Important Notice for Providers
CAQH ProView™ - the next generation Universal Provider Datasource® (UPD) - is launching on Monday, March 2, 2015. During the transition from UPD to CAQH ProView, the CAQH UPD system will be unavailable beginning 8 p.m. ET Tuesday, February 24 through Monday morning, March 2. MedCost will be unable to access provider applications through CAQH and, therefore, will not be able to initiate the credentialing process for new providers until the system is available. MedCost has taken the necessary steps with Aperture, our credentialing partner, to ensure that providers who are due for recredentialing will not be affected during this downtime. If you have any questions, please call the MedCost Customer Service Contact Center at 1-800-824-7406.
You’re Part Of Our Team
MedCost is grateful to the number of hospitals, primary care physicians, specialists, facilities, and ancillary services that have helped to make our network the largest independent provider network in the Carolinas.
Benefits Of Network Participation
Through participation in the MedCost Network, providers accept discounted fees from our members for a broad range of medical services. In turn, employers accessing the network structure their health care plans to encourage plan members to stay within the network for medical care. This arrangement provides a stable patient base for you, and allows employers in the area to offer affordable health care options to their employees.
Online Tools And Services To Assist You
MedCost offers a variety of online tools and services to support and assist you with administrative procedures, including:
- Electronic submission of claims to reduce processing time
- Claims Repricing Inquiry* and Provider Claim Activity Report* to simplify claim follow-up
- Reference Guide* with information on all companies (active and inactive) accessing the MedCost Network, including group number, effective and termination dates, and claim administrator and certification vendor contact information. (No benefit information appears in the Reference Guide.)
- Direct links to claim administrators with online claim status, including MedCost Benefit Services, so you can find answers regarding payment status and eligibility
- Online certification request* and Health Management Certification Status Query* to complete the certification process from start to finish or search for a specific certification using the MedCost Reference Number
- Training and reference materials, such as our comprehensive Provider Manual, Client Repricing Inquiry demonstration, and educational webinars, to make sure you and your staff have a thorough knowledge of MedCost processes
- (Re)Credentialing applications for easy download or the ability to (re)credential using your CAQH ID.
*Login and password required for access.
Specialized Contacts Just For Providers
MedCost’s Customer Service Contact Center can handle all sorts of inquiries, whether from members, employers, or providers, but there is another option when you have specific questions or concerns—MedCost Provider Specialists. Each Provider Specialist works with providers from a particular geographic area—eastern North Carolina, western North Carolina, or South Carolina. Along with offering support with everyday issues, they conduct and assist with educational training sessions, share and review data with providers to ensure that all processes work smoothly, and if necessary, act as liaisons with other internal departments or external vendors to resolve any problems.
Doing Our Part For Prompt Payment Of Claims
Although MedCost does not issue payment on claims, we make every effort to ensure that you will receive prompt payment. Most claims are sent to us electronically, and we reprice them to reflect your allowable amounts before forwarding them to the appropriate claim administrator, including MedCost Benefit Services, usually within 2 business days.