Frequently Asked Questions
When will I receive my provider contract?
The provider contract will be issued once the credentialing process is completed.
If the credentialing and contracting process is not yet completed, will I be able to see members?
No, you must complete the credentialing and contracting process before accepting members.
Who do I call with questions regarding credentialing or contracting status?
Contact your provider relations representative at 1-888-251-2224. Find information about your provider relations representative.
Where can I see my authorization reports?
You may view your authorization report through the Community Care ePortal. Learn more about the ePortal.
What do I do if I have a waiting list and cannot see a member within the required access standards?
Contact the member services line to notify us, and we can assist with locating a provider that can see the member within access standards. You must also notify your Provider Relations Representative immediately in writing.
How do I enter authorizations through the ePortal?
Learn more about Community Care’s ePortal and the authorization codes available for ePortal entry.
How much time will I have to enter Outpatient Registrations for members already in treatment?
Registration should be submitted following the initial outpatient visit; not to exceed 60 days from the initial date of service.
What happens when the member is in treatment with another provider?
Community Care will not reject the second registration, but it will be important for providers to address this from a clinical perspective (i.e., does it make clinical sense for members to be seeking services for the same type of care from more than one provider?).
What happens if I forgot to check Eligibility Verification System (EVS)?
You will not get paid if the member is ineligible with Community Care on the date of service. Providers must check eligibility frequently to ensure that claims can be processed. The registration of a member will remain active even if the member loses eligibility for part of the year and then regains it later. Providers will not need to register members again if eligibility is re-established.
How will I know which other providers are within the network?
Call the Customer Service Line to inquire. Provider directories are available and updated semi-annually.