Commonwealth Care Alliance Massachusetts and CCA Health Rhode Island have transitioned to a new claims vendor, Cognizant, as of April 1, 2023.The following resources and tools will provide guidance for a successful transition to the new claim submission processes.

Electronic Claims Submissions

Electronic submitters can continue to use their existing clearinghouse or use the Availity Essentials Provider Portal. Electronic claims should be submitted using the new payer ID A2793 for all CCA plans.

For more information, please refer to the EDI Companion Guide.

EDI Transactions

837 claim submission;
Real-time eligibility & benefit inquiry (270/271); and
Claim status inquiry (276/277)

Note: For dates of service through March 31, 2023, submit claims for Senior Care Options & One Care Plans to EZNET and Medicare Advantage Plans via Change Healthcare.

Register for Availity Essentials Provider Portal

To register for the Availity Essentials Provider Portal, click on the registration button in the upper right corner and follow the registration instructions. For registration support contact Availity Client Services at 800-Availity (800-282-4548), Monday through Friday, 8 am to 8 pm ET.

Paper Claims Submissions

Paper claims and Provider Appeals must be mailed to the new mailing addresses below:

Paper claims mailing address:
Attn: Claims, P.O. Box 3085, Scranton, PA 18505

Provider payment disputes and appeals mailing address:
Attn: Appeals, P.O. Box 3566, Scranton, PA 18505

Online Provider Resources

Provider Manuals: All updated provider manuals are available at the links below. Refer to Section 1: Key Contacts and Section 6: Claims & Billing Procedures for all detailed changes.

Trainings – CCA provider training recordings held in February and March are accessible at the links below:

Provider Updates: CCA provider website connects you to all the latest updates including FAQ’s at the links below:

Claim Transformation Resource Guide – Reference sheet is available here