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MultiPlan Medicare Advantage Network

MultiPlan’s provider network for access to Medicare Advantage programs
Hospital hallway with female doctor speaking to an elderly female patient in a wheelchair being pushed by a female nurse

Get access to Medicare Advantage programs

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.

Join the network

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

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.

WellCare Health Plans, Inc.

Working with the MultiPlan Medicare Advantage Network

Please promptly inform MultiPlan of any changes to your directory or other information.

  • Click here to update your directory information.
  • Centers for Medicare & Medicaid Services (CMS) requires Medicare Advantage Organizations to maintain information regarding network adequacy and availability. To support this requirement, MultiPlan asks all providers participating in our Medicare Advantage network to inform us of any changes to your provider directory information (e.g., street address, phone number, office hours) and whether you accept new patients.

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.

    • Inquiries regarding payment related issues should be directed to the payer identified on the ID card. It is the payer’s responsibility to ensure that payments are made in compliance with the program.
    • Note that MultiPlan does not process, reprice or pay Medicare Advantage claims. Contact the payer listed on the member ID card for questions regarding claim payment. 

To verify eligibility, contact the payer as indicated on the patient’s Medicare Advantage ID card.

Female nurse or doctor typing on keyboard

Required general compliance and fraud, waste and abuse training

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.

Male doctor with female patient listening to heart with stethoscope

MultiPlan’s code of conduct

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 us

Contact our Government Business Service Center for issues related to your participation in our Medicare Advantage Network, such as:

  • Questions about your participation status
  • Changes to your demographic information
  • Inquires about our credentialing criteria
  • Copies of your provider contract
  • Credentialing application submissions (W-9 required)

 

govtcoordinator@multiplan.com
(Phone) 1-866-971-7427 (Fax) 630-799-3587
MultiPlan, ATTN: GBSC
6116 Shallowford Road Suite109B
Chattanooga, TN 37421

More information

Get more information about MultiPlan’s 

Are you a payor? To learn more about MultiPlan, contact us.

Are you a patient? Please refer to your patient ID card for instructions on where to find program information about your healthcare plan, or visit our member page.