CommuniCare Advantage, a provider-owned health plan specializing in Medicare Advantage services, offers a dedicated Provider Portal designed to support healthcare professionals serving multiple populations across Ohio, Maryland, and Indiana. This portal serves as a critical tool for providers participating in Medicare Advantage Prescription Drug (MAPD), Institutional Special Needs Plan (ISNP), and Chronic Condition Special Needs Plan (CSNP) networks.
Official Links
- Website: https://communicare-advantage.com/
- Providers Page: https://communicare-advantage.com/providers/
What Providers Can Do
While specific portal functionalities are not explicitly detailed on the available pages, CommuniCare Advantage emphasizes a collaborative approach to healthcare delivery. Providers can likely expect to:
- Manage patient information
- Submit and track prior authorizations
- Access provider-specific documentation
- Coordinate care for Medicare Advantage members
Who Can Use the Portal
The Provider Portal is designed for:
- Physicians
- Healthcare professionals
- Providers serving in:
- MAPD plans
- ISNP (Institutional Special Needs Plan)
- CSNP (Chronic Condition Special Needs Plan)
Accessing the Portal
For direct portal access or inquiries, providers are encouraged to contact:
- Email: [email protected]
Key Features and Services
CommuniCare Advantage’s provider network offers several unique benefits:
-
Case Management Support
- Coordinated care delivery
- Personalized patient care strategies
-
Reimbursement
- Medicare Fee Schedule reimbursement
- Partnership with local, community-based healthcare leaders
-
Care Coordination Model
- Health risk assessment
- Interdisciplinary care team support
- Individualized care planning
Privacy and Security
While specific portal security details are not provided, CommuniCare Advantage emphasizes:
- Compliance with Medicare regulations
- Commitment to member privacy
- Adherence to healthcare information standards
Available Provider Documents
Providers can access various critical documents through their resources:
- Exception Request Forms
- Prior Authorization Forms
- Part D Coverage Determination Forms
- Provider Manual
- PCP Dismissal Forms
Customer Support
Contact Information:
- Phone: (855) 969-5861
- TTY: 711
- Hours:
- 8:00 a.m. to 8:00 p.m. (7 days a week, October 1st – March 31st)
- 8:00 a.m. to 8:00 p.m. (Monday-Friday, April 1st – September 30th)
Unprovided Information
Details not explicitly confirmed include:
- Exact login process for the Provider Portal
- Comprehensive list of portal features
- Mobile app availability
- Specific security protocols
CommuniCare Advantage’s Provider Portal represents a commitment to collaborative, patient-centered healthcare delivery. Providers interested in joining the network or accessing the portal should contact the provider relations team directly.
Disclaimer: CommuniCare Advantage is an HMO with a Medicare contract. Enrollment depends on contract approval/renewal.
FAQ
Who owns CommuniCare Advantage?Founder and Chairman of the Board Stephen L. Rosedale established the CommuniCare Family of Companies in 1984. As a young man, Steve worked in various healthcare environments and developed a passion for caring.
Who is the largest Medicare Advantage provider?
What is the institutional special needs plan for CommuniCare Advantage?Institutional Special Needs Plans (ISNPs) provide specialized care for those who reside in long-term care facilities. Specifically, they serve Medicare Advantage-eligible individuals who, for 90 days or longer, have had or are expected to need the level of services provided in a long-term care facility.
https://communicare-advantage.com/providers/
Providers · How CCA Can Benefit Providers · Provider Search · Provider Portal · Pharmacy Search · Provider Appeals & Grievances · Resources · Member Resources
https://communicare-advantage.com/
Providers · How CCA Can Benefit Providers · Provider Search · Provider Portal · Pharmacy Search · Provider Appeals & Grievances · Resources · Member Resources