2 Who is Maryland Physicians Care –Provider sponsored statewide MCO –Incorporated in 1996 –A Maryland hospital owned MCO; owners include: Holy Cross Health.

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Presentation transcript:

2 Who is Maryland Physicians Care –Provider sponsored statewide MCO –Incorporated in 1996 –A Maryland hospital owned MCO; owners include: Holy Cross Health Meritus Medical Center ( formerly Washington County Health System) Western Maryland Health System –Provides managed care services to over 180,000 HealthChoice members

3 No Pharmacy Copays Free prescription and over-the-counter medications Free vision care for adults (21 and older) One eye exam every year One set of glasses OR contact lenses every two years One pair of lenses every year (when needed) Free vision care for children (20 and under) One eye exam and set of glasses every year One set of contact lenses (when medically necessary) Low-cost dental care for adults (21 and older) Free exams and cleanings two times a year Limited X-rays once a year Limited cavity fillings (with some cost to you) Simple and medically necessary emergent extraction (with some cost to you) 20% discount on non-covered dental services Added Value Benefits Free SafeLink Cell Phone: Free cell phone 250 free monthly minutes Unlimited text messaging Click hereClick here to download the Safelink application More benefits at NO COST to our members: Routine primary care provider visits and physical exams Urgent and emergency care Immunizations for children Primary mental health services Substance abuse treatment and counseling Mammograms Small Miracles Program (incentives for pregnant women) Case managers for health conditions like asthma, diabetes and high blood pressure Disease management educational programs Transportation assistance

Only MCO that operates Statewide. Hospital owned MCO which affords us additional access to a robust network of providers Written referrals are not required Code specific Prior Authorization Requirements Access to online prior authorization submission tool with the possibly of immediate auto-auth approval Healthy Groove – “Take Steps to Live Well” features free, fun healthy activities to show our members simple steps to live well. They can participate in free healthy food tastings and cooking demonstrations. Then dance and sing with interactive and music-based games in our Healthy Groove van! 4 Why Join MPC?

5 Enhanced HIPPA Compliant Web Portal, My MPC Source Convenient, safe access Single sign-on – One log-in and password allows you to move smoothly through various systems. Mobile interface – Enjoy the additional convenience of access through your mobile device. Personalized content and services – After log-in, you will find a landing page customized for you. Real-time data access – View updates as soon as they are posted. Better tracking –Know immediately the status of each claim submission and PA request. Auto-Auths – Depending on the auth type and service location, it is possible to receive an auto-approval on your request. Detailed summaries – Find easy access to details about denied PA requests or claims. Enhanced information to analyze, track and improve services and processes. New Member Mobile APP – MPC now has a mobile app, available in both the App and Play Store on Google. The APP allows our members to utilize all of the features on our Medicaid Web Portal, via the mobile phone.

NEW WEB PORTAL FEATURES Increase of maximum number of providers that can be added to a “Super User” account from 10 to 100 Display associated providers in “Super User” handling and search dropdown menus in ascending order 6

WEB PORTAL TRAINING Did you know that your Provider Relations Representative can provide on site training for you and your team? We are happy to offer on site training or training documents to cascade to your team as needed. 7

REDETERMINATION 8

PROVIDER FORUM DECEMBER 4TH Please Join Maryland Physicians Care for our upcoming Provider Forum! At this meeting, we will discuss topics and information that is important to you as well as your relations with our MCO as a whole. You will have the option of attending in person or via live meeting. Contact your Provider Relations Representative for Details 9

Q & A