PROVIDERS

ADVANTAGE Care Select is committed to the provision of high quality, cost-effective, outcomes-oriented care to our members. We realize that the successful pursuit of these goals requires the active participation of a committed provider network.

ADVANTAGE Care Select provider responsibilities include, but are not limited to, the following:

• Verifying member eligibility on the date of service
• Referring members to participating network providers and facilities
• Abiding by ADVANTAGE Care Select policies for prior authorization:
     Prior Authorization Bulletin
     Prior Authorization Forms
• Prescribing pharmaceuticals from the Indiana Care Select Preferred Drug List
• Notifying us upon receipt of an NPI
• Notifying us in advance of any changes in address, phone number, etc.
• Notifying us in advance of any provider additions or terminations
• Not balance billing members

ADVANTAGE Care Select welcomes your participation in the Care Select Program.  In order to enroll as an ADVANTAGE Care Select Provider please complete the following forms and return all to :

• Care Select Addendum
• Managed Care PMP Enrollment Form
• ADVANTAGE Care Select Provider Demographic Form
• Covering Physician Form
• Attestation and Authorization Form

All forms should be returned to:

ADVANTAGE Health Solutions, Inc.
Attn: Care Select, Katie Tucker
9045 River Road, Suite 200
Indianapolis, IN  46240