Commonwealth Care Alliance

Commonwealth Care Alliance

Providers > Provider Resources

Provider Resources

Commonwealth Care Alliance is committed to giving our providers the resources, information, and support they need to provide outstanding care to our members. Below is a list of resources you can access through our website.

In Common: Provider/Partner Newsletter
In Common is a quarterly newsletter designed to give our providers, partners, and colleagues news, insights, and information concerning our unique part of the healthcare world.

Administrative Forms, Lists and Notices
Find here all necessary PDF forms and notices.

Online Provider Training
Sign up for a password and learn more about our Senior Care Options plan.

CMS Provider Directory Requirements
The Centers for Medicare and Medicaid Services (CMS) regulations requirements for provider directories.

ICD-10 Codes Now in Effect
Commonwealth Care Alliance implemented ICD-10 codes October 1, 2015. Transactions with dates of service on or after October 1, 2015 must be submitted with the appropriate ICD-10 diagnosis codes. ICD-9 codes will not be accepted on claims for services on or after October 1, 2015. Learn more about the ICD-10 implementation at Commonwealth Care Alliance or visit the Emdeon and CMS websites.

Health Plan Operations Improvements are Underway
Commonwealth Care Alliance is focused on improving our health plan operations and streamlining business processes to better serve both our members and provider partners.

 

Important Information:

Commonwealth Care Alliance makes prior authorization changes for 2017

Commonwealth Care Alliance has updated the list of services that require prior authorization. For a complete list of services requiring prior authorization please refer to the 2017 Provider Manual . Formulary changes have also been made effective 1/1/17 and can be found in the 2017 Formulary. In addition, Commonwealth Care Alliance has a preferred arrangement with ABBOTT Diabetes Supplies for Glucometer and test strips, which must be obtained through Commonwealth Care Alliance’s pharmacy network.

 

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Last Updated 11/28/2016