To Our Valued Provider Partners:
As part of Health Plan Inc.’s (HPI) acquisition of MedCost last year, employer group health plans currently administered by MedCost Benefit Services are transitioning to HPI in phases through the end of this year. It is important to note that your participation in the MedCost Network (or MedCost Virginia Network, if applicable) remains unchanged. You will continue to see these members as you do today, and your contracted network status will not be affected.
To date, a pilot group of five employer health plans has successfully transitioned to HPI, with a second, larger group of plans set to transition later this month. Our remaining employer groups will transition in two additional phases projected for August and October, with all MedCost Benefit Services clients fully transitioned by the end of the year. As each phase is completed, you can expect to see more members presenting HPI medical/pharmacy ID cards. Please use the information on the member's current ID card when verifying eligibility, obtaining precertification, or contacting Customer Service.
What Will Change
As MedCost Benefit Services employer groups transition to HPI, you will notice the following administrative updates:
ID Cards
- Members will begin presenting new HPI medical/pharmacy ID cards that include:
- HPI’s logo, along with the employer’s logo and the appropriate MedCost network logo. (See sample below.)
- New HPI group and member ID numbers.
- Updated Customer Service and precertification contact information.
- Once a MedCost Benefit Services employer group has transitioned to HPI, all inquiries (including those for dates of service prior to transition) should be directed to HPI Customer Service, using the number on the member’s ID card.
Medical/Pharmacy ID Card Sample (Front)
Medical/Pharmacy ID Card Sample (Back)
Members have been advised to present their new ID cards to providers
and pharmacies at their first visit on or after the effective transition date.
Provider Portal Access
- For members presenting an HPI ID card, please use the HPI provider portal at hpitpa.com to access:
- Eligibility and benefits information
- Claims payment status
- Continue using the MedCost Benefit Services provider portal to access information for members who have not yet transitioned to HPI.
Communications
- You may begin to see HPI’s name on administrative communications, such as Explanation of Benefits (EOBs).
What Will Stay the Same
- Your MedCost (or MedCost Virginia) network participation remains unchanged.
- As a participating MedCost network provider, you will continue to use MedCost provider web application services for:
- Claims Submission and Repricing
- Provider Reference Guide
- Claims submission remains the same:
- Continue using the same EDI for electronic claims.
- Continue using the same mailing address for paper claims.
Remember to include the new HPI Group Number and HPI Member ID (if applicable) when filing claims.
- Existing precertifications and prior authorizations remain in effect.
- Member benefits will not significantly change.
- Member cost shares (copays, coinsurance, deductibles) remain the same.
Our Commitment
We are working to ensure a smooth transition with minimal disruption to your practice. These changes are administrative in nature and are designed to support improved long-term capabilities.
If you have questions, please refer to the customer service number on the member’s ID card or contact MedCost Network Services at [email protected].
Thank you for your continued partnership and the care you provide to our members.
Sincerely,
MedCost in partnership with Health Plans Inc. (HPI)