Medicare AdvantageDecember 31, 2019
Delegation of functions for Medicare Advantage plans
Category: Medicare
We are pleased to announce that we have expanded certain Anthem Medicare Advantage plans with OptumCare® Network of Connecticut (OptumCare IPA). This includes our CareMore at-home program and our delegation of certain administrative functions for members who select or are assigned an OptumCare IPA PCP.
Our delegation of administrative services shall apply to the following Anthem MediBlueSM plans:
- Anthem MediBlue Plus (HMO)
- Anthem MediBlue Dual Advantage (D-SNP)
- Anthem MediBlue Select (HMO)
Members who have selected a PCP who is part of the OptumCare IPA will be issued new ID cards to reflect the updated information outlined below. Please note: This delegation does not apply to members who select/are assigned PCPs outside of the OptumCare IPA.
Providers who have questions about participation in the OptumCare IPA should call the OptumCare Network Development Department at 860-284-7304.
Effective October 1, 2019, OptumCare IPA was delegated for claims processing services, in addition to the previously communicated administrative functions for Anthem MediBlue Plus (HMO), Anthem MediBlue Dual Advantage (D-SNP) and Anthem MediBlue Select (HMO) members who have selected an OptumCare IPA PCP. Anthem will retain all other services.
Claims submission address
Providers should submit all claims for services provided to OptumCare IPA attributed members to the address or electronic payer ID below. This information also is printed on the back of the member’s ID card. Anthem will continue to pay some services; however, OptumCare IPA will automatically redirect those services to us for processing.
Claims related questions can be directed to OptumCare IPA’s Provider Service number at 888-556-7048.
Paper claims should be submitted to:
OptumCare Network of Connecticut
P.O. Box 2500
Rancho Cucamonga, CA 91729-2500
OptumCare IPA electronic payer ID: E3287
Administrative functions previously delegated — effective July 1, 2018:
- Precertification requests
- Medical management
- Credentialing process for OptumCare IPA providers
If you have any questions, please contact the Medicare Provider Services Unit at
866-673-4157.
PUBLICATIONS: January 2020 Anthem Connecticut Provider News
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