For Providers
© Copyright 2024 – Care N’ Care – All rights reserved. Y0107_24_144_M
Benefits and Eligibility
Follow a manual added link
Availity Provider Portal Login
Benefits & Eligibility Verification
Claims Status & Details
Plan Specific Information
HIPAA Eligibility Transactions
(270/271 Benefits & Eligibility Files): For set up, your IT & clearinghouse must contact Change Healthcare (CNC clearinghouse vendor).
Customer Service
844-806-8216 (M-F 7:30 a.m. – 5:00 p.m.)
Availity Registration
Providers can now register for the new Provider Portal service with Availity at availity.com/provider-portal-registration.
How to get assistance with the Availity Provider Portal?
Availity Provider Portal users, please contact Availity at 1-800-282-4548.
Claims Information
How to verify Claims Status?
- Provider Portal
- Claims Customer Service: 844-806-8216 (M-F 7:30 a.m. – 5:00 p.m.)
Claims Payer ID:
66010
Mailing Address:
Care N’ Care Insurance Company
Attention Claims
P.O. Box 4375
Scranton, PA 18505
Clearinghouse
- Availity: 1-800-282-4548
- Availity Essentials Portal Registration
- Availity Essentials Overview
-
Electronic Payments EFT (Electronic Funds Transfer)
- Enrollment for EFTs is handled by Availity. Providers first need to register for Availity’s portal.
Availity Essentials Portal Registration - Please refer to Availity’s training site for assistance.
Register and Get Started with Availity Essentials – Overview - Be sure to register for electronic remittance advices (ERAs) and enroll for EFTs.
- Providers will need a bank letter or voided check to submit their enrollment for EFTs. This check validation piece also helps with the overall validation process.
- Only providers enrolled with Availity for EFTs will be able to receive electronic payments from Care N’ Care.
Electronic Remittance Advices (ERA’s)
- Availity: 1-800-282-4548
- Availity Essentials Portal Registration
How to send a refund check payable to Care N’ Care?
Please send a letter on company letterhead informing Care N’ Care of the refund to include:
- Name of Provider, TIN, NPI
- Name of Member and ID number
- DOS
- Claims number
- Amount
Mailing Address:
Care N’ Care Insurance Co Inc
P.O. Box 674534
Dallas, TX 75267-4534
How to return a check in error?
Please send a letter on company letterhead informing Care N’ Care of the refund to include:
- Name of Provider, TIN, NPI
- Check number, check date and amount
Mailing Address:
Care N’ Care Insurance Company
Attention Claims
P.O. Box 4375
Scranton, PA 18505
In-Network (INN) Disputes
Providers have 60 days from the date of notification of the claims decision to file a written dispute to Care N’ Care to include:
- A written dispute request on company letterhead
- Copy of the original claim form
- Copy of remittance notification of denial
Note: In-Network Disputes do not require medical records or supporting documentation to be included along with your dispute. If it’s determined after reviewing your filed dispute, medical records or supporting documentation is needed then Care N’ Care will contact you with this request.
Mailing Address:
Care N’ Care Insurance Company
Attention Appeals & Grievances Department
1603 Lyndon B. Johnson Freeway, Suite 300
Farmers Branch, TX 75234
Out-of-Network (OON) for Non-Contracted Provider Appeals
Providers have 65 days from the date of notification of the claims decision to file a written dispute to Care N’ Care to include:
- A written appeal request on company letterhead
- Copy of the original claim form
- Copy of remittance notification showing the claim in question
- A signed Waiver of Liability Form, promising to hold the member harmless regardless of the outcomes as required by the Centers for Medicare and Medicaid Services (CMS).
Note: In-Network Appeals do not require medical records or supporting documentation to be included along with your appeal. If it’s determined after reviewing your filed appeal, medical records or supporting documentation is needed then Care N’ Care will contact you with this request.
OON Appeals may be faxed or mailed to Appeals & Grievances Department:
- Fax: 817-810-5214 (Attention to: Appeals & Grievances Department)
Mailing Address: - Care N’ Care Insurance Company
Attention Appeals & Grievances Department
1603 Lyndon B. Johnson Freeway, Suite 300
Farmers Branch, TX 75234
How to obtain Out-of-Network (OON) Appeal status?
- To receive status on your filed Out-of-Network Appeal, fill out the Out-of-Network Appeal Status form.
- Fax to A&G to 817-810-5214
