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NetCare Launches New Health Risk Assessment & Wellness Tool

Netcare Opens Health & Wellness Assessment Office

Netcare Health Names New Marketing & Sales Manager

Innoviant Update - June 13, 2008

Pharmacy (PBM) changing from NMHCRX to Innoviant, Inc. effective May 01, 2008

Innoviant-Selected as new Pharmacy Benefits Manager for Netcare

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Electronic Claims Submission

NetCare is committed to the timely and accurate processing of your claims.  We are therefore pleased to offer electronic submission of both medical and dental claims to NetCare.  Providers who submit claims electronically will enjoy quicker responses and cost savings from reduced paper work.  Take advantage of these features and become a trading partner with NetCare.

NetCare has contracted with Interactive Payer Network/Emdeon that serves as our Clearinghouse Provider since 2004.  IPN/Emdeon will handle all the necessary documentation and training and will handle all testing through final implementation with your facility.

We also realize that you may deal directly with your own Clearinghouse Provider to submit claims on your behalf.  In cases such as this, you may have your Clearinghouse Provider contact IPN/Emdeon directly to initiate this process.

Once you have fully implemented electronic submission with NetCare, you will be able to initiate claims tracking of the claims submitted to us.  This process will verify that your claims reached NetCare, including the time it left your office, how many vendors it has passed through and the time it reached NetCare.

We encourage you to explore the possibility to submitting claims electronically for greater efficiency and accuracy. 

NetCare’s Payer Identification Number is: 66055
Interactive Payer Network (IPN)/Emdeon Contact: 

Shawn Reese
Implementation Manager
5910 Landerbrook Drive, Suite 110
Cleveland, Ohio  44124
E-Mail:  sreese@emdeon.com
Phone:  440.720.0700 ext.207
Facsimile:  440.720.0702

NetCare’s Contact for EDI Submission: 

Ed Gozalo
WLT Systems Administrator
424 West O’Brien Drive, Suite 200
Hagatna, Guam  96910
E-Mail:egozalo@netcarelifeandhealth.com
Phone:  671.472.3610, ext 506
Facsimile:  671.472.3615

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Participating Provider Manual
Credentialing Criteria
Utilization Review
Pre-Certification
HIPAA

National Provider Identifier
Need Claim Status
Eligibility Verification
Provider Updates
Prescription Prior Authorization Forms

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