Member Eligibility

Each time a member receives services, you should confirm eligibility. To verify eligibility for services, request to see the member's current ID card. New members may use a copy of the enrollment form as a temporary identification card until they receive their ID card.

If you are a primary care physician (PCP), you may also check your most recent Membership by PCP report. This report is sent to all PCPs upon request, and it lists each member who has selected or has been assigned to that PCP. (More information appears later in this section.)

Eligibility & Referral Line
You may also use the ConnectiCare Eligibility and Referral Line. This system requires that you have a touch-tone phone and know your ConnectiCare provider ID number, as well as the member's identification number, to verify eligibility. It is generally available between 7:00 a.m. and 9:30 p.m., Monday through Friday, and from 7:00 a.m. to 2 p.m. on Saturday.

If you don’t know the member's ID number, contact Provider Services during regular business hours to verify eligibility and benefits.

Medavant
Medavant, an online transaction system available to ConnectiCare participating providers, also offers a secure means for entering and verifying referrals.

For additional details on using ConnectiCare's Eligibility & Referral Line or Medavant, refer to Automated & Online Features.