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PROVIDER HOTLINE. April 14, 2010 Maryland Department of Health and Mental Hygiene. When to Call the Hotline. Call the Hotline if you have questions about: Services/Benefits; Medications; Pre-authorizations for your patient from their MCO; MCO policies and/or requirements; or

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Presentation Transcript
provider hotline

PROVIDER HOTLINE

April 14, 2010

Maryland Department of Health and Mental Hygiene

when to call the hotline
When to Call the Hotline
  • Call the Hotline if you have questions about:
  • Services/Benefits;
  • Medications;
  • Pre-authorizations for your patient

from their MCO;

  • MCO policies and/or requirements; or
  • Billing issues.
contact information
Contact Information

Ellen Mulcahy-Lehnert (CRU Supervisor)

Email: [email protected]

or

Ann Price (Division Chief)

Email: [email protected]

1-888-767-0013

1-410-767-6859

8:30 AM – 4:30 PM, Monday – Friday

Afterhours – Leave message

how to prepare for a call
How to Prepare for a Call
  • You will be asked to provide the following
  • information when you call the Hotline:
  • Provider name, caller name and relation to

provider;

  • Provider MA #;
  • MCO(s) involved in complaint/question;
how to prepare for a call1
How to Prepare for a Call
  • Detailed information regarding complaint,

including:

    • Description of the complaint, such as billing or denial of treatment
    • services;
    • The names of all relevant persons involved (MCOs, provider, client);
    • Relevant dates, such as treatment dates, when the MCO was
    • contacted, what was said, what follow-up communication has
    • occurred and what is the status of the complaint;
    • If the complaint is in regards to particular member or several
    • members, whether the member(s) is/are in HealthChoice or PAC and
    • their MA numbers; and
    • If the issue involves only one member, has treatment already started
    • or have services been requested for authorization.
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