Provider Resource Guides
Please refer to the provider resource guides for important information on who to contact and the self-service tools available to providers.
- Provider resource guide: Senior Care Options & One Care Plan
- Provider Resource Guide: Medicare Advantage Plan
Key Contacts
You can find key resources to support CCA members in our updated Provider Manual, Section 1, “Key Contact Information.” This includes an up-to-date contact list available online.
Massachusetts:
- Senior Care Options / One Care Provider Manual.
- Medicare Advantage Prescription Drug Provider Manual.
Rhode Island:
Claims Submission Information
Please ensure you are utilizing the appropriate billing address and payer IDs by product to minimize reimbursement delays.
1. Medicare Advantage Plan Claims
Please reference the Medicare Advantage (MA) Provider Manual, Section 6, “Claims and Billing Procedures,” for billing guidance, EDI claims information (including payer ID), and billing address.
- Massachusetts: Medicare Advantage Provider Manual
- Rhode Island: Medicare Advantage Provider Manual
Electronic Claims Submissions
- To submit original or corrected claims electronically, providers must submit claims through Change Healthcare Portal or your clearinghouse using the MA payer ID 14316.
Paper Claims, Corrected Claims, and Provider Appeals
- Mail Medicare Advantage plan paper claims (original, corrected, and provider appeals) to the address listed below:
Commonwealth Care Alliance – MA
P.O. Box 3012
Milwaukee, WI 53201-3012
Claim Status
- To check the status of a claim, providers must use the QicLink Benefit Exchange system.
2. Senior Care Options and One Care Plan Claims
Please reference the Senior Care Options / One Care Provider Manual, Section 6, “Claims and Billing Procedures,” for billing guidance, EDI claims information, and billing address.
- Massachusetts: Senior Care Options / One Care Provider Manual
Electronic Claims Submissions
- To submit original or corrected claims electronically, providers must submit claims through EZNet Online Claims Web Portal or your clearinghouse using the SCO/ONC payer ID 14315.
Paper Claims, Corrected Claims and Provider Appeals
- Mail Senior Care Options or One Care paper claims (original, corrected, and provider appeals) to the address listed below:
Commonwealth Care Alliance
P.O. Box 548
Greenland, NH 03840-0548
Claim Status
- To check the status of a claim, providers must use the EZNet Online Claims Web Portal.
Thank you for your continued support and the quality of care you provide to CCA members. If you have any questions, please contact CCA Provider Services at 866-420-9332.