As of Jan. 1, 2018, participating providers in a HealthChoices Physical Health Managed Care Organization (MCO) must have a valid Promise Identification number issued by Pennsylvania’s Department of Human Services (DHS) in order to bill for services.
Here’s what to do if you are receiving billing denials from HealthChoices Physical MCOs:
If you have not enrolled or revalidated your status at a Medicaid provider, you will no longer be able to bill a Medicaid MCO for services. Those patients will be reassigned to a new physician.
To verify your service locations and provider or group status, please log on to your Promise account at http://promise.dpw.state.pa.us. Providers are strongly encouraged to verify status and locations as soon as possible.
Pennsylvania Medical Society (PAMED) members with questions also can contact PAMED's Knowledge Center at 855-PAMED4U (855-726-3348) or KnowledgeCenter@pamedsoc.org.
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