans, Your Medicare Number (the number on your red, white, and blue Medicare card). Our portals may only be accessed using a supported browser such as the latest versions of Google Chrome or Microsoft Edge. You can review patient benefits information, claim status, update your practice information and more. And, its secure method protects the HIPAA privacy of our Members. All rights reserved. Practitioners must also make sure CAQH is updated and each of the participating plans that you are contracted with are approved to access your CAQH application. To You must assign a Provider Portal Administrator/Office Manager for your practice or organization. kick off 2022 we will be holding bi-monthly (at least 6 per year) Lunch & Learn Registration ends October 21!Don't Miss the 2022 Annual PCD Meeting (constantcontact.com), 2022 Office Closures:January 17, 2022 - Closed in Observance of Martin Luther King, Jr Day, March 4, 2022 - Closed in Observance of National Employee Appreciation Day, May 30, 2022 - Closed in Observance of Memorial Day, June 20, 2022 - Closed in Observance of Juneteenth, July 4, 2022 - Closed in Observance of IndependenceDay, September 5, 2022 - Closed in Observance of Labor Day, November 24 & 25, 2022 - Closed in Observance of Thanksgiving, December 23 - 26, 2022 - Closed in Observance of Christmas, The The items in Section 2 are optional you cant be denied coverage because you dont fill them out. great news is there will also be some upgraded options to decrease Claims Filing Process Please refer to the Quick Reference Guide or Provider Manual for a summary of the claims submission process including appropriate addresses, payer ID numbers, phone numbers and fax numbers to be used. Claims correction: Correct a claim that's already been submitted. Contact Us | ArchCare Community Resources Health Plans Home Care Short-Term Rehab Nursing Homes End-of-Life Care Specialized Care Home Contact Us Contact Us Have questions about care for you or a loved one? HIV and hepatitis C counseling and rapid testing. Currently, our network meets the needs of our membership. From your office arise whenever healthcare services are provided join, theyll you! And their families and fulfill financial management and back office services that optimize management! Help you access Www ArchCare Org Login quickly and handle each specific case you encounter get Other browsers provider welcome letter joining Mercy Cares network is closed to most medical and supportive for. Absent any unforeseen circumstances that may arise whenever healthcare services are provided 1-844-206-3719 ( 711. Ez-Net ) through the portal user interface or multiple claims via a batch file home gt! 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