FAQs

CareConnect was created by one of the largest health systems in the country, so we are aware of all the challenges you face in serving your patients and managing your practice. Our unique approach to provider relations includes integrating care delivery to make things easier for you, your staff and your patients. That's why we call CareConnect healthier insurance.

For a complete list, please view our Preauthorization Requirements.

You can submit claims electronically or by mail. For electronic submissions, we use the Change Healthcare Clearinghouse. Our Payer ID Number — 46227 — should be included on all submissions. For paper submissions, claims should be billed on standard CMS-1500 (professional) or UB-04 (facility) forms and mailed to:

CareConnect
Attn: Claims Department
P.O. Box 830259
Birmingham, AL 35283-0259

Claims must be submitted within 120 days of the date of service for prompt adjudication and payment, unless otherwise noted in your provider agreement.

You can check member eligibility and claims status in one of two ways—by logging in to the Provider Portal or by using our new automated phone service. Just call 855-706-7545 and press 2 to get the information you need within minutes. 

You can update your information — such as address, group name, hospital affiliation and languages spoken — by completing the Provider Information Change Form. Please email completed form with additional documentation to providerupdates@careconnect.com.

For our current formulary, please visit CareConnect.com/prescription-drugs.

To find the most recent copy of our Provider Manual, view our Provider Manual.

If a provider in your group practice would like to be added to the network, email us at providerinquiry@careconnect.com with the subject line “Add a provider.” Include a contact name and phone number or email address, the name and address of your group practice, practice TIN and the name of the provider you would like to add to the network. A network services representative will contact you.

You can initiate the appeals process by contacting a Customer Service Connector at 855-706-7545 and asking for the Grievance & Appeals Unit. If you prefer, appeals may be faxed to 844-447-2525, emailed to careconnectappeals@careconnect.com, or mailed to:

CareConnect
Attn: Grievances & Appeals Unit
2200 Northern Blvd, Suite 104
East Hills, NY 11548

Appeals must be received within 180 calendar days of the denial.

We offer Disease Management programs for patients with Diabetes or Asthma. To refer a patient, simply call a Customer Service Connector at 855-706-7545 and ask to speak to Medical Management.

Our Physician Advisory Group consists of physician leaders from the CareConnect network. The Advisory Group meets on a quarterly basis to receive business updates, discuss network issues, identify areas for collaboration, and review/approve evidence-based clinical practice guidelines and medical policies.

CareConnect follows evidence-based clinical practice guidelines approved by the Physician Advisory Group. Click here to view all of our clinical practice guidelines