Provider Network eBlast

Updates from FirstCarolinaCare 

Effective January 1, 2021, our payer partner FirstCarolinaCare (FCC) will begin transitioning to a new claims processing vendor (Health Alliance), a new pharmacy benefit manager (OptumRx), as well as new prior authorization processes with online access to submit prior authorization requests through their new provider portal. According to the FCC Provider Resource Guide, important things to note when a group transitions to Health Alliance are:

• New phone number
• New claims address
• New EDI number
• New member ID card (shows new group number/new member ID)

FCC commercial members will transition to the new vendors and processes when they undergo their 2021 plan renewal. Until groups renew, they will remain with their current vendor (DST Healthcare Solutions) and current processes. It is important to obtain a member’s ID card at each visit. Once members transition to the new processes and vendors, their member ID number will start with 94.

There are immediate steps that you can take to be prepared prior to January 1, 2021. FCC’s provider notice includes instructions on how to register for electronic remittances, electronic funds transfer, and the new FCC Provider Portal. 

We encourage you visit www.firstcarolinacare.com to familiarize yourself with the new enhanced features their website offers and to complete the registration process. FCC’s Provider Resource Guide is available on their website. If you have any questions or need additional education or assistance after reviewing the Resource Guide, please reach out to Barbara Adcock at [email protected]. The FCC provider team is available for assistance with any questions or concerns.

Plan Changes Likely with New Calendar Year - Be Sure to Verify Benefits 

It is always important to verify benefits for a patient to ensure you collect the appropriate co-payment, co-insurance, deductible, etc., at the time of service. This is especially true as we begin a new calendar year when benefits can likely change. Please obtain the most current copy of the patient’s insurance ID card at each visit and check members’ benefits. Payer information is listed on the back of the ID card; the payer will have the patient’s most current eligibility status. MedCost also offers a convenient listing on our website to give you a direct link to our payer partners with online access. 

MedCost Benefit Services Welcomes New Employer Groups  

MedCost Benefit Services is pleased to welcome the following new employer groups to our client family:

Effective December 1, 2020

Piggly Wiggly (Group Number 7280)                  

Effective January 1, 2021

EmergeOrtho (Group Number 7245)

Crossnore School (Group Number 7265)

Western Carolina Community Action (Group Number 7350)  

 For eligibility questions regarding these employer groups, please contact 1-800-795-1023.

Holiday Reminder  

MedCost offices will be closed on Friday, January 1, 2021, in observance of the New Year's holiday. 

As 2020 comes to a close, we want to thank you for being part of the MedCost Network and express our gratitude for your extraordinary efforts in caring for our health plan members.