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

2. 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

3. My MPC Source HIPAA Compliant Website

4. Prior Authorization Search Tool

11. www.MarylandPhysiciansCare.com 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

12. Member Eligibility Member eligibility can be checked several ways: 1.Call EVS @ 866-710-1447 2.Log onto EVS at:Log onto EVS at: https://encrypt.emdhealthchoice.org/emedicaid/_Portal/ provWelcome.jsp 3.Log on to MPC’s Secure HIPAA compliant web portal at: https://MarylandPhysiciansCare.abovehealt h.com https://MarylandPhysiciansCare.abovehealt h.com

13. 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 61778 Phoenix, AZ 85082-1778

14. 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 800-953-8856 For unscheduled admits fax to: 800-385-4169

15. Contact Information Provider Relations 1-800-953-8854 option 2, option 4 Prior Authorization Monday – Friday 8:00am – 5:00pm 1-800-953-8854, option 2, option 2 1-800-953-8856 (fax) Secure HIPAA Compliant Website Link: https://MarylandPhysiciansCare.abovehealth.com/

16. Contact Information Claims Inquiry 1-800-953-8854 option 2, option 3 Secure HIPAA Compliant Website Link: https://MarylandPhysiciansCare.abovehealth.com/ Appeals Inquiry 1-800-953-8854 option 2, option 7 Fax: 1-866-831-0790 Email: mpc.appeals@marylandphysicianscare.com Basic appeals status should be checked by calling the claims inquiry number listed above

17. Contact Information Claims Resubmission Address: Maryland Physicians Care Attn: Claims Resubmission P.O. Box 61778 Phoenix, AZ 85082-1778 Appeals Address: Maryland Physicians Care Attn: Appeals 509 Progress Dr. Linthicum, MD 21090

18. Contact Information Special Needs Coordinator for Case Management Services 1-800-953-8854 option 2, option 6 HEDIS Coordinator Roger Yates 410-401-9493 – Direct line

19. Questions?