* Search by Provider Type: Please Select Urgent Care Walk In Clinic Delivery System: Any Network MDwise Connect Select Health Behavioral Health We have recently upgraded our portal, so if you bookmarked our site, you may need to update it with the new Product Overview 2. Search jobs. Quality information about individual providers is limited, but can often be found on hospital websites that are listed. You can call MDwise customer service and we can research specific doctors for you. New mdwise careers are added daily on SimplyHired.com. www.in.gov. When are enrolled in Hoosier Healthwise through MDwise, you will have an assigned doctor or primary medical provider (PMP). Provider Search – Search for primary care providers and specialists in your area. member’s program and MDwise delivery system on the MDwise web portal. Manage Your BBB Accreditation. The doctor you choose will be part of a hospital delivery system that serves the county in which the member resides . Company Profile, Contact information, Current and former Employee directory, Corporate history, state/tax IDs. Jul 15, 2010 … MDwise Customer Service makes outbound phone call to new members … Mailed to member on paper plus available on the MDwise web portal. Program * Facility Type Filter your search results to only include facilities of the selected type. Indiana HIP, Hoosier Care Connect and Hoosier Healthwise Members: If you are having difficulties finding a provider with the below link, our customer service team can help you: Anthem 888-291-3762 MDwise 844-231-8310 You can also search IHCP Provider Locator. (PMP Only) coordinating care in partnership with their medical provider(s). If you have questions about the quality of MDwise providers please ask us. Search Provider relations jobs in Indianapolis, IN with company ratings & salaries. Any position that can assist with making me a more knowledgeable CSHCS Search – Search for CSHCS providers in your area. Your PMP can refer you to a specialist if there is a medical reason to do so. • A new Valence provider portal has been created for claims processed by Valence (all claims with date of service January 1, 2017 and forward) • The Valence portal hosts a number of features designed to enhance the user experience Business Profile. The low-stress way to find your next mdwise job opportunity is on SimplyHired. Find Eye Care Doctors (for HIP Plus, HIP State plan and HIP Basic members ages 19–20). MDwise is a non-profit health maintenance organization focused on helping uninsured Indiana families and individuals needing health coverage. Search for experienced certified partners near you. 20 open jobs for Provider relations in Indianapolis. View statements from MDwise 1200 Madison Ave. #400, Indianapolis, IN, 4625 Read the full notice . www.in.gov. When are enrolled in HIP through MDwise, you will have an assigned doctor or primary medical provider (PMP). Revenues are expected to approach $6 billion annually for McLaren Health Care, which is headquartered in Grand Blanc, Michigan, and All of these things drive me to work at my best potential. 10 mdwise jobs available. MDwise Care Select Provider Search. You must see your PMP before he/she can refer you to a specialist. myMDwise By MDwise, Inc. www.in.gov. MDwise will now require a Provider Refund Form be submitted with the refund check. PMP Rules 5. See salaries, compare reviews, easily apply, and get hired. Provider relations: 317-621-7581 Pharmacy: 317-621-7519. MDwise, Inc. 1200 Madison Ave Ste 400. Together, MDwise and McLaren Health Plan will serve more than 620,000 members, making it one of the region's largest provider-sponsored health plans. The doctor you choose will be part of a hospital delivery system that serves the county in which the member resides. MDwise is your local, Indiana-based nonprofit health care company. Use this tab to search for a doctor or specialist in our network. MDwise Provider Directory. Facility Name Filter your search results to only include facilities Find a Microsoft certified solution provider. The State has awarded contracts to Anthem, Managed Health Services (MHS) and MDwise. MDwise is a non-profit health maintenance organization focused on helping uninsured Indiana families and individuals needing health coverage. Log in or create an account to view and maintain your CareFirst CHPDC access. Apply to Customer Relations Representative, Customer Service Representative, Compliance Officer and more! My MDwise Provider Portal. Welcome to the MDwise "Find a Doctor" Online Provider Directory. Select your job title and find out how much you could make at MDwise. TA Ward Region 2 317-983-6137 tward@mdwise.org Michelle Phillips Region 3, Hospice, Home Health 317-983-7819 mphillips@mdwise.org David Hoover Region 5 317-983-7823 dhoover@mdwise.org Tonya Trout Region 6 317 This estimate is based upon 1 MDwise Provider Relations salary report(s) provided by employees or estimated based upon statistical methods. myMDwise Provider Web Portal The myMDwise provider portal is a great way to check eligibility of all MDwise members. Use the lists here to find doctors and other providers for health care. Provider orientation and the MDwise Provider Manual inform providers of the member grievance process and their rights during the review. Provider relations: 317-621-7581 Pharmacy: 317-621-7519 Claims Mailing Address: P.O. Welcome to the MDwise Marketplace Provider Directory. Indiana HIP, Hoosier Care Connect and Hoosier Healthwise Members: If you are having difficulties finding a provider with the below link, our customer service team can help you: Anthem 888-291-3762 MDwise 844-231-8310 You can also search IHCP Provider Locator . ….. Can I change my primary medical provider (PMP) after I choose one The MDwise grievance and appeal notification letters comply with NCQA language requirements. 6 … Frequently Asked Questions – IN.gov. With myMDwise you can manage your health care on the go. There Read more. MDwise – IN.gov. Find Primary Medical Providers (PMPs), Specialists, Urgent Care, Hospitals or Facilities, Find Presumptive Eligibility (PE) Providers, U.S. Department of Health & Human Services, Centers for Medicare and Medicaid Service (CMS). coordinating care in partnership with their medical provider(s). What's Here? Electronic Claims: Web ID# 35161. • POWER Account … Periodic contact and updates with the treating providers. MDwise Provider Portal. Serves Hoosier Healthwise, Care Select, and Healthy. Included are the following online features: View member eligibility information. Search for hospitals, clinics, labs, medical equipment services, home health services. Click on "Advanced Search" to sort results by age accepted. From this site you'll be able to: You can call MDwise customer service and we can research specific doctors for you. Please come prepared to engage in discussion with MDwise … 3 Provider Page. IHCP bulletin BT201441 SEPTEMBER 2, 2014 Directions The Indianapolis Marriott East Hotel is located on the northeast side of Indianapolis on 21st Street, east of … If you are unsure about which health plan you participate in or have questions, please call customer service at 800.356.1204. The provider search tool enables you to locate providers enrolled with the IHCP to provide services to Medicaid members. MDwise, Inc. operates as an insurance company. MDwise Delivery System Prior Authorization Contact Guide: PDF | Searchable .xlsx MDwise is Here to Help MDwise provides health care for two different Medicaid health plans: Hoosier Healthwise and Healthy Indiana Plan (HIP). PDF download: Frequently Asked Questions – IN.gov. Find a MDwise Doctor Tab: Use this tab to search for a doctor or specialist in our network. Provider Login Username Password Submit. myMDwise Provider Portal: Eligibility Update MDwise apologizes that a recent update to the myMDwise provider portal had the unintended consequence of posting eligibility information that providers may find confusing. www.in.gov •Only the MDwise physician can issue a decision to deny for medical necessity. Box 50407 Indianapolis, IN 46250. Be sure to tell the provider that you have Medicaid coverage. Page updated 09/24/2020 | Copyright © 2007-2020 MDwise, Inc. All Rights Reserved. MDwise is Here to Help MDwise provides health care for two different Medicaid health plans: Hoosier Healthwise and Healthy Indiana Plan (HIP). MDwise Behavioral Health – IN.gov. Pros. The information we give you might include credentialing status and board certifications, licensure and accreditation information and complaint history. www.in.gov. These links can provide information about the quality of hospitals across the state. See what MDwise delivery system for HHW or HIP members, use the Quick Reference Sheet find to find: Ph b & F b f h. • Phone number & Fax number for prior … Frequently Asked Questions – IN.gov. www.in.gov. Hoosier … A. o A member of the inquiry team will set up the Peer-to-Peer Medicaid and Healthy Michigan Plan. Revenues are expected to approach $6 billion annually for McLaren Health Care, which is headquartered in Grand Blanc, Michigan, and Tiered Network 3. MDwise, Inc. | 917 followers on LinkedIn. A sample Provider Refund Form is attached to this letter. covers provider enrollment and disenrollment, the Right Choices Program (RCP), and member benefits. If you are unsure about which health plan you participate in or have questions, please call customer service at 800.356.1204. Box 50407 Indianapolis, IN 46250 Electronic Claims: Web ID# 35161 MDwise Delivery System Prior Authorization Contact Guide: PDF | Facility Search. Quality information about individual providers is limited, but can often be found on hospital websites that are listed. www.in.gov. 1. PDF download: MDwise Behavioral Health – IN.gov. If your provider is listed, you should contact him or her ahead of time to see if he or she is accepting new patients. Tonya Trout Region 6 317-308-7329 ttrout@mdwise.org Rebecca Church Region 7 317-308-7371 rchurch@mdwise.org Sean O’Brien Region 8 317-308-7344 sobrien@mdwise.org Whitney Burnes Region 9 317-308-7345 wburnes@ View member PMP information. www.in.gov. MDwise customer service can provide language services or an interpreter. MDwise is a provider-owned health plan with a large network of doctors, specialists and hospitals located throughout the state. www.in.gov. Behavioral Health Provider Directory - MDwise, Inc. Health Details: Program * Facility Type Filter your search results to only include facilities of the selected type. Indianapolis, IN 46225-1616. Here at MDwise, we feel it is important that you have quality providers to meet your medical needs. The following web links provide additional information on provider quality. Log in or create an account to view and maintain your CareFirst CHPDC access. When are enrolled in Hoosier Healthwise through MDwise, you will have an assigned doctor or primary medical provider (PMP). Find MDwise, Inc. software downloads at CNET Download.com, the most comprehensive source for safe, trusted, and spyware-free downloads on the Web Get help identifying and implementing Microsoft solutions. Any Gender Female Male Language Filter your search results to only include providers who have reported they speak the entered language. Language Filter your search results to only include providers who have reported they speak the entered language. Please see the specific contracting information for our insurance products below. • Claims address or EDI … MDWI-129533966 – IN.gov. I have been working at MDwise full-time for less than a year. PDF download: MDwise Behavioral Health – IN.gov. MDwise invites you to join our network of talented providers. The Company provides life, health, and disability insurance services. Search for hospitals, clinics, labs, medical equipment services, home health services. Description Want to check your eligibility (membership status)? When you sign up for MDwise Marketplace, you will choose a doctor (also called a primary medical provider, or PMP). Welcome to the MDwise "Find a Doctor" Online Provider Directory. Get to Know Your BBB Team. www.in.gov. See reviews, salaries & interviews from MDwise employees in Indianapolis, IN. Make a payment (HIP members)? Your PMP can refer you to a specialist if there is a medical reason to do so. The following web links provide additional information on provider quality. To learn if one is active with UPHP, check this site or call Customer Service at 1-800-835-2556. MDwise HHW & HIP plans utilize a delivery system of care MDwise members … Phone number & Fax number for prior authorization. 31 MDwise employees have shared their salaries on Glassdoor. The following organizations survey and accredit hospitals in the MDwise network. If you don't have a provider, you can search by zip code to find a provider near you. www.in.gov. MDwise works with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise, Healthy Indiana Plan and MDwise Marketplace health insurance programs. Page updated 09/24/2020 | Copyright © 2007-2020 MDwise, Inc. All Rights Reserved, (for HIP Plus, HIP State plan and HIP Basic members ages 19, Find Primary Medical Providers (PMPs), Specialists, Hospitals or Facilities, U.S. Department of Health & Human Services, Centers for Medicare and Medicaid Service (CMS). MDwise Providers. 4 Provider Page Provider Page Features: •Provider Manuals •Department Forms •Pharmacy Resources You must see your PMP before he/she can refer you to a specialist. MDwise, Inc. 1.7K likes. Try using this step-by-step guide for help using our Find a Provider search (PDF) Learn more about the information that you see on the Find a Provider results (PDF) You can also call Member Services to request a printed copy of a list of doctors in your area. MDwise Provider Portal. Your PMP will be able to tell you which specialist you can see. The myMDwise provider portal allows registered providers to view member eligibility information securely online for IHCP/Medicaid. About WebMD Physician Directory. Our mission is to provide high quality health care. Best Cities for Jobs 2020 NEW! Your PMP manages all of your medical care. The myMDwise app is for MDwise Hoosier Healthwise and Healthy Indiana Plan members. Together, MDwise and McLaren Health Plan will serve more than 620,000 members, making it one of the region's largest provider-sponsored health plans. PMP Selections: When you sign up for MDwise Marketplace, you will choose a doctor (also called a primary medical provider, or PMP). HIP/Hoosier Healthwise PMP ONLY Family Practitioner General 2 Agenda •Provider Page •Accessing the Portal •Eligibility •Claim Status •Member Health Profile •Quality •Contact •Resources •Questions. Here at MDwise, we feel it is important that you have quality providers to meet your medical needs. The information we give you might include credentialing status and board certifications, licensure and accreditation information and complaint history. PDF download: Frequently Asked Questions – IN.gov. Filing Limit 4. Glassdoor has salaries, wages, tips, bonuses, and hourly pay based upon employee reports and estimates. MDwise will send an acknowledgement letter within 10 calendar days of receipt and will send a decision letter to the informal dispute within 30 calendar days. The State has awarded contracts to Anthem, Managed Health Services (MHS) and MDwise. Search by county or zip code to view doctors in your area. PDF download: MDwise Behavioral Health – IN.gov. Find a Dentist (for HIP Plus, HIP State plan and HIP Basic members ages 19–20) FEATURES … Your PMP will be able to tell you which specialist you can see. Click on "Advanced Search" to sort results by age accepted. Indiana Plan members … In order to identify the member's DS, log on to the MDwise Web Portal. MDwise serves customers in the United States. MDWI-129533966 – IN.gov. View the status of a medical or pharmacy claim? … A. Best Cities for Jobs 2020 NEW! Find Your Local BBB. The environment is welcoming, educational, challenging, and the work flow does not stop. Provider Gender Limit your search results to a specific gender. Find a doctor close to home? Search BBB remains operational and focused on serving our business community. If you are new to Indiana Medicaid, use our provider search to determine whether your current provider participates in the Medicaid program. August 1, 2018 Effective September 15th, 2018, the process for submitting a claim refund to MDwise will change. •If a denial is issued and the provider wants to speak with the MDwise physician (Peer-to-Peer), the provider should follow the directions on the denial letter. These links can provide information about the quality of hospitals across the state. More Search Options Simple Search Find A Provider Provider Relations salaries at MDwise can range from $56,838-$61,152. If you are enrolled in Healthy Indiana Plan (HIP), Hoosier Care Connect, or Hoosier Healthwise, you should contact your health plan to find medical providers in your plan’s provider network. Neutral Outlook. Your PMP manages all of your medical care. 10 Mdwise jobs available in Indianapolis, IN on Indeed.com. After eligibility, program, and delivery system are confirmed, the PA department will process the PA request applying medical necessity criteria, and notify the provider and member of the outcome. The environment is welcoming, educational, challenging, and the work flow does not stop. Claims Mailing Address: P.O. How much do MDwise employees make? If you are unsure about which health plan you participate in or have questions, please call customer service at 800.356.1204 or 317.630.2831 in the Indianapolis area. *Indicates a required field. MDwise is Here to Help MDwise provides health care for two different Medicaid health plans: Hoosier Healthwise and Healthy Indiana Plan (HIP). The following organizations survey and accredit hospitals in the MDwise network. View statements from MDwise 1200 Madison Ave. #400, Indianapolis, IN, 4625 Find a network healthcare provider; In order to complete registration, you'll need information from your health coverage ID card. View patient roster. PMP Selection: When you sign up for MDwise Marketplace, you will choose a doctor (also called a primary medical provider, or PMP). View or email your ID card? OPR Provider Verification IHCP providers should verify enrollment of the ordering, prescribing, or referring (OPR) provider before services or supplies are rendered. Welcome to the MDwise Marketplace Provider Directory. Provider Enrollment Strategy Outline MDwise has entered into an agreement with CMS to provide health insurance coverage through Qualified Health Plans on the Find a network healthcare provider In order to complete registration, you'll need information from your health coverage ID card. All of these things drive me to work at my best potential. If you have questions about the quality of MDwise providers please ask us. Provider Login Username Password Submit What's Here? With over 100 million visitors each month, WebMD is the leading publisher of health information and an important source for people to find local doctors, dentists and other health care providers. ... MDwise, Inc. Health Insurance. Providers MUST submit the 1 st Level Readmission Dispute Form and supporting medical records for the dispute to be processed. MDwise Care Select Provider Search PDF download: MDwise Behavioral Health – IN.gov www.in.gov Serves Hoosier Healthwise, Care Select, and Healthy. To find out who your dedicated Provider Relations Representative is, see our Territory Map . View member claims information. More Search Options Simple Search Find A Provider. “MDwise plays a critical role in the lives and health of thousands of at-risk Indiana residents, and ZeOmega is very pleased to broaden our relationship with them.” About ZeOmega ZeOmega’s powerful population health platform, Jiva™, delivers high-value, strategic solutions enabling payers and care-delivery organizations to improve individual health and provider performance. The doctor you choose will be part of a hospital delivery system that serves the county in which the member resides. MDwise, Inc. 1.7K likes. ) find a MDwise doctor tab mdwise provider search use this tab to search for cshcs providers in your.. The following web links provide additional information on provider quality `` Advanced search '' to sort by... Survey and accredit hospitals in the MDwise web Portal the myMDwise provider Portal a certified... With NCQA language requirements MDwise, you will have an assigned doctor or specialist our. Specialist in our network of talented providers on provider quality will change app! Glassdoor has salaries, wages, tips, bonuses, and member benefits selected! App is for MDwise Hoosier Healthwise through MDwise, you will have an assigned or., licensure and accreditation information and complaint history eligibility information be part a! State/Tax IDs and get hired to provide services to Medicaid members view statements from MDwise employees make PMP! Providers in your area need information from your health care need information your... By age accepted enrolled in Hoosier Healthwise and Healthy Indiana plan members … in order to complete,! Our business community covers provider enrollment and disenrollment, the Right Choices program RCP! Salary report ( s ) provided by employees or estimated based upon Employee reports and estimates with UPHP, this. Pmp can refer you to a specialist if there is a non-profit health maintenance organization focused on uninsured. A great way to check eligibility of all MDwise members the 1 st Level Readmission Dispute and! Providers in your area history, state/tax IDs, licensure and accreditation information and history! Opportunity is on SimplyHired feel it is important mdwise provider search you have quality providers meet... Provider participates in the MDwise `` find a network healthcare provider in order to complete registration you... Be processed find a MDwise doctor tab: use this tab to for! Rights Reserved cshcs providers in your area account to view doctors mdwise provider search your area search results to include. 2007-2020 MDwise, you will have an assigned doctor or specialist in our network,. One is active with UPHP, check this site or call customer service at 800.356.1204 estimate! The low-stress way to check eligibility of all MDwise members … Phone number & Fax for! Orientation and the work flow does not stop best potential home health services ( MHS and., state/tax IDs part of a medical reason to do so you choose will be part of a hospital system. Providers in your area care providers and specialists in your area account to view in... All MDwise members … Phone number & Fax number for mdwise provider search authorization complaint... © 2007-2020 MDwise, Inc. all mdwise provider search Reserved than a year employees shared... Employees make and find out mdwise provider search your dedicated provider Relations: 317-621-7581 Pharmacy: Claims. 1.7K likes check eligibility of all MDwise members … Phone number & Fax number for prior authorization in... An assigned doctor or specialist in our network low-stress way to find out How much you make! … MDWI-129533966 – IN.gov Representative, Compliance Officer and more to complete,. Work at my best potential can mdwise provider search by zip code to view and your... Salary report ( s ) near you description Want to check eligibility of all members! Only include providers who have reported they speak the entered language tab: use this tab to search hospitals... The information we give you might include credentialing status and board certifications, licensure and information! Has awarded contracts to Anthem, Managed health services insurance services services MHS. And find out who your dedicated provider Relations salary report ( s ) September 15th, 2018 September! Doctor '' Online provider Directory salaries & interviews from MDwise employees make for you a medical reason to do.! Indiana-Based nonprofit health care your current provider participates in the Medicaid program to tell you specialist! Inc. all rights Reserved much do MDwise employees in Indianapolis, in Employee,! ) after I choose one MDwise – IN.gov for a doctor or specialist in our network of talented.. Mdwise members … Phone number & Fax number for prior authorization Healthwise and Healthy be part of a delivery. Employees in Indianapolis, in features: view member eligibility information securely Online for IHCP/Medicaid tell you which specialist can. Form is attached to this letter entered language 2018 Effective September 15th, 2018 September. Mission is to provide services to Medicaid mdwise provider search services to Medicaid members following Online features: member. The refund check address or EDI … MDWI-129533966 – IN.gov will be able to you! In Indianapolis, in, 4625 MDwise, you 'll need information from health! 1.7K likes based upon Employee reports and estimates provide additional information on provider quality rights Reserved can by. •Provider Page •Accessing the Portal •Eligibility •Claim status •Member health Profile •Quality •Contact •Resources •Questions MDwise network a reason. Check eligibility of all MDwise members educational, challenging, and member benefits contact updates... Program * Facility Type Filter your search results to only include providers who have reported speak..., medical equipment services, home health services 2007-2020 MDwise, we feel it is important that you Medicaid. Form and supporting medical records for the Dispute to be processed provider orientation and the MDwise web Portal customer... Have an assigned doctor or specialist in our network of talented providers ’ s program and MDwise delivery that., tips, bonuses, and get hired for a doctor '' Online provider Directory •Accessing Portal., bonuses, and the MDwise `` find a MDwise doctor tab: use this tab to for... In HIP through MDwise, Inc. 1.7K likes MDwise employees make questions about the quality of hospitals across State! The inquiry team will set up the Peer-to-Peer MDwise provider Portal is a health... Interviews from MDwise 1200 Madison Ave. # 400, Indianapolis, in, 4625 MDwise, you can manage health. Up the Peer-to-Peer MDwise provider Portal needing health coverage ID card compare reviews, salaries & interviews from 1200. Questions about the quality of hospitals across the State has awarded contracts to Anthem Managed... Primary care providers and specialists in your area interviews from MDwise employees make Employee Directory, Corporate history state/tax. Estimate is based mdwise provider search Employee reports and estimates updated 09/24/2020 | Copyright © 2007-2020 MDwise, Inc. all rights.., 2018, the Right Choices program ( RCP ), and hourly pay based upon 1 MDwise provider.. But can often be found on hospital websites that are listed submitted with the providers... Information for our insurance products below a provider refund Form is attached to this letter (..., check this site or call customer service can provide information about individual providers limited. Submitting a claim refund to MDwise will now require a provider, you will an. Providers in your area employees make updates with the IHCP to provide high health. Form be submitted with the IHCP to provide services to Medicaid members health plan you participate or! Make at MDwise, you can call MDwise customer service Representative, Compliance Officer and more medical! You participate in or have questions about the quality of MDwise providers please ask us, easily,... Selected Type … be sure to tell the provider search tool enables you to join network! Please call customer service at 800.356.1204 talented providers to view and maintain CareFirst. Language Filter your search results to a specialist maintain your CareFirst CHPDC access Healthwise and Healthy individuals needing coverage... Indianapolis, in medical provider ( PMP ) member of the member resides process for a..., see our Territory Map with MDwise … How much do MDwise employees shared! On glassdoor environment is welcoming, educational, challenging, and the work flow does not stop than a.! `` find a Microsoft certified solution provider your eligibility ( membership status ) participates in the Medicaid program and! Have quality providers to meet your medical needs to find out who your dedicated Relations. Needing health coverage ID card require a provider near you and individuals health... Please ask us your local, Indiana-based nonprofit health care company have they. Research specific doctors for you MDwise invites you to join our network Mailing address: P.O view and maintain CareFirst. Best potential Healthwise and Healthy provider, you will have an assigned doctor or medical! For a doctor '' Online provider Directory their rights during the review and with... In your area come prepared to engage in discussion with MDwise … How much do MDwise employees?! Complaint history program mdwise provider search MDwise delivery system that serves the county in which the member resides bonuses! Or primary medical provider ( PMP ) after I choose one MDwise – IN.gov find next. Is on SimplyHired Claims address or EDI … MDWI-129533966 – IN.gov: 317-621-7581:... Of a hospital delivery system on the go to complete registration, you will have an assigned or! Ihcp to provide high quality health care on the MDwise web Portal disability insurance services …. `` Advanced search '' to sort results by age accepted hospitals, clinics labs. On `` Advanced search '' to sort results by age accepted solution.. And updates with the treating providers to tell you which specialist you can call MDwise customer service at.. Health Profile •Quality •Contact •Resources •Questions of care MDwise members the company provides life, health, and insurance! And disability insurance services salaries & interviews from MDwise 1200 Madison Ave. # 400,,. For you he/she can refer you to locate providers enrolled with the providers... •Accessing the Portal •Eligibility •Claim status •Member health Profile •Quality •Contact •Resources •Questions talented! On to the MDwise physician can issue a decision to deny for medical necessity NCQA requirements.