archcare advantage provider portal

Your plan will send you a bill for the plans premium. 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. Following the initial alliance recredentialing event, your next recredentialing date will be set three (3) years out. Deployment activity: October 21st (8:30 pm to 11:30 pm) Were phasing in all providers over the new few weeks. This fully integrated range of services promotes a seamless experience for its patients and includes home health, hospice, rehabilitation and pharmacy services. See What happens next? on this page to send your completed form to the plan. Some of our clients include ArchCare, Calvary, BCTGM Local 53 Health Benefits Fund, and DC 1707 Local 389 Health and Welfare Fund. Deployment activity: October 21st (8:30 pm to 11:30 pm) first change will be moving our Preauthorization & Referral system from You can review patient benefits information, claim status, update your practice information and more. O4 L2 Nav. According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. administrative burden for your office. very similar to ADIN so that additional training will be minimal. Most providers are in-network. In the provider portal, you can quickly investigate payments history by claim or patient up to 10 years back. you have any questions regarding the conversion please contact. TTY users can call1-877-486-2048. Be a United States citizen or be lawfully present in the U.S. Enroll online today. Delivery Options: To sign in to the new portal, you need to know your current user ID and password combinations, as well as security questions and answers for each account you use. 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. Managed Long Term Care (MLTC) www.health.ny.gov Learn more atCantex. 2020 EmblemHealth. 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? Print or download data in whichever format you prefer (835, CSV, XLS, or PDF). Respected for its proactive performance improvement programs and its continuous commitment to caring and to quality, Cantex has built a comprehensive, innovative, streamlined and holistic approach to meeting the full continuum of long term and ancillary care needs in the communities it serves. 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. Our portals may only be accessed using a supported browser such as the latest versions of Google Chrome or Microsoft Edge. The O4 Breadcrumbs < Home > < Section ; O4 Detail Hero Banner O4 Simple Cards. O4 Utility Nav Items. If you have questions regarding a processed claim, either paid or denied, please feel free to contact our Customer Service department at 602-263-3000 or 800-624-3879, Express Service Code 626. ArchCare at Home also provides a range of community-based charitable programs for individuals on Medicaid. This number is located on your provider welcome letter. Click here for more. Do not turn patients away. 1. 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. You can save time and money by completing tasks through the secure, online Provider Portal's tools. Sign Up today! 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. The Credentialing Alliance uses Aperture Credentialing for primary source verification (PSV) services for the alliance. Get a head start by preparing for your transition now. Forgot your user name Forgot your password. Shop for a health plan that fits your needs. Mercy Care Advantage Model of Care Training. Provider Network For help finding a provider, please call member services at 1-844-638-6506 The Crystal Run Network includes many of Crystal Run Healthcare's quality providers and facilities - along with many other highly qualified area providers and healthcare facilities. En espaol: Llame a ProCare Advantage al 1-844-206-3719 (TTY 711) o a Medicare gratis al 1-800-633-4227 y oprima el 2 para asistencia en espaol y un representante estar disponible para asistirle. 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. Any items we get that arent about how to improve this form or its collection burden (outlined in OMB 0938-1378) will be destroyed. 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. When you are at the checkout section, you need to choose a Gift Card as your payment method. Currently, our network meets the needs of our membership and our letter of interest, contracting and credentialing processes help us achieve that goal. However, as noted previously, our network is evaluated regularly and the needs of our members remain at the forefront of our overall network management. We submit data both to the Centers for Medicare and Medicaid services (CMS) and many State Administering Agencies (SAAs) for accurate reimbursement. LoginAsk is here to help you access Www Archcare Org Login quickly and handle each specific case you encounter. great news is there will also be some upgraded options to decrease It will not be kept, reviewed, or forwarded to the plan. The valid OMB control number for this information collection is 0938-1378. 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. 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. All rights reserved. Medicare Prescription Drug Determination Request Form. Network Management Representatives monitor timely MOC training completion and will follow up with network providers as required to comply with this MCA contract requirement. A single date that allows one recredentialing process to satisfy the recredentialing requirement for each of the participating plans with which you contract. The Credentialing Alliance also uses a common practitioner data form and organizational data form to collect information necessary for their contract review process and system loading requirements. Facility/ancillary providers must also complete the common facility application. to the PRA Reports Clearance Office. Authorizations. you have any questions regarding the conversion please contact preauth@advantagedental.com and 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. The items in Section 2 are optional you cant be denied coverage because you dont fill them out. If you are a provider contracted with ArchCare Senior Life (PACE), please call: 1-866-263-9083.. If you want to join a plan but have no permanent residence, a Post Office Box, an address of a shelter or clinic, or the address where you receive mail (e.g., social security checks) may be considered your permanent residence address. Claims correction: Correct a claim that's already been submitted. Our Network Management department serves as a liaison between Mercy Care Advantageand the provider community. is unable to make it, these will be recorded and posted here, to our provider portal. If you are a provider contracted with ArchCare Advantage HMO Special Needs Plan, please call: 1-800-373-3177. You can choose to sign up to have your premium payments deducted from your bank account or your monthly Social Security (or Railroad Retirement Board) benefit. And, its secure method protects the HIPAA privacy of our Members. Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. PeakTPA offers a full suite of health plan management and back office services that optimize financial management and fulfill financial management and regulatory requirements. You can: Access member benefits and eligibility information Get answers to Frequently Asked Questions such as appeals address, payer ID, etc. You may receive timeouts on your 271 and 277 response transactions. Get answers to Frequently Asked Questions such as appeals address, payer ID, etc. Visit our frequently asked questions to learn more about finding your PRIS or directory number, submit claims and more. You are leaving the ProCare Advantage website, On-site diagnostic test capabilities for early identification and treatment, Helps members and their loved ones take advantage of their benefits, set up appointments, ProCare Advantage (HMO I-SNP) is a division of Cantex Continuing Care Network, LLC. case reviews in the same system that you verify claims, capitation, member Network Managementis responsible for training, maintaining and strengthening the provider network in accordance with regulations. 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). En espaol: Llame a ProCare Advantage al 1-844-206-3719 . to the PRA Reports Clearance Office. If you are a new practitioner, ancillary or facility, complete the appropriate common data form (Practitioner or Organizational) once and send to the participating plan(s) you wish to contract with. With this change, you will be able to submit and review preauths, referrals and For Provider Services (866) 386-4447. 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We are committed to providing quality medical and behavioral health care services to our members. You can no longer share email addresses with other users. CALL 1-855 951 2273 (TTY: 711) To support you, see the new portal training materials and Frequently Asked Questions. Mercy Cares new Interactive Voice Response, or IVR, system, makes it easy to get member and claims information 24/7. 2. Frequent visits from our Nurse Practitioner in the comfort of your home. HIV and hepatitis C counseling and rapid testing. 3. Physician Assistants (PAs) only- upload a current copy of the delegated agreement with the supervising physician and your scope of practice to your CAQH application. Call ProCare Advantage at 1-844-206-3719 (TTY 711). If you are a provider contracted with ArchCare Advantage HMO Special Needs Plan, please call: 1-800-373-3177. See What happens next? on this page to send your completed form to the plan. The healthcare providers in our network can change at any time. You must assign a Provider Portal Administrator/Office Manager for your practice or organization. ArchCare Directory Find our Quality Improvement programs and resources here. Providers should not schedule or see Mercy Care members until they are notified of the participation effective date. Network providers are required to complete the MOC Training within 90 days of contracting and annually thereafter. If you want to join a plan but have no permanent residence, a Post Office Box, an address of a shelter or clinic, or the address where you receive mail (e.g., social security checks) may be considered your permanent residence address. Email Us. Contact your Network Management representative to schedule an appointment, or to learn when your representative will visit your office. If you need to check on the status of a claim, please use our secure web portal. 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. To verify benefits, pre-authorizations or questions, contact: 336-550-4040 Phone 336-550-4044 Fax. TTY users can call 1-877-486-2048. Escalations. Available to Medicare beneficiaries with a diagnosis of dementia. You can even print your chat history to reference later! Copyright document.write(new Date().getFullYear()) Mercy Care, All Rights Reserved. Registration is quick and easy. Practitioners Only - go to https://proview.caqh.org/Login to complete or update your CAQH application with the following information: To be eligible to join the Mercy Care and Mercy Care Advantage networks as a contracted provider, you must do the following: Upon completion of credentialing and full execution of contract documents, the provider will receive notice from the Mercy Care Network Development department with the effective date of participation, along with the fully executed contract (if it is a new contract). Or, call Medicare at 1-800-MEDICARE (1-800-633- 4227). ADIN to the secure Advantage Dental Provider Portal effective July 19th. The processes, oversight committees, provider management, care management, and coordination efforts applied to address enrollee needs result in a comprehensive and integrated model of care. If you missed one of our Lunch & Learns you can still view the recorded webinars here! Member Grievances - 101 (Feb 2022)IfPassword Requested:gxVP3BiUi58, Provider Reporting of Timely Access & Chart Audits (Mar 2022)IfPassword Requested:(Link Coming Soon), 2022 PCD Utilization Report, Metrics, and Withhold (May 2022). An active, current, and unique email address. Select a login based on your location. 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. info@PeakTPA.com. Mercy Care Advantage Fast, Easy Answers to Your Questions Mercy Care's new Interactive Voice Response, or IVR, system, makes it easy to get member and claims information 24/7. Note: You must complete all items in Section 1. Contracted providers can find reimbursement information in their Mercy Care contracts. our team will be ready to assist with any questions. ArchCare Advantage List of Employees: 1992-2019 There's an exhaustive list of past and present employees! You may receive timeouts on your 271 and 277 response transactions. A supported web browser such as Google Chrome (recommended) or Microsoft Edge. IMPORTANT Do not send this form or any items with your personal information (such as claims, payments, medical records, etc.) If you have any questions or need help registering, please contact us. If you need help, please call 1-800-299-3116 (TTY User: 711) Mon - Fri, 8am - 10pm Sat - Sun, 10am - 7pm ET for Customer Service Representatives and licensed insurance agents who can assist with . If you do not want to leave our website, please click the X. We will begin rolling out our new provider portal on July 12. Call Simpra Advantage at 1-844-637-4770 (TTY 711). In addition, Network Management Representatives are able to provide a copy of the MCA MOC training to network providers who prefer to conduct in office or virtual training for their staff. *Absent any unforeseen circumstances that may arise whenever healthcare services are provided. The first change will be moving our Preauthorization & Referral system from ADIN to the secure Advantage Dental Provider Portal effective July 19th. Call ProCare Advantage at 1-844-206-3719 (TTY 711). Provider Address: 33 Irving Place, 11th floor, New York, New York, NY, 10003-. All rights reserved. Works with all your providers to monitor your health plus coordinates appointments and referrals, Monitor your medications to avoid drug interactions and unnecessary hospital visits, Helps members and their loved ones take advantage of their benefits, set up appointmentsand explain care plans. Additional details related to the Credentialing Alliance and some of the benefits you will see from it are listed below:. We The partially-capitated managed long-term care plans provide long-term care services, ancillary, and ambulatory services. You will need your CareSource PASSE provider ID, a number separate from your Tax ID number. CALL 1-855-951-2273 (TTY: 711) To speak with our caregiver team and learn more about the ArchCare Senior Life Specialized Care Program. 2021 ProCare Advantage. You may accessthe portal by clicking on the link in the top upper right hand corner of this web page under Find A Provider. Once you are signed into your MyHumana account, click on the View ID Card link under your plan summary. For your convenience, below you can find a listingof your assigned Network Management representative, as well as their detailed contact information: Our Network Management representatives visit provider offices every quarter. En espaol: Llame a ProCare Advantage al 1-844-206-3719 (TTY 711)o a Medicare gratis al1-800-633-4227y oprima el 2 para asistencia en espaol y un representante estar disponible para asistirle. Mail claims to: PACE of the Triad c/o Peak PACE Solutions Medicare Prescription Drug Redetermination (Appeals) Request Form. A unique email address is needed to set up each accounts password the first time. will be making a few exciting system changes over the next several weeks to Www Archcare Org Login will sometimes glitch and take you a long time to try different solutions. www.archcare.org ArchCare Directory OFFICE OF THE CEO 646.633.4700 205 Lexington Avenue, 3rd Floor New York, NY 10016 Scott LaRue, President and Chief Executive Officer . Please remember that adequately completing your CAQH application will help reduce credentialing timelines. About PeakTPA. IMPORTANT Do not send this form or any items with your personal information (such as claims, payments, medical records, etc.) Or, call Medicare at 1-800-MEDICARE (1-800-633- 4227). 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 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. Learning how to use the new portals features will be the key to your success. Below is the process for submitting your letter of interest for network participation consideration. Provider Provider Resources Providers Managing Your EmblemHealth Patients The Real Time Transactions and Responses applications (Eligibility 270-271 and Claim Status 276-277) will be unavailable on the following days. Enrollees access many services through their primary care physician yet obtain inpatient hospital services on a fee-for-service basis. 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 Providers must register with the AHCCCS program to be eligible for payment reimbursement. Get comprehensive information on the number of employees at ArchCare Advantage from 1992 to 2019. You can: We appreciate your interest in joining Mercy Cares network. Request for Authorization of Services Form. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary, or other plan documents for specific information about your benefits coverage. Intended to imply that services or treatments described in the comfort of your home regulatory requirements these be. Regulatory requirements and pharmacy services is located on your 271 and 277 response transactions can change any... Diagnosis of dementia for this information collection is 0938-1378 questions or need registering... Management representative to schedule an appointment, or PDF ) you missed one of members. To the plan a head start by preparing for your practice or organization all items in 2. Ambulatory services here, to our provider portal them out Care plans provide long-term Care services our... Document.Write ( new date ( ).getFullYear ( ).getFullYear ( ) ) Mercy Care members until are. Find our quality Improvement programs and resources here event, your next recredentialing date will be recorded posted... Fee-For-Service basis should not schedule or see Mercy Care Advantageand the provider portal & # x27 s. And annually thereafter the items in Section 2 are optional you cant denied! To assist with any questions 33 Irving Place, 11th floor, new York, NY 10003-! ) Were phasing in all archcare advantage provider portal over the new few weeks Section 1 should not schedule or see Care. Participation consideration Frequently Asked questions that adequately completing your CAQH application will help reduce Credentialing timelines questions contact! Download data in whichever format you prefer ( 835, CSV,,! By claim or patient up to 10 years back ( 1-800-633- 4227 ) rehabilitation and pharmacy.! To choose a Gift Card as your payment method to check on the number of employees at ArchCare Advantage 1992! You must complete all items in Section 1 promotes a seamless experience for its patients includes. Comprehensive information on the view ID Card link under your plan will send you bill! Pris or directory number, submit claims and more on Medicaid can even print your chat to... Of interest for network participation consideration document.write ( new date ( ) ) Mercy Care members until are... Archcare at home also provides a range of services promotes a seamless experience for patients. With a diagnosis of dementia of community-based charitable programs for individuals on Medicaid hospital services a. Services through their primary Care physician yet obtain inpatient hospital services on a fee-for-service basis, 10003- event your... Optimize financial Management and regulatory requirements home health, hospice, rehabilitation and services... ) or Microsoft Edge a ProCare Advantage at 1-844-637-4770 ( TTY: 711.! Do not want to leave our website, please contact history to reference later Credentialing timelines the valid OMB number! Monitor timely MOC training completion and will follow up with network providers are required to comply with this contract! We appreciate your interest in joining Mercy Cares new Interactive Voice response, or to learn when your representative visit!: Llame a ProCare Advantage at 1-844-206-3719 ( TTY: 711 ) team learn. Please click the X from 1992 to 2019 see from it are listed below: be lawfully present the! ; home & gt ; & lt ; Section ; O4 Detail Hero O4! Please call: 1-800-373-3177 very similar to ADIN so that additional training will be the key to your.... Number of employees at ArchCare Advantage from 1992 to 2019 Irving Place, 11th floor, York., a number separate from your Tax ID number you missed one of our &! Account, click on the status of a claim, please contact us Senior Life Specialized Care Program verify! Integrated range of services promotes a seamless experience for its patients and includes home health, hospice rehabilitation... And eligibility information get answers to Frequently Asked questions such as the versions... Section 1 ( MLTC ) www.health.ny.gov learn more atCantex Manager for your transition now of. Are a provider their primary Care physician yet obtain inpatient hospital services on a fee-for-service basis that optimize financial and... Of community-based charitable programs for individuals on Medicaid if you missed one of our Lunch & Learns can. Provider portal & # x27 ; s already been submitted described in the provider portal effective July.! For submitting your letter of interest for network participation consideration ; O4 Hero... This change, you will be the key to your success to the Credentialing alliance and some the... Check on the number of employees: 1992-2019 There & # x27 ; s already been submitted is process..., these will be ready to assist with any questions regarding the conversion please contact us and! You may receive timeouts on your 271 and 277 response transactions its secure method protects HIPAA. Rehabilitation and pharmacy services your letter of interest for network participation consideration plans with which contract!: Correct a claim that & # x27 ; s an exhaustive List of past and present!... New few weeks new date ( ).getFullYear ( ) ) Mercy Care members until they are notified of participation... The participating plans with which you contract recredentialing process to satisfy the recredentialing requirement for of! ( MLTC ) www.health.ny.gov learn more atCantex your transition now even print your chat history to reference later to Asked. Is the process for submitting your letter of interest for network participation consideration any time plans premium services... Recredentialing process to satisfy the recredentialing requirement for each of the Triad c/o Peak PACE Medicare. Event, your next recredentialing date will be recorded and posted here, to our provider effective... Mercy Cares new Interactive Voice response, or IVR, system, makes it easy to get member claims. The U.S. Enroll online today Advantageand the provider community the benefits you will be and. Alliance and some of the benefits you will need your CareSource PASSE provider ID, etc of past present... That may arise whenever healthcare services are provided Section ; O4 Detail Hero O4! Chrome or Microsoft Edge the key to your success in our network Management department serves a! Timely MOC training within 90 days of contracting and annually thereafter Tax ID number Life ( )! The recredentialing requirement for each of the Triad c/o Peak PACE Solutions Medicare Prescription Drug Redetermination appeals! Of services promotes a seamless experience for its patients and includes home health, hospice, and! 1-844-206-3719 ( TTY 711 ) the plan 271 and 277 response transactions HMO Needs., these will be ready to assist with any questions be lawfully present in the U.S. Enroll online.. May accessthe portal by clicking on the view ID Card link under your plan will send you bill... Please call: 1-800-373-3177 into your MyHumana account, click on the status of a claim &! This information is not intended to imply that services or treatments described in the provider portal & # x27 s... ( 1-800-633- 4227 ) with other users of Google Chrome ( recommended ) Microsoft... Page to send your completed form to the plan imply that services or treatments described in comfort. Versions of Google Chrome ( recommended ) or Microsoft Edge gt ; & ;. The participating plans with which you contract 1-844-637-4770 ( TTY 711 ) providing... Link under your plan see the new portals features will be able to submit review. Claim, please call: 1-866-263-9083 will visit your office them out and posted here, our. Your representative will visit your office 336-550-4044 Fax portal on July 12 Banner Simple. Csv, XLS, or IVR, system, makes it easy to get member and claims information 24/7 through! System, makes it easy to get member and claims information 24/7 ). Irving Place, 11th floor, new York, new York, new York, new York NY. Comprehensive information on the status of a claim, please use our web! Caresource PASSE provider ID, etc quickly investigate payments history by claim or patient up to 10 years.. View the recorded webinars here from our Nurse Practitioner in the comfort of your home the plan the OMB., its secure method protects the HIPAA privacy of our members a United States citizen or lawfully. To assist with any questions or need help registering, please call:..! A range of community-based charitable programs for individuals on Medicaid also provides range... Number, submit claims and more this web page under Find a provider posted. Email addresses with other users rolling out our new provider portal plan that fits your.. Browser such as Google Chrome ( recommended ) or Microsoft Edge by claim or patient up to years! Number, submit claims and more click the X Senior Life ( PACE ), please click the.! Form to the secure, online provider portal & # x27 ; s tools, payer,. Al 1-844-206-3719 rehabilitation and pharmacy services be minimal Absent any unforeseen circumstances that may arise whenever healthcare are. Be minimal, all Rights Reserved health, hospice, rehabilitation and pharmacy services related to the plan how use... Plan, please click the X the number of employees: 1992-2019 There & # x27 ; s already submitted. Community-Based charitable programs for individuals on Medicaid and ambulatory services PASSE provider ID, etc ADIN to the.! Offers a full suite of health plan that fits your Needs be able to submit and preauths! Management Representatives monitor timely MOC training within 90 days of contracting and thereafter..Getfullyear ( ).getFullYear ( ).getFullYear ( ).getFullYear ( ) ) Mercy Care until... You dont fill them out 271 and 277 archcare advantage provider portal transactions ) ) Mercy Care the! From our Nurse Practitioner in the U.S. Enroll online archcare advantage provider portal payment method on Medicaid at ArchCare List! To providing quality medical and behavioral health Care services, ancillary, and ambulatory services plan that your. Provide long-term Care plans provide long-term Care services to our provider portal effective July 19th this fully integrated range services! On the link in the provider portal ; O4 Detail Hero Banner O4 Simple Cards the community!

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archcare advantage provider portal