Tools & Resources

Check Eligibility Verification

Contact Provider Customer Service to assist with verifying member benefits and eligibility.

Benefits & Eligibility – 844-806-8218
2020 Benefits & Eligibility Provider self-serve IVR – 844-806-8215

Pre-Authorization & UM Referral Submissions

Care N’ Care’s Utilization Management and Pre-Authorizations are coordinated by SilverBack Care Management.

For In-Network Provider referrals and pre-authorizations.

How to Submit Pre-Authorization Requests:

Fax 888-965-1964
Acuity Connect Web Portal
- PPO health plan referrals serve as a courtesy notification. They are not requested for PPO plans, but encouraged to help better manage the patients healthcare.
- HMO plans require referrals
- PPO and HMO plans are required to submit pre-certifications and must be submitted prior to date of service.

How to Register for Acuity Connect Web Portal (Pre-Authorization Web Portal)

Contact 844-632-2095
Acuity Link

Pre-Authorization Requests

Please note that Silverback Care Management no longer processes retro requests after services have already been rendered. Silverback Care Management requires a referral or preauth prior to seeing the patient or rendering services. Therefore, please submit this request through Silverback TPA. If you have any questions for Silverback Care Management, please contact our call center at (855) 359-9999.

Claims Information

Claims Status & Inquiries

Provider Customer Service: 844-806-8216

New Claims Payer ID: 66010

New Mailing Address:

Care N’ Care Claims
P.O. Box 4375
Scranton, PA 18505

Clearinghouse

Change Healthcare: 866-506-2830

Change Healthcare Website: Click Here

EFT (Electronic Funds Transfer) Enrollment

Change Healthcare: 866-506-2830 (option 2)

EFT Enrollment Registration: Click Here

Change Healthcare EFT Website: Click Here

*Must enroll for ERA’s in order to receive EFT at Change Healthcare

ERA’s (Electronic Remittance Advice) Enrollment

Change Healthcare: 866-506-2830 (option 4)

Change Healthcare ERA Website: Click Here

New Care N’ Care Member ID Cards & ID Numbers

In the month of May, members will receive their new Care N’ Care member ID cards to include a new member ID number. Providers are encouraged to verify benefits & eligibility. If need to, providers can bill with the old member ID number to submit claims until the new ID number is obtained.

How to send a refund check payable to Care N’ Care?

Care N’ Care Finance
1701 River Run, Suite 402
Fort Worth, TX 76107

How to return a check in error?

Care N’ Care Claims
P.O. Box 4375
Scranton, PA 18505

In-Network Disputes

Providers can contact Provider Customer Service at 844-806-8216.

Second level, submit in writing to Care N’ Care:

A dispute request on your company letterhead
Copy of original claim form
Remittance notification of denial
Clinical/supporting documentation that supports the providers reason for reimbursement
Mailing Address: Care N’ Care Provider Claims Disputes

1701 River Run, Suite 402
Fort Worth, TX 76107

Out-of-Network Appeals

Providers can contact Provider Customer Service at 844-806-8216.

Second level, submit in writing to Care N’ Care:

An appeal request on your company letterhead
Copy of the original claim form
Remittance notification of denial
Clinical records or other documentation that supports the providers reason for reimbursement
A completed Waiver of Liability Form
Mailing Address: Care N’ Care Appeals & Grievances

1701 River Run, Suite 402
Fort Worth, TX 76107

Fax: 817-810-5214 (Attention: Appeals & Grievances)

FAQ’s – New Claims Process

Alerts

CMS New Medicare ID Cards

Forms

Tools

RAF Presentations

Frequently Asked Questions (FAQ’s)

How do I submit a claim?

Claims can be sent electronically or by mail to:

Electronically
Payer ID: 66010

Claims Mailing Address:

Care N’ Care Claims

P.O. Box 4375

Scranton, PA 18505

How do I check claims status?

Contact Provider Customer Service to assist with checking a claims status.

Phone: 844-806-8216

How do I submit a change in my demographic information? (Address, NPI, TIN, etc.)

Providers may submit any updates or changes by filing out the Provider Update Online Form.

What is the phone number and fax number for Pre-Authorization Department?

Phone: 855-359-9999
Fax: 888-965-1964

How do I verify benefits and eligibility?

Contact Provider Customer Service to assist with verifying member benefits and eligibility.

Benefits & Eligibility – 844-806-8218

How do I check if we are a contracted provider?

Network status can be viewed on our online provider directory at our website at

https://www.cnchealthplan.com/search/

The Member ID card has a separate phone number for Dental, Vision, and Hearing. Is that the number I call for those benefits?

The phone number on the ID card is for Members who have the supplemental combination rider, which is for dental, vision, and hearing OR for Members who have the supplemental dental rider only. If they did not enroll for either supplemental rider, call the benefits and eligibility line.

Who do I contact if I have questions about my contract or need a copy of my contract?

Contact your Provider Concierge for assistance.

Phone: 817-687-4004
Email: providerconcierge@cnchealthplan.com

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