iCare’s purpose is to measurably improve the health of our members. iCare understands that to achieve this, it is essential to build and maintain relationships with high-quality providers.
Provider Portal Provider Applications Credentialing
Self Service Option
Register in our Provider Portal to obtain live Eligibility Status, ID Cards and Authorization information. In addition, all claim processing information is available including the Explanation of Payment. Please send your TIN and NPI to ProviderRelationsSpecialist@icarehealthplan.org so we can generate a PIN to assist with registration.
Electronic Option
270/271 Eligibility Status Check
Use the Eligibility and Benefit Inquiry (270) transaction to inquire about the health care eligibility and benefits associated with a subscriber or dependent. The Eligibility and Benefit Response (271) transaction is used to respond to a request inquiry about the health care eligibility and benefits associated with a subscriber or dependent. You can obtain detailed benefit information including member ID number, date of coverage, copayment, year-to-date deductible amount, and commercial coordination of benefit (COB) information when applicable. Physicians and other health care professionals can perform eligibility (270/271) transactions in batch or real-time mode, based on your connectivity method.
276/277 Claim Status Check
Use the Claim Status Inquiry (276) transaction to inquire about the status of a claim after it has been sent to a payer, whether submitted on paper or electronically. The Claim Status Response (277) transaction is used to respond to a request inquiry about the status of a claim after it has been sent to a payer, whether submitted on paper or electronically. Once we return an acknowledgment that a claim has been accepted, it should be available for query as a claim status search. Physicians and other health care professionals can perform claim status (276/277) transactions in batch or real-time mode, based on your connectivity method.
While claim submission has been affected by the cyberattack on Change Healthcare, there are multiple options to submit claims to iCare.
iCare’s Timely Filing Limit is 120 days from the date of service (DOS) on a CMS 1500 claim form unless otherwise specified in the Provider’s Contract. iCare’s Timely Filing Limit is 120 days from the Thru date on a UB04 claim form unless otherwise specified in the Provider’s Contract
If you have any questions or concerns, please contact ProviderRelationsSpecialist@icarehealthplan.org.
Some tips for registering with the iCare Provider Portal:
CMS released the final rule effective 1/1/2023 which revises Medicare Advantage (MA) Part C programs to implement changes of communications in part, related to Maximum Out of Pocket. The MOOP limit in an MA plan (after which the plan pays 100 percent of MA costs) is calculated based on the accrual of all Medicare cost-sharing in the plan benefit, whether that Medicare cost-sharing is paid by the beneficiary, Medicaid, or other secondary insurance, or remains unpaid. Click to learn more about how this affects iCare Members and Providers.
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iCare welcomes a variety of providers to join our Provider Network to assure the broadest choice of quality providers for iCare Members. As iCare continues to grow, so does our network of providers.
Provider Applications Credentialing Contact Us
iCare strives to improve health outcomes for our members. That’s why we work in conjunction with numerous industry, state and federal programs to measure our results.
Quality Programs
These manuals are a provider’s primary resources to efficiently conduct transactions related to iCare members.
Medicare & Medicaid Manual
FCP Manual
Whether you are already an iCare provider or looking to become one, we make it easy for you to communicate with the people you need to connect with.
Contact Us
Quickly review your listing – or the listings of other physicians, facilities, pharmacies or other contracted providers – using iCare’s Find A Provider tool.
Find a Provider
If you need to update demographics or add/remove providers, please use the applicable form:
Name, Tax ID, Physical or Billing Address Changes:
Demographic Change - Fillable PDF Form
Demographic Change - Web Form
Adding or removing providers associated with a contracted provider group:
Affiliation Change - Fillable PDF Form
Affiliation Change - Web Form
All documentation that providers need to do business with iCare is in one convenient location. Handy filters help you locate forms, applications, policies or whatever you need.
View Provider Documents
Website, Claim and Enrollment Status Check, annual MOC Review
New PO Box for Claims and Review/Reopen, Home Health Care Services EVV Soft Launch, Prior Auth Changes for 2024
See All News
See All Documents
Leaving iCareHealthPlan.org
By clicking this link, you may be leaving the iCareHealthPlan.org website. Independent Care Health Plan (iCare) only provides these links and pointers for your information and convenience. When you select a link to an outside website, you are leaving the www.iCareHealthPlan.org website.
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