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Medicare Advantage Organizations that administer these programs use our network in defined geographic areas to supplement their own networks to provide greater access to quality affordable healthcare for their members. Note that MultiPlan does not process, reprice or pay Medicare Advantage claims.
This application request applies to participation in the MultiPlan Medicare Advantage Network only. You may already participate in one or more of our PPO networks (e.g., PHCS, MultiPlan, HealthEOS, etc.) that serve privately-funded health plans, which are covered by a separate agreement.
Our Medicare Advantage clients have been approved by the Centers for Medicare and Medicaid Services (CMS) to administer Medicare Advantage programs in defined geographical areas. These clients manage all aspects of the plan including claim processing and payment. Note that MultiPlan does not process, reprice or pay Medicare Advantage claims.
Please promptly inform MultiPlan of any changes to your directory or other information.
The Medicare Advantage ID card identifies the Medicare Advantage Organization and plan and may contain the MultiPlan Medicare Advantage (or Beech Street Network) logo. The MultiPlan network accessed by the Medicare Advantage Organization may be referenced in the claim reimbursement documentation.
Submit claims as indicated on the member’s Medicare Advantage ID card.
To verify eligibility, contact the payer as indicated on the patient’s Medicare Advantage ID card.
The Centers for Medicare & Medicaid Services (CMS) and your MultiPlan Medicare Advantage Network provider agreement mandate all those contracted to provide health care services to Medicare Advantage beneficiaries must complete the applicable Medicare Advantage program compliance trainings.
MultiPlan’s Code of Business Conduct and Ethics contains the legal and ethical standards of conduct required of all parties with which MultiPlan contracts. We expect all providers participating with MultiPlan to comply with our Code in every aspect of their business conduct.
Contact our Government Business Service Center for issues related to your participation in our Medicare Advantage Network, such as: