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Frequently Asked Questions

How Can I Become Part of the Maryland Physicians Care Provider Network?

If you are interested in a contract with MPC, please submit a non-binding letter of intent to the MPC Contracting Department.

Mail
Maryland Physicians Care
Attn: Contracting Department
1201 Winterson Road, 4th Floor
Linthicum Heights, MD 21090

E-mail
mpcprovidercontracts@mci-mcmi.com

Fax
410-734-5351

For additional information on the criteria we use to help make contracting decisions, visit Become A Provider.

Where Do I Send My Claims?

View claims and EOPs for free through MPC’s secure web portal.

Electronic Clearinghouse Availity
Payor ID – 76498
Phone: 1-800-Availity

Mail paper claims to:
Maryland Physicians Care
P.O. Box 21099
Eagan, MN 55121

Send resubmissions to the same address — marked “Resubmission” on the claim.

Whom Do I Call With Questions About A Claim Payment or Claim Status?

Contact Provider Services at 1-800-953-8854.

MPC uses InstaMed to provide free Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA). To register, call 866-945-7990 or visit instamed.com/eraeft.

How Do I Obtain A Current Provider Manual, Directory, and/or Preferred Drug List?
As a PCP, How Do I Obtain a Member Panel Listing?

Log into the secure provider portal, and search under Eligibility and PCP Panel Roster for a current member panel listing, or contact your Provider Relations Representative for assistance.

How Do I Find Out Who My Provider Representative Is?

Maryland Physicians Care assigns every network provider a representative. Provider representatives are in regular contact with providers and/or office staff. You can confirm your provider representative’s name and phone number by viewing the territory contact list or calling the Provider Relations Department at 1-800-953-8854.

How Do I Obtain Pharmacy Authorizations From Maryland Physicians Care?

Medication Request Through the Pharmacy Benefit
Print the applicable prior authorization forms for Outpatient Pharmacy Medications Processes and fax to 1-877-251-5896 or contact ESI prior authorization department at 1-800-753-2851.

Medication Request Through the Medical Benefit
Print the applicable New Prior-Authorization Form (PDF) (required form as of 4/1/21) and fax to 1-800-953-8856 or contact Pharmacy prior authorization department at 1-800-953-8854.

How Do I Obtain UM Authorizations From Maryland Physicians Care?

PRE-SERVICE REQUEST

Print the applicable prior authorization form and fax to 1-800-953-8856 or contact the prior authorization department at 1-800-953-8854.

NOTIFICATION OF INPATIENT ADMISSION

Print the applicable prior authorization form and fax to 1-800-385-4169 or contact the prior authorization department at 1-800-953-8854.

How Do I Verify Enrollment of a Patient?

Contact the State of Maryland’s Eligibility Verification System (EVS) at 1-866-710-1447 or contact Member Services at 1-800-953-8854 to verify enrollment.

What Are Services Covered by Maryland Physicians Care?

Please refer to the HealthChoice Benefit Summary page for a brief description of covered benefits. For a complete description of benefits, please refer to the Member Handbook.

How Can Healthchoice Recipients Join Maryland Physicians Care?

Visit the Maryland Health Connection website or call Maryland Health Connection at 1-855-642-8572 for additional information.

Where can I go to determine if a procedure requires preauthorization?

Use the MPC Pre-Authorization tool to see if a prior authorization is needed. It’s quick and easy!

The newest edition of MPC’s Provider Newsletter is now available!

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MPC Members: Sign up for Belong.

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Attention: Similac Powdered Formula Recall

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