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QualChoice Health Insurance  ♦  January 5, 2017

Individual Metallic Plan Members Must Have PCP

As of January 1, 2017, QualChoice individual metallic plan (Bronze, Silver, Gold, Platinum and Catastrophic) members, as well as those with insurance through HealthCare.gov or Arkansas Works, are in the Select network and are required to choose a PCP. These members may be identified by their unique QualChoice ID card:

Rosters of newly assigned members will be available through My Account* under the Provider Reports tab. Learn more.

Specialists filing claims for members of individual metallic plans will be required to submit the referring PCP’s name and NPI # when billing for services with POS codes 11, 12, 17, 19, 22 and 24. Submission of the referring PCP name and NPI is NOT required for POS codes 20, 21, 23 and 81.

*If you haven’t registered for the new My Account provider portal, view the step-by-step video here: Using My Account.

For more questions or information, call QualChoice: 501.228.7111 or 800.235.7111
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