NaphCare’s Provider Portal is a comprehensive, HIPAA-secure online platform designed specifically for healthcare providers working with correctional healthcare services. This digital tool streamlines claims management, offering 24-hour access to critical information and efficient claims processing for medical professionals serving inmates in jails, prisons, and halfway houses.
Official Links
- Website: https://www.naphcare.com/claims
- Provider Portal Login: https://providerportal.naphcare.com/Account/Login
What is the NaphCare Provider Portal?
The Provider Portal is an inclusive digital platform that enables healthcare providers to:
- Check claims status
- Retrieve Electronic Explanation of Payment (EOP) reprints
- Access claims-related information
- Submit and track electronic claims
- Manage direct deposit information
- Dispute or appeal claims
Who Can Use It
Healthcare providers serving patients in correctional settings can access the portal. To enroll, providers must:
- Complete a Provider Portal Access Form
- Provide a valid user-specific email address
- Submit phone number
- Include an authorized signature
- Provide group Tax ID number
- Include applicable National Provider Identifier (NPI) numbers
How to Access
Providers can access the portal by:
- Completing the Provider Portal Access Form
- Emailing the form to [email protected]
- Alternatively, faxing the form to 205.545.9470
Key Features and Services
Claims Submission
- Electronic claims submission via EDI (Payer ID: 58182)
- Accepts CMS-approved forms (1500/UB04)
- Follows Correct Coding Initiative (CCI) edits
Claims Status Tracking
Providers can view claim statuses, including:
- Received/Processing
- Pending Check
- ACH Issuance
- Pending Denial
- Paid
- Denied
Claims Dispute and Appeal
- Online dispute submission
- Ability to attach supporting documentation
- Independent review by appeals department
Direct Deposit
- Encouraged for faster payments
- Avoids lost or delayed checks
- Downloadable form available in the portal
Privacy and Security
The NaphCare Provider Portal is:
- HIPAA-secure
- Requires password updates every 90 days
- Prevents username/password sharing
Customer Support
Support Contact:
- Email: [email protected]
- Claims Inquiries: (205) 536-8457
- Toll Free: (800) 416-0288
Billing and Payment
- Claims paid according to contract rates
- Timely filing based on vendor contracts
- Requires current W9 on file
- Patients are not responsible for co-pays or deductibles
Important Considerations
- Recommended to use inmate ID instead of social security number
- Authorization forms required for non-emergent care
- EOPs are issued weekly and not sent via USPS
Unprovided Information
The following details were not explicitly specified in the source documents:
- Mobile app availability
- Specific portal interface screenshots
- Detailed login process beyond form submission
NaphCare’s Provider Portal offers a secure, efficient platform for healthcare providers in correctional settings to manage claims, streamline billing, and access critical patient information quickly and confidentially.
FAQ
What does NaphCare stand for?McLane sold his family drug store to focus all of his resources on correctional healthcare, changing the company name from Correctional Pharmacy Systems to National Prison Healthcare, now known as NaphCare.
What is the payer ID for NaphCare claims?NaphCare’s National Payer ID is 58182 for electronic submission of claims (through your clearinghouse). You can submit claims and review status through the Provider Portal.
How does NaphCare work?NaphCare partners with hospitals and physicians across the country to provide proactive healthcare to patients in correctional facilities. With our accessible management team and no need for prior authorizations, our physicians can focus on patient care.
Is NaphCare for inmates?NaphCare is the largest provider of healthcare services to the BOP, supporting medical care for approximately 36,000 adults housed in federal prisons across the country.
https://providerportal.naphcare.com/
To access the Provider Portal, you will need to complete the Provider Portal Access Form . Email the completed form to [email protected] or fax to
https://www.naphcare.com/claims
To access the Provider Portal, you will need to complete the Provider Portal Access Form. Email the completed form to [email protected] or via fax to