UPDATE INSURANCE POLICY INFORMATION ON CAQH
To make credentialing and re-credentialing as seamless as possible, it is important to update and maintain your insurance policy information (Certificate of Insurance/COI) on CAQH. Ensuring you maintain current information and documentation helps us to complete the credentialing process efficiently and avoid delays. You can update your information here.
CLAIM APPEAL REVIEW
If you are submitting a repricing claim appeal for review by our Network Management Reimbursement Team, please be sure to include a fax number and email address so correspondence on our findings can be returned to you in a timely manner.
MEDCOST BENEFIT SERVICES ENHANCES SEARCH FUNCTIONALITY
We are excited to inform you of a recent enhancement to the MedCost Benefit Services Provider Portal.
We understand the importance and value of easily managing your patient accounts. With that in mind, the search functionality under the Claims Payment and Reimbursement section has been expanded to include your Patient #. You can now search for information by using either the member Alt ID# or Patient #. Log in here to access this new search feature.
YOUR ENTITY'S NETWORK PROVIDER INFORMATION AT YOUR FINGERTIPS
MedCost has a provider search function (available to anyone with a secure login to our provider website) that allows you to search for effective and termed providers for your entity. Note: The report will not include any providers that may be in process.
You can access the report by logging in to the Provider portal and following the steps below. Please ensure you run the report in Internet Explorer for optimal performance; it will not work correctly using other browsers.
- Select Web Applications.
- Select Provider Roster Report.
- Select Practice/Facility for which you wish to run report.
- Choose either active, termed, or all providers (full roster).
- Click Submit. (It will take a few minutes.)
The Excel report will include the following column headings:
- MedCost Relationship ID
- Provider Name
- Provider NPI#
- Practice Name
- Tax ID
- Effective Date
- Termination Date
OPPORTUNITIES FOR LEARNING ABOUT MEDCOST
Are you new to MedCost? Or need a refresher? Learn more about our administrative processes by going to “Provider OnBoarding” on our website. Under the “Online Training” section, you can access our series of educational videos whenever it’s convenient for you.
Videos include:
- About MedCost
- MedCost Credentialing
- MedCost Network
- MedCost Tools and Resources
- MedCost Claims Guidelines
- MedCost Health Management
- MedCost Provider Demographic Changes
MID-LEVEL PROVIDER FILING
Services rendered by a non-credentialed Physician Assistant (PA) or Nurse Practitioner (NP) should be identifiable on a claim and filed under the supervising MD’s name and assigned NPI. The supervising MD must be a participating provider in the MedCost Network.
You may submit a request to credential your Physician Assistant(s) or Nurse Practitioner(s) through the Provider portal of our website. Once a PA or NP is credentialed, claims can be filed under their names.
Claims should be submitted to MedCost for repricing, but please check the member’s ID card to determine where claims should be sent for processing. Sending claims to the wrong location will only delay adjudication and payment turnaround.