From Oct. 1, 2021 to May 31, 2023, we delegated the medical management of some ConnectiCare Medicare Advantage members to Optum Care. The affected members are assigned/attributed to a PCP who is part of the Optum Care Network of Connecticut IPA; this includes ProHealth Physicians. Medicare Advantage members enrolled in ConnectiCare Dual Special Needs Plans (D-SNPs) are excluded from this delegation.
Here are some frequently asked questions and answers to help you understand this change:
- Which members/plans are followed by Optum Care Network of Connecticut and how do we identify them?
All ConnectiCare Medicare Advantage members (excluding D-SNP) will be managed by Optum Care Network of Connecticut from Oct. 1, 2021 to May 31, 2023. Member ID cards will have the Optum logo on the bottom. See below for sample ID card.
- Are claims submitted to ConnectiCare or Optum Care Network of Connecticut?
All claims should continue to be submitted to ConnectiCare.
- Is ConnectiCare or Optum Care Network of Connecticut responsible for grievances and appeals?
All grievances and appeals will be handled by ConnectiCare and can be sent to Medicare_AppealsandGrievances@connecticare.com.
- Where should providers submit preauthorization requests?
Preauthorization requests from Oct. 1, 2021 to May 31, 2023 can be submitted to Optum Care Network of Connecticut by calling 888-556-7048 or by faxing the request to 855-268-2904.
