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FAQ

Service Case
Q: Can I include claims, EOBs, or other supporting material with the cases I submit?
Yes, we encourage you to send us claims, EOBs and other supporting material pertinent to the inquiry. After the case is created, a confirmation screen will display with the option to upload or fax the document(s).

If faxing, we recommend that you use the fax cover sheet that is available for download on the confirmation screen because it is pre-populated with the appropriate fax number, the full group or provider name, tax ID number and, most importantly, the applicable case number. Using this fax cover sheet will ensure your additional documents are quickly associated with the correct case.
Q: I received notification that my case was closed; however, upon review I found that it is not resolved. How do I reopen my case?
If you feel any inquiry remains unresolved or the response did not meet your expectations, please contact Customer Service at 800-950-7040. For fastest service, please have your case number handy.
Q: My request pertains to more than one network; however, I am only allowed to choose one network when submitting my request online. Which network should I choose and how do I ensure that all networks are addressed in the resolution?
Currently our service request form only supports the selection of one network; however, you can specify additional networks when creating your case. Upon selecting any of the available reasons for inquiry, a "comments" field appears. Please be specific within that field if your request/question pertains to more than one network, and we will address all networks specified.
Claim
Q: How do I find out the status of a claim payment?
MultiPlan does not pay claims; therefore, any questions pertaining to claims payment, including initial payment and payment on adjusted claims, should be directed to the payer listed on the patient identification card.
Q: How do I verify benefits, eligibility or claim payment status?
MultiPlan is not an insurance company, health plan or health plan administrator; rather, we are an independent PPO Network that serves a diverse group of payers. As such, we do not maintain information on benefits, coverage or eligibility, nor do we pay claims. For these types of inquiries, please contact the insurance company or benefits administrator. That telephone number can typically be found on patient ID cards.
Q: Where do I submit claims?
Claims should be submitted to the location specified on patient identification card (usually on the back of the card).
Q: What is your policy regarding timely filing of appeals?
Unless otherwise required by applicable law or your contract, all requests for appeal or adjustments must be submitted within one hundred eighty (180) days from the date of the payer's original payment or explanation of payment. Requests for appeal or payment adjustments submitted after this date will be denied, and, per your network contract, you may not bill the payer or the patient for any outstanding amount.
Q: How do I obtain a copy of the Pricing Statement?
Open a new customer service case and select "Request copy of Advice Sheet" in the Reason for Inquiry drop down list.
Q: Do I need to supply a copy of the EOB in order to obtain a copy of a Pricing Statement?
MultiPlan does not need a copy of the EOB, but we do need a copy of the claim in order to supply this information. Instructions are provided when you open a new customer service case and select "Request copy of Advice Sheet" in the Reason for Inquiry drop down list.
Q: Why do you need a copy of the claim?
We request a copy of the HCFA or UB to be certain we have complete and accurate information needed to research any type of appeal, participation or balance billing dispute.
Q: Why do you need a copy of the Explanation of Benefit – (EOB)?
MultiPlan does not pay claims so we do not receive copies of EOBs. We request the EOB in order to confirm key information needed to research issues on your behalf. The information identified on the EOB includes the network (e.g. MultiPlan, PHCS, Beech Street) the amount paid per the benefit plan, the patient responsibility and the date payment was issued.
Demographic
Q: How do I obtain a copy of an existing contract?
You may request a copy of a contract by opening a new customer service case and choosing "Request copy of contract" in the Reason for Inquiry drop down list. For security reasons, this request must be made in writing. When your case is created, you'll have the option to either upload a signed letter or fax it to the attention of your case number.

All letters must be on the provider’s letterhead. For individually participating practitioners, the request must be signed by the practitioner. For a facility contract, the request must be signed by the facility administrator, CEO, president or owner. For a group contract, the request must be signed by the group administrator or a duly authorized representative.
Q: How do I add a practitioner to an existing group contract?
If you are a practitioner requesting to join the network under an existing contracted group, please contact the group administrator for further assistance.

If you are the group administrator or a duly authorized representative of the group, submit the information below based on whether your practitioner credentialing is non-delegated (MultiPlan verifies credentials) or delegated (you verify credentials) to:

E-mail: registrar@multiplan.com
Fax:     781-487-8273
USPS:   MultiPlan
c/o Registrar
16 Crosby Drive
Bedford, MA 01730

Groups with non-delegated credentialing
Submit a completed practitioner application. If you need a copy of the MultiPlan Practitioner Application, please contact Customer Service at 800-950-7040.

Note: MultiPlan accepts the submission of a CAQH ID in place of a completed application. If you prefer this option, please be sure to include:

  • Provider Name (Last, First, Middle Name/Initial)
  • CAQH ID
  • TIN
  • Group Name and, if possible, the MultiPlan Group ID Number

Groups with delegated credentialing
Submit the practitioner profile that includes the following:

  • Provider Name (Last, First, Middle Name/Initial)
  • Degree
  • Specialty
  • Primary service address (and billing address if different) Note that the service address cannot be a PO Box.
  • Phone Number
  • Tax ID
  • Group Name and, if known, the MultiPlan Group ID Number
Q: How do I join a MultiPlan network?
Follow the instructions on the Open a Customer Service Case page under "Request to join or terminate the networks."
Q: I have a contract with MultiPlan. How do I submit recredentialing materials?
Follow the instructions on the Open a Customer Service Case page under "Submit an application for recredentialing."
Q: How do I check a practitioner’s recredentialing status?
You can obtain recredentialing status by opening a new customer service case and selecting "Recredentialing status" in the Reason for Inquiry drop down list.
Q: How do I check the status of an application to join?
You can obtain application status by opening a new customer service case and selecting "Application status" in the Reason for Inquiry drop down list.
Q: How long does it take for my application to be processed?
Please allow 90 – 120 days from the receipt of a completed application for processing.
Q: How do I update my information (address, telephone, etc) with MultiPlan?
You have several options for updating your information. To learn more, select "Update your demographic information" on the Open a Customer Service Case page
Q: How long should I allow for my demographic updates to be completed?
Please allow up to ten business days for your demographic update to be completed. If your update does not appear on our online Provider Search within ten business days from the date of your original submission, please create a new customer service case and choose “Status of demographic change” in the Reason for Inquiry drop down list.
Q: How do I confirm the date a practitioner became effective with your network(s)?
Open a customer service case and select "Verify participation status" in the Reason for Inquiry drop down list.
Q: We already have a group contract with MultiPlan and would like to be approved for delegated credentialing. What is the process?
To find out whether your group is eligible for delegated credentialing, please contact your local Network Development Executive or call Customer Service at 800-950-7040.
Q: How do I obtain a roster?
Open a new customer service case and select "Roster report" in the Reason for Inquiry drop down list.

Note: A roster is a list of all practitioners participating under a specific TIN. You will receive a report in PDF format which will include all effective dates, addresses and networks associated with each practitioner we have in our records as participating under that TIN.
Miscellaneous
Q: How do I request a copy of my fee schedule?
To request a copy of a Fee Schedule, open a new customer service case and select "Request a Fee Schedule" in the Reason for Inquiry drop down list.
Q: How do I get a copy of your Client List or Provider Handbook?
Follow the instructions on the Open a Customer Service Case page under "Obtain our Client List or Provider Handbook."
Q: Where can I find information about MultiPlan's products and how best we can work together to benefit patients?
Click here for an overview of MultiPlan’s network services.

We also have a Providers section filled with useful provider-specific information like handbooks, self-update tools, and philanthropic programs: https://www.multiplan.com/webcenter/portal/MultiPlan/provider#otherinfo