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It is important for ConnectiCare to keep our provider network information current. Up to date provider information allows ConnectiCare to accurately generate provider directories, process claims, and communicate with our network of providers. Send changes by email to cci-providerfileoperations@molinahealthcare.com. Organizations delegated for credentialing must include a roster profile. The roster template can be found in the Provider Network Management Portal under the Roster Upload tab.
Visit our Provider Online Directory at least quarterly to validate your information for correctness and completeness. Providers must notify ConnectiCare in writing at least 30 days in advance, when possible, of changes, such as:
Providers must ensure ConnectiCare has accurate practice and business information. Accurate information allows us to better support and serve our members and providers.
Maintaining an accurate and current Provider Directory is a state and federal regulatory requirement and a National Committee for Quality Assurance (NCQA) requirement. Invalid information can negatively impact members’ access to care, member/primary care provider (PCP) assignments and referrals. Additionally, current information is critical for timely and accurate claims processing. Providers must validate their information on file with ConnectiCare at least once every ninety (90) days for correctness and completeness. Failure to do so may result in your REMOVAL from the ConnectiCare Provider Directory.
Provider information that must be validated includes, but is not limited to:
The information above must be provided as follows:
Additionally, in accordance with the terms specified in your Provider Agreement, providers must notify ConnectiCare of any changes, as soon as possible, but at a minimum thirty (30) calendar days in advance, of any changes in any provider information on file with ConnectiCare. Changes include, but are not limited to:
Your National Provider Identifier (NPI) data in the National Plan & Provider Enumeration System (NPPES) must be reviewed to ensure accurate provider data. Providers are legally required to keep their NPPES data current. When reviewing your provider data in NPPES, please update any inaccurate information in modifiable fields, including provider name, mailing address, telephone and fax numbers, and specialty. You should also include all addresses where you practice and actively see patients and where a patient can call and make an appointment. Do not include addresses where you could see a patient but do not actively practice. Please remove any practice locations that are no longer in use. Once you update your information, you must confirm it is accurate by certifying it in NPPES. Remember, NPPES has no bearing on billing Medicare fee-for-service. If you have any questions about NPPES, you may reference NPPES help at NPPES.cms.hhs.gov.
ConnectiCare provider manuals are customarily updated annually but may be updated more frequently as needed. Visit 2026 Marketplace Provider Manual and 2026 Medicare Provider Manual to access the most current provider manuals.
ConnectiCare has adopted Molina’s clinical policies (MCPs). Providers, medical directors and internal reviewers use these policies to determine medical necessity. The Molina Clinical Policy Committee (MCPC) reviews MCPs annually and approves them bimonthly.
Our health plan members speak many different languages. As of late 2025, most language translation requests for Medicare members were for Spanish, accounting for 83% of the total. This was followed by 3% for Chinese Dialects, 2% each for Portuguese, Arabic, and Ukrainian, and 1% each for Russian, Vietnamese, Haitian Creole, Korean, and Albanian. Among Marketplace members, 79% of the language translation requests were for Spanish, followed by 7% for Polish, 4% for Portuguese, 3% each for Chinese Dialects, 2% each for Italian, and Russian, 1% each for Haitian Creole, and Gujarati, and 0.3% each for Bengali, and Albanian. If you need assistance addressing the language needs of your patients, please contact ConnectiCare Provider Services at (800) 828-3407 from 8 a.m. to 6 p.m., Monday through Friday We also provide resources for providers.
Let’s partner to achieve health equity! Training modules and resources on cultural competency are available to review when communicating with and serving diverse patient populations. This information helps you and your staff understand and address disparities to improve health care and patient outcomes. Our provider partners are important to us, and assisting you is one of our highest priorities. We look forward to supporting your efforts, so all members have the same opportunity to attain their highest level of health.
We are committed to improving health equity as a culturally competent organization. We support and adhere to the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care established by the Office of Minority Health. We also comply with regulatory and accreditation standards focused on health equity.
Building culturally competent health care: resources for providers and staff
Cultural competency can positively impact a patient’s health care experiences and outcomes. Cultural competency training modules and resources are available to providers and office staff. You can access the resources through Availity Essentials Provider Portal. Once you are logged into Availity, navigate to ConnectiCare under Payer Spaces, then select the Resources tab. Select Culturally and Linguistically Appropriate Services Provider Training Resources and Links.
Cultural competency education resources include:
These resources provide helpful tips and recommendations for effectively supporting diverse subpopulations and communities that may experience unique challenges or barriers to accessing health care.
Training modules last five to ten minutes. Depending on the topic of interest, you may participate in all or just one module. Upon completing the training, please submit the provider attestation form available through Availity Essentials. Please contact your Provider Relations Representative if you have any questions.
ConnectiCare is required to offer training annually to our providers regarding Cultural Competency, access to language services and available resources for our members. Upon completing the training, please complete the Culturally and Linguistically Appropriate Services Training Attestation. The attestation is completed through an online electronic form.
Note: Providers have the option to utilize their own CLAS training that meets the National Standards for CLAS in Health and Health Care.
ConnectiCare’s language access services
Language access services ensure mutual understanding of illness and treatment, increase patient satisfaction and improve health care quality for patients who speak a language other than English. ConnectiCare ensures effective communication with members by providing language access services. Providing language access services is a legal requirement for health care systems that receive federal funds. A member cannot be refused services due to language needs. ConnectiCare provides the following services directly to members at no cost, when needed:
ConnectiCare members and providers are instructed to call Member and Provider Services to schedule interpreter services or to connect to a telephonic interpreter.
ConnectiCare‘s materials are always written simply in plain language and at required reading levels.
You can access resources and materials on cultural competency, disability-related services, and language access services by logging in to the Availity Essentials Provider Portal. After logging in, navigate to ConnectiCare under Payer Spaces, then select the Resources tab to view the available resources.
For additional information on ConnectiCare’s language access services or cultural competency resources, contact your Provider Services Representative or visit connecticare.com.
In alignment with requirements from the Centers for Medicaid & Medicare Services (CMS), ConnectiCare requires PCPs and key high-volume specialists, including cardiology, oncology/hematology, and pain management to receive training about ConnectiCare’s Special Needs Plans (SNP) Model of Care (MOC). The SNP MOC is the plan for delivering coordinated care and care management to members with special needs. Per CMS requirements, managed care organizations (MCOs) are responsible for conducting their own MOC training, which means multiple insurers may ask you to complete separate training. Visit SNP MOC Provider Training for training materials and attestation forms. The completion date for this year’s training is December 31, 2028. If you have any additional questions, please contact ConnectiCare Provider Services representative at (800) 828-3407.
The Health Outcomes Survey (HOS) will be distributed to select patients soon. This survey captures patient-reported information on both physical and mental health status and plays a critical role in evaluating care outcomes over time. Why It Matters: How You Can Help: Explain that patients’ survey responses directly influence how care is delivered at both the individual and population level. Their feedback helps identify gaps and allows care teams to adjust treatment approaches and prioritize resources in areas such as risk of falling, urinary incontinence, physical activity, emotional and physical health, pain management and access to services. Even brief encouragement from a trusted provider can significantly increase participation rates and the quality of insights gathered. Thank you for your partnership in improving patient outcomes and experience.
Pain should not be viewed as an inevitable part of aging—it is a clinical signal that warrants attention. When patients report ongoing discomfort, it presents an important opportunity for assessment and intervention. Encourage open dialogue about pain during visits, even if time is limited. Brief, focused conversations can uncover underlying issues and support improvements in comfort, mobility, and overall quality of life. Reinforce to patients that effective, evidence-based strategies for pain management are available, and that you can partner with them to identify safe and appropriate options. Consider prompting patients to describe the nature, location and impact of their pain to better guide evaluation and treatment planning. Providing simple tools or guidance on how to communicate their symptoms can enhance the effectiveness of these discussions. Taking a proactive approach helps ensure patients feel heard and supported—and reinforces that maintaining comfort and function is important at every stage of life.
Bladder health is an important component of overall well-being and should be routinely addressed as part of preventive and ongoing care. Urinary incontinence and bladder control issues are common—particularly among older adults—but are often underreported due to stigma or discomfort discussing symptoms. Proactively creating a supportive environment can help normalize these conversations. Encourage patients to share concerns about leakage, urgency, frequency, or nocturia and reassure them that these issues are common and manageable. Why This Matters: How You Can Support Patients: Even brief counseling can empower patients to take the first step toward improved bladder control and overall comfort. Reinforcing that help is available and that these conditions are not just something they must live with can significantly improve engagement and outcomes.
GB Collects is a nationwide debt collection vendor that ConnectiCare has contracted with to collect outstanding debts from providers due to overpaid claims. Once ConnectiCare has made all required notifications of overpayment and attempts to recoup the overpaid amounts, providers will receive notice that the matter is being managed by our Overpaid Claim Collection Vendor, GB Collects.
