Maryland Physicians Care & American Association of Healthcare Administrative Management June 21, 2013

Who We Are Maryland Physicians Care (“MPC”) is a Maryland Medicaid MCO owned by: Western Maryland Health System Meritus Health Maryland General Health System St. Agnes HealthCare

My MPC Source HIPAA Compliant Website

Prior Authorization Search Tool

The following information can be found on our website: Various Forms Provider Manual Current Drug Formulary Search the directory of participating providers Access to our Secure HIPAA Compliant Website

Member Eligibility Member eligibility can be checked several ways: 1.Call Log onto EVS at:Log onto EVS at: provWelcome.jsp 3.Log on to MPC’s Secure HIPAA compliant web portal at: h.com h.com

Claims Tips Fill out claim form completely including NPI # Timely filing limit for original submissions is 180 days from the date of service Send claim to proper address: Maryland Physicians Care Attn:Claims PO Box Phoenix, AZ

Prior Auth Tips Provide the following: Member information Clinical note/explanation of medical necessity Diagnosis and procedure codes Date(s) of Service When faxing use a cover sheet with correct phone & fax numbers for your practice Fax to MPC at For unscheduled admits fax to:

Contact Information Provider Relations option 2, option 4 Prior Authorization Monday – Friday 8:00am – 5:00pm , option 2, option (fax) Secure HIPAA Compliant Website Link:

Contact Information Claims Inquiry option 2, option 3 Secure HIPAA Compliant Website Link: Appeals Inquiry option 2, option 7 Fax: Basic appeals status should be checked by calling the claims inquiry number listed above

Contact Information Claims Resubmission Address: Maryland Physicians Care Attn: Claims Resubmission P.O. Box Phoenix, AZ Appeals Address: Maryland Physicians Care Attn: Appeals 509 Progress Dr. Linthicum, MD 21090

Contact Information Special Needs Coordinator for Case Management Services option 2, option 6 HEDIS Coordinator Roger Yates – Direct line

Questions?