Meet Vicki Tantillo, CCA’s Director of Provider Services. Vicki is responsible for the team that serves as a single point of contact for questions, problem-solving, and access to care, for our valued provider network on behalf of the individuals we mutually serve. Here she offers tips for getting the answers to providers’ questions as quickly as possible.
Q: Vicki, your teams talk to CCA’s providers all day long. What have you learned and what can you share?
A: We love talking to our providers, but there are situations where they can avoid having to call us altogether! We can also help providers navigate our Interactive Voice Response (IVR) so that – when they do need to call – they get to the right spot faster.
Q: If a provider calls in to CCA Provider Services, what should they come prepared with?
A: To assist a provider more efficiently, they should have the following information ready:
- Facility or Group name
- National Provider Identifier (NPI) number
- Member information (name, date of birth, member ID number)
- Prior Authorization number
- CPT code for the service in question
- Claim number in question
Q: Are there ways we can help save our providers’ time and get what they need faster?
A: Absolutely. We value our providers’ assistance in serving our members and we understand the importance of their time. So, I’d like to share a list of online portals and a list of the things these platforms can help with, to get our providers what they need without having to call CCA Provider Services:
Commonwealth Care Alliance Provider Portal | View patient information View member eligibility View and search authorizations Search remittance advice Submit provider information forms Secure messaging |
Availity | Submit claims Check claim status Check member eligibility and benefits |
Payspan | 835 Claim Payment Advice / Electronic Funds Transfer (EFT) Access the explanation of payment / paper check Payment processing status |
Q: You mentioned tips for navigating our IVR system, if providers do need to call us?
A: If our portal tools don’t answer provider’s questions, they can call 1-866-420-9332 for support options. Here’s a quick guide to help providers select what they need from the menu efficiently:
Option 1 | Payment assistance with connection to Payspan. |
Option 2 | Check on a member’s eligibility Find a member’s CCA identification number |
Option 3 | Speak with a representative to assist with items such as: Member eligibility Member benefits Claim support Authorization inquiries and guidance Provider participation information Pharmacy related inquiries |
Option 4 | Speak with a member of our Care Partner Team |
Option 5 | Request a behavioral health authorization |
Option 6 | Report an inpatient facility admission |
Option 7 | Assistance with Durable Medical Equipment |
Option 8 | Speak with a representative for Pharmacy related questions |
Option 9 | Speak with a representative for all other inquiries, including authorizations |
Option 0 | To hear the menu choices again |