Provider Alert: Closed Labor Day
In observance of Labor Day, Care N’ Care business offices will be closed on Monday, September 2, 2024. We will resume normal business hours on Tuesday, September 3 .
Availity Provider Portal Login
Benefits & Eligibility Verification
Claims Status & Details
Plan Specific Information
IVR (Automated Service)
844-806-8215
HIPAA Eligibility Transactions
(270/271 Benefits & Eligibility Files): For set up, your IT & clearinghouse must contact Change Healthcare (CNC clearinghouse vendor).
Customer Service
844-806-8216 (M-F 7:30 a.m. – 5:00 p.m.)
Availity Registration
Providers can now register for the new Provider Portal service with Availity at availity.com/provider-portal-registration.
How to get assistance with the Availity Provider Portal?
Availity Provider Portal users, please contact Availity at 1-800-282-4548.
PPO/HMO Plan Comparison
2024 Benefit Highlight Brochure (PPO/HMO): English or Español
Summary of Benefits
2024
Evidence of Coverage
2024
2024
Acuity Connect Portal
Acuity Connect Registration
817-632-3033
Care N’ Care’s Utilization Management, Pre-Authorization and Referrals are coordinated by Southwestern Health Resources (SWHR).
Providers are highly encouraged to utilize the Prior Authorization Code Lookup search tool to verify if specialty drugs, codes and services require an authorization.
Providers can search their network status under Find a Provider.
Pre-Cert Authorization Forms:
Pre-Authorization forms can be faxed to UM Department.
Submit Pre-Authorizations and Referrals:
Providers can call UM & CM Customer Service at 855-359-9999.
How to verify Claims Status?
Claims Payer ID:
Care N’ Care Insurance Company
Attention Claims
P.O. Box 4375
Scranton, PA 18505
Electronic Payments EFT (Electronic Funds Transfer)
Electronic Remittance Advices (ERA’s)
How to send a refund check payable to Care N’ Care?
Please send a letter on company letterhead informing Care N’ Care of the refund to include:
Mailing Address:
Care N’ Care Insurance Co Inc
P.O. Box 674534
Dallas, TX 75267-4534
How to return a check in error?
Please send a letter on company letterhead informing Care N’ Care of the refund to include:
Mailing Address:
Care N’ Care Insurance Company
Attention Claims
P.O. Box 4375
Scranton, PA 18505
In-Network (INN) Disputes
Providers have 60 days from the date of notification of the claims decision to file a written dispute to Care N’ Care to include:
Note: In-Network Disputes do not require medical records or supporting documentation to be included along with your dispute. If it’s determined after reviewing your filed dispute, medical records or supporting documentation is needed then Care N’ Care will contact you with this request.
Mailing Address:
Care N’ Care Insurance Company
Attention Appeals & Grievances Department
1603 Lyndon B. Johnson Freeway, Suite 300
Farmers Branch, TX 75234
Out-of-Network (OON) for Non-Contracted Provider Appeals
Providers have 60 days from the date of notification of the claims decision to file a written dispute to Care N’ Care to include:
Note: In-Network Appeals do not require medical records or supporting documentation to be included along with your appeal. If it’s determined after reviewing your filed appeal, medical records or supporting documentation is needed then Care N’ Care will contact you with this request.
OON Appeals may be faxed or mailed to Appeals & Grievances Department:
How to obtain Out-of-Network (OON) Appeal status?
2024 Terms and Conditions
1603 Lyndon B. Johnson Freeway, Suite 300
Farmers Branch, TX 75234
Company
Plans
Policies & Procedures
© Copyright 2024 – Care N’ Care – All rights reserved. Y0107_24_144_M
Printable FormsAutomatic Bank Draft Form: English or Español
Direct Member Reimbursement Request: English or Español
Vision Out-of-Network Claim Form: English
DentaQuest Dental Out-of-Network Claim Form: English
Disenrollment Form: English or Español
Care N’ Care Insurance Company has an update for our providers regarding the recent cyber security incident impacting Change Healthcare.
Care N’ Care is currently receiving electronic claims through the clearinghouse, Availity.
If providers are interested in signing up with Availity for electronic claims submission, Availity has created the Availity Essentials product to help providers get started.
Providers first need to register for Availity’s portal (see link below).
If providers should have questions, Availity has created a helpful training site related to the registration process (see link below).
Availity has also created Availity Lifeline, a self-service resource for any providers interested in registering on and transacting with Availity Essentials (see link below).
After registering for the portal, the next step will be to register for electronic remittance advices (ERAs) and enroll for electronic funds transfers (EFTs).
Providers will need a bank letter or voided check to submit their enrollment for EFTs. This check validation piece also helps with the overall validation process.
Care N’ Care strongly encourages providers to enroll with Availity for EFTs as only providers enrolled with Availity for EFTs will be able to receive electronic payments from Care N’ Care in the future.
Providers who are not enrolled with Availity for EFTs will receive paper checks as payment for claims.
Care N’ Care intends to maintain both Availity and Change Healthcare as clearinghouses for receipt of electronic claims going forward to increase the resiliency of our claims processing.
Our payer ID number for EDI claims submissions with both clearinghouses remains 66010.
Care N’ Care’s focus is on continuing to service our members and providers as we seek to minimize any disruptions.
We will continue to monitor the situation and provide updates as they become available.
Should you have any questions, please contact our Provider Claims Team at 844-806-8216.
—Last revised 4/10/2024
Call 1-833-492-9866 (TTY:711)
Customer service representatives are available Monday – Friday 7 a.m. – 6 p.m. CST, to assist you.
Please visit athome.medline.com/cnc to place your order.
To download a copy of the OTC Catalog, go to:
llame al 1-833-492-9866 (TTY:711)
Los representantes de servicio al cliente están disponibles de lunes a viernes de 7 a.m. a 6 p.m. CST para ayudarlo.
Visite athome.medline.com/es/cnc para realizar su pedido.
Para descargar una copia del Catálogo OTC, vaya a:
Request Plan MaterialNeed a copy of your plan material? Would you like an electronic copy emailed to you or a printed copy mailed to your home? Complete the form below to let us know and we will make sure you receive as requested!
Find a Hearing ProviderCare N’ Community has partnered with several Tarrant County YMCAs to jointly offer a host of weekly programs designed to increase independence, reduce isolation and encourage healthy living of local-area seniors.
The programs – open to all seniors in the area – vary greatly from week to week, depending on the needs and wants of the participants. Some programs stress physical activity, such as water aerobics; some are strictly social, such as adult coloring classes or organized breakfast and lunch groups; and some are educational, such as safety tips from local police or healthcare tips from local doctors and nurses.
Currently, Care N’ Community offers programming at the following YMCA locations:
Speak to a Local Medicare Guide Today!Call one of our Local Medicare Guides today at 1-800-994-0217 (TTY 711).
They are available 8am to 8pm, CST seven days a week from October 1 – March 31, or 8am to 8pm, CST, Monday through Friday, April 1 – September 30 to help with any questions you may have.
Member PortalCall: 1-877-374-7993 (TTY 711)
October 1 – March 31, 8 am – 8 pm, (CST) seven days a week or April 1 – September 30, 8 am – 8 pm (CST), Monday through Friday.
Mail: Care N’ Care Insurance Company, Inc.
Attn: Customer Experience Team
1603 Lyndon B. Johnson Freeway, Suite 300
Farmers Branch, TX 75234
By Phone: 817-687-4004
Care N’ Share NewsletterMembers automatically receive a copy mailed to your home. If you would prefer to receive electronically and save paper – Sign-up today! Just complete the form below and we will add you to our eNewsletter that is delivered by email, every quarter. It is the same newsletter that is mailed to members homes.
Communication PreferenceIt’s your choice! Email, Text Messages, U.S. Mail or some of each?
In an effort to reduce paper and deliver communication to our members, we offer plan material and communications electronically to our members. If you choose, we will securely send plan materials to your email address instead of your mailbox. It’s easy and will help us reduce our carbon footprint by limiting the materials we print.
The email electronic option does not apply to all mailings sent to you from Care N’ Care. To protect your personal health information, we will continue to send personal health information to you by U.S. Postal Service.
Make your choice by completing the form below or contacting your Customer Experience Team to assist you.
Thank you for your interest in becoming part of the Care N’ Care provider network. Please complete the online contract request form. Provider selection is based on numerous factors.
Pay OnlineMembers may pay their monthly premium online using PayPal. PayPal allows you to make payments using a variety of methods including:
Lost or damaged Care N’ Care member identification card? Complete the online form below to request a replacement card.
To make a change to your primary care physician on your ID card, please contact your Customer Experience Team at 1-877-374-7993 (TTY 711) or email yourteam@cnchealthplan.com
Provider eNewsletter Request to Receive 1099 Form Become a VolunteerPlay a role in the evolution of our growing senior communities while you expand your social circle, refresh those workplace skills you spent so long developing, or just enjoy the satisfaction that comes with being a community volunteer. Volunteers can be of any age! There are a variety of opportunities for volunteers seeking tasks that are detail-oriented, focused, offer flexibility, and critical to the community.
Become a Strategic PartnerOur mission that Care N’ Community, will work hand-in-hand with the areas in which we serve to create an intergenerational support system that fosters and promotes well-being, empowerment and independence for safe and vibrant aging.
Our vision is to engage the community in such a way that we all prosper and do not age alone.
Care N’ Community is looking for strategic partnerships with local businesses and organizations who also have a vested interest in the success of the aging community as well. Care N’ Care is focusing on the link between strong communities, senior involvement, population health and encouraging our communities to become more involved and innovative in their efforts to work in concert. These partnerships offer educational, social and volunteer opportunities for everyone.
Volunteer OpportunitiesTransportation: Every once in a while seniors need a little assistance getting to medical appointments, social or cultural events, worship services, hairdresser or barbers, grocery stores and running errands. There are organizations in our community to assist seniors with these needs. Many seniors need assistance with errands such as grocery shopping, clothing and gift shopping, or picking up prescriptions.
Social Programs: Staying active in retirement is easy. With the senior social programs, there is always something fun and exciting going on in the area. Help host an outing or just attend. Active seniors will have the opportunity to attend outings such as going to lunch, attending fitness classes, cultural events, and entertainment or going to shopping destinations. There’s no one-size-fits all, there are a variety of activities available. Once a week, once a month, first Tuesday of the month whichever the case may be, we love social and like-minded gatherings. From a men’s breakfast group, to lunch bunches, book clubs, coffee groups, happy hours and small group studies there is an opportunity for everyone. Making new friends and escaping the isolation from home is always a treat.
Convenience Task & Handyman Services: Assistance with light yard work, minor household organization and cleaning, pet care, plant care, minor household chores such as hard to reach light bulbs, hang pictures, check smoke alarms, moving outdoor furniture, and simple repairs. Neighbors helping neighbors at home. For home repairs that require a little more work or a skilled tradesman, Care N’ Community can refer seniors to organizations that have pre-screened vendors.
Contact:
Kelli Blackwelder, Community Engagement Manager
Phone: 1-844-656-7667
Email: social@carencommunity.com
Staying active in retirement is easy. With the senior social programs, there is always something fun and exciting going on in the area. Active seniors will have the opportunity to attend outings such as going to lunch, attending fitness classes, cultural events, and entertainment or going to shopping destinations. There’s no one-size-fits all, there are a variety of activities available. Once a week, once a month, first Tuesday of the month whichever the case may be, we love social and like-minded gatherings. From a men’s breakfast group, to lunch bunches, book clubs, coffee groups, happy hours and small group studies there is an opportunity for everyone. Making new friends and escaping the isolation from home is always a treat.
Contact:
Kelli Blackwelder, Community Engagement Manager
Phone: 1-844-656-7667
Email: social@carencommunity.com