Provider Feedback and iCare Response
We understand that iCare and our providers are each much more effective when we work together. That includes listening to providers so we can make working with iCare easy for providers. Here are examples of what we asked, and what we learned.
Provider response: “Claims are not even processed until at least 1 week after receipt. You usually make the 30-day rule.”
iCare response: This question will be revised to state, “Are claims processed within the time frame set forth in your contract.” “Timely” can be subjective. iCare provider contracts state that clean claims will be processed within 30 days, which is standard in the industry.
Provider response: “The application to be a provider was submitted in Nov 2017. We finally got a contract in March 2019. iCare was in the middle of a big project, so we had to wait.”
“I have not had any response to a contracting application that I submitted.”
iCare response: Time frames for processing applications in part depends upon whether the application was complete and accurate when it was submitted, whether additional information needs to be requested from the provider to begin processing, and how promptly the applicant supplies the required information. iCare is required by CMS and DHS to credential all providers prior to contracting. The credentialing process can also take some time, especially if additional information needs to be requested from the applicant or from regulatory agencies. iCare strives to ensure that applications are processed timely, that providers are kept informed of status, and that if additional information is needed it is promptly requested. iCare will continue to monitor its processes and look for opportunities for improvement.
Provider response: “I have done this update, but the changes have not been implemented.”
iCare response: iCare encourages providers to periodically check their information on the Provider Search Tool.
If your information is inaccurate, you can update it from the Update Contract Info page.
iCare has also updated its Provider Directory auditing processes, and audits are done monthly as well as quarterly to ensure accuracy.
Provider Response: “We are not able to view Long term care clients (CLAIMS) on the portal this takes more of our time to have to call you all and deal with you over the phone line. I also would like to be paid by ACH instead of live checks.”
iCare Response: LTC Providers do have access to review their claims on the Provider Portal. If a provider is not able to view the claims, please email email@example.com or for technical assistance. In addition, webinar and training materials are updated regularly and available on our website. iCare is working to implement Electronic Funds Transfer within the near future. Communication will be sent to all of our providers when this function is available. Additional information will be available on our website as well as in our Provider Bulletins.
Provider response: “What is onboarding training?”
iCare response: “Onboarding” is new provider training. This question is only relevant for new providers so it will be removed from the Recredentialed Provider Survey. In addition, the question will be re-worded to state: "Did you find the new provider training helpful?"
Provider response: “I will review this information.”
iCare response: Provider education webinars are frequently updated and added to our website, so be sure to check for new content regularly.
Provider Response: “They are not always accurate. We do have to make phone calls at least 6 times per month if not more.”
iCare Response: Please contact your Provider Relations Rep for assistance in resolving claim processing issues or email firstname.lastname@example.org. In addition, webinar and training materials are updated regularly and available on our website.
Provider Response: “We were signed up for Direct Deposit in 2018. In January of 2019 it stopped. Once the dept was notified, the representative stated they never offered Direct Deposit for payment. The situation never got resolved.”
iCare Response: Electronic Funds Transfer capabilities are not yet available with iCare. iCare is working to implement Electronic Funds Transfer within the near future. Communication will be sent to all of our providers when this function is available. Additional information will be available on our website as well as in our Provider Bulletins.
How do you as a provider want to be notified of upcoming changes, i.e. provider forums, email blasts, other? Please provide any responses to this question to QI@icarehealthplan.org
What types of provider webinars would you be interested in seeing? Please provide any responses to this question to QI@icarehealthplan.org
In addition to the required topics for the monthly provider bulletin, what else would you like to see in there? Please provide any responses to this question to QI@icarehealthplan.org
Are you interested in participating as a member on one or more of iCare’s Quality Committees, Stakeholder Planning Advisory Committee (SPAC), Grievances and Appeals Committee, Credentials Review Committee (CRC)? If so, we will need your contact information in order to get in touch with you to further discuss your participation. Please provide any responses to this question to QI@icarehealthplan.org
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