FAQ's - Frequently Asked Questions:
1) How can I contact HCPC healthcare management staff?
2) When can I contact Customer Service?
3) What products & services does HCPC offer?
4)
How do I request permission for a hyperlink?
5)
How do I get sales information about HCPC?
Laboratory
Eye doctor
Mental
Health or Substance Abuse facility
Dermatologist
Pediatrician
Chiropractor
Durable
Medical Equipment (DME) provider
Other specialist
7)
How can I find out if my doctor is in the HCPC network?
8)
What is a " preferred provider"?
9) I am a member, how do I nominate a provider to be part of the HCPC network?
10)
What happens if my doctor terminates in the middle of an episode of care?
11)
Can I go to a non-network provider?
12)
Do I need a referral to see a specialist?
13)
What if a network provider is not available to treat my condition?
14)
What is a primary care physician?
15)
Where can I go for a mammogram?
16)
How do I find a doctor to help with pregnancy
17)
Where can I go for an ultrasound?
18)
Are there dentists in the HCPC Network
19)
Are there pharmacies in the HCPC Network?
20)
I am a client, how do I get a directory?
21)
I am an employee/member, how do I get a network directory?
22)
How do I get more information about my plan or benefits?
23)
Do you cover emergency care?
24)
I am a patient/member, how do I get an ID card?
25)
How do I obtain a list of pharmacies?
26)
How do I appeal the way a claim was paid or denied?
27)
What do I do if I need care while traveling?
28)
I am a patient/member, how do I change my name or address?
29)
I am leaving my provider group, but want to retain my membership with HCPC
30)
We are a facility of service, how do we apply to be part of the network?
31)
I am a provider of service, how do I apply to be part of the network?
32)
How can I obtain a provider fee schedule?
33)
How are patients directed to participating providers?
34)
I am a provider, how do I get a directory?
35)
Does HCPC consider itself a Covered Entity or Business Associate?
36)
Will HCPC require authorization from individuals before using / disclosing?
37)
Will HCPC and its clients be able to accept electronic claims transmissions?
38)
Does HCPC expect to meet the HIPAA compliance deadlines?
40)
Does HCPC have a corporate HIPAA compliance committee?
1) On this site
there is a heading labeled "Contact Us". From there you can send an
email to the appropriate department. If you are not sure which department to
send it too, send it to the e-mail marked 'General'
2) Customer Service
is available from 8 a.m. to 4:30 p.m. Monday through Friday at (800) 427-9005
3) In addition to
the HCPC preferred provider network, precertification, utilization review, and
case management services are provided. In addition, HCPC offers a fraud and
abuse program, and two prescription drug programs. Information on each of these
products may be found on this site under ‘Products and Services’.
4) In the ‘Contact
Us’ section of this site, you can contact the Sales Department for additional
information.
5) In the ‘Contact
Us’ section of this site, you can contact the Sales Department for additional
information.
6) Under the 'Find a Doctor or Hospital' section of this site, you can enter the physician specialty needed. For example enter Ophthalmologist and a list of Ophthalmologists will be shown. The same can be done for other specialties of interest. For non-physician vendors, such as durable medical equipment, they will be listed under Ancillary Providers.
7) Under ‘Find a
Doctor or Hospital' section of this site, you can enter your doctor’s name to
determine if he or she is in the HCPC network.
8) A preferred
provider is one who is a member of the HCPC network.
9) Under the
section of this site ‘For Employees and Plan Members’, there is an
application form in which you may nominate your doctor for membership in the
network.
10) HCPC provider
contracts require doctors to continue care for existing patients for a period
of at least 90 days after the provider leaves the network.
11) Please contact
the plan administrator or your benefits department for specific benefit plan
information.
12) Please contact
your plans administrator or your benefits department regarding benefits for
specialists and the need for referral.
13) Please contact
your plans administrator or your benefits department regarding benefits for out
of network provider.
14) A primary care
physician is your family practitioner, pediatrician, internist or gynecologist. Please
contact the plan administrator or your benefits department for specific benefit
plan information regarding any need to select a PCP.
15) Under 'Find a
Doctor or Hospital' section of this site, you will able to search the HCPC
network under Ancillary Providers for a Mammogram facility.
16) Under 'Find a
Doctor or Hospital' section of this site, you can enter the specialty OB/GYN and
a list of doctors will be shown. You can also contact HCPC’s Provider
Relations Department (800) 427-9005 and someone will assist you in making a
selection.
17) Under 'Find a
Doctor or Hospital' section of this site, you will able to search the HCPC
network under Ancillary Providers for an Ultrasound facility.
18) The HCPC
network does not include dentists.
19)HCPC provides
several pharmacy network programs. You should contact your plan administrator or
benefits department to determine if your plan makes use of these networks.
20) Under 'Contact
Us' section of this site, you can send a request to our Sales Department for
copies of our directory - or call us at (800) 427-9005.
21) Copies of the
HCPC directory are available from your plan administrator or your benefit
department.
22)
Please contact your plan administrator or
benefits manager for specific plan benefits.
23) Please contact
your administrator or benefits department for specific plan information
regarding emergency care
24) Please contact
your plan administrator of benefits department for information on how to obtain
an ID card
25) HCPC provides
several pharmacy network programs. You should contact your plan administrator or
benefits department to determine if your plan makes use of these networks and
how to get a list of pharmacies.
26) Please contact
your plan administrator or benefits manager to obtain details on how to appeal a
claim.
27) Please contact
your plan administrator of benefits department for information on obtaining
benefits while traveling
28) Please contact
you administrator or benefits department for specific plan information regarding
address changes.
29) Under the
'For Providers' section of this site, please follow the instructions to submit
your new information.
30) Under the 'Contact Us' section of this site, you can send a request to the Provider Relations Department.
31)
A copy of the HCPC membership application can be obtained
at the ‘For Providers’ location.
32) Under the
'Contact Us' section of this site, you can send a request for a sample fee
schedule to the Provider
Relations Department.
33) Patients are
directed to participating providers through the member’s use of the network
directory. Patients may also contact HCPC directly to obtain a
list of appropriate doctors or facilities.
34) Under the
'Contact Us' section of this site, you can send a request for a directory to our Provider
Relations Department.
35)
HCPC
considers itself a Business Associate, however it has measures in place to
support the requirements of a Covered Entity.
36)
There may be circumstances where HCPC may require authorization from the patient
in accordance with HIPAA regulations to perform healthcare related activities.
37) HCPC can accept
electronic transmissions.
38) HCPC has met
its required HIPAA compliance deadlines
39) HCPC has in
fact completed its HIPAA employee training and has an ongoing employee manual directed
to the requirements and obligations under HIPAA.
40) Yes, HCPC has a
HIPAA compliance committee that addresses HIPAA requirements and obligations.