Health Plans

Just click on the name of the plan to jump down the page for more information.

Health plans participating with Eastern Connecticut Physician Hospital Organization are:

Aetna
Aetna Better Health
Americhoice by United HealthCare
CIGNA HealthCare
ConnectiCare
Coventry Health/First Health
Great-West Healthcare
MultiPlan/PHCS
National Preferred Provider Network
Northeast Health Direct
Prime Health Services, Inc.
Three Rivers Provider Network
WellCare Medicare Advantage Program

A summary of fee schedules for all contacted health plans, as well as searchable detailed fee schedules for the plans with fee schedules, are available on the password-protected section of our site. Click here to enter this section.

Health plans not participating with Eastern Connecticut Physician Hospital Organization are:

Anthem Blue Cross and Blue Shield of Connecticut
Anthem – National Governance Service
Evercare
Health Net of the Northeast, Inc.
United Health Care – Oxford

 

Participating Health Plans:

Aetna
151 Farmington Avenue
MA54
Hartford, CT 06156
www.aetna.com

Contact: Bonnie Narducci, Network Manager CT/RI
Phone: 877-393-1732
Fax: 860-754-5739
Email: narduccib@aetna.com

• Provider Relations HMO Phone: 800-353-1232
• Provider Relations Non-HMO Phone: 888-632-3862
• Phone Claims Issues (HMO): 800-353-1232
• Phone Claims Issues (non-HMO): 888-632-3862
• Fax Claim Issues: 859-455-8650
• Phone Credentialing Issues: 800-353-1232
• Phone Preauthorizations: 800-245-1206

 

Aetna Better Health (HUSKY & Charter Oak)
151 Farmington Avenue RS46
Hartford, CT 06516
www.aetnabetterhealth.com

Contact: Dawn Marie Washburn, Provider Services Liaison
Phone: 860-808-2687
Fax: 860-450-1313
Email: WashburnD1@aetna.com

• Provider Relations Phone: 866-742-3120
• Fax Claims Issues: 866-742-3120
• Phone Credentialing Issues: 800-353-1232
• Phone Preauthorizations: 866-742-3120

  

Americhoice by United Healthcare (HUSKY & Charter Oak)
400 Capital Boulevard
Rocky Hill, CT 06067
www.americhoice.com

Contact: Marybeth Carney, Provider Advocate
Phone: 860-221-0171
Email: marybeth_carney@uhc.com

• Provider Services: 866-573-2451
• Claims Issues: 866-573-2451
• Phone Credentialing Issues: 877-842-3210
• Phone Preauthorizations: 877-416-2088

  

CIGNA HealthCare
900 Cottage Grove Road
B7NCS310
Bloomfield, CT 06152-2310
www.cigna.com

Contact: Cynthia Brown, Senior Provider Service Representative
Phone: 860-226-1986
Fax: 860-961-1124
Email: cynthia.brown@cigna.com

 

ConnectiCare
175 Scott Swamp Road
PO Box 4050
Farmington, CT 06034-4050
www.connecticare.com

Contact: Sharon T. Kiefer, Education & Service Representative
Phone: 860-674-2057
Fax: 860-674-2849
Email: skiefer@connecticare.com

• Provider Call Center: 800-828-3407 (There is a menu that can be followed for areas of assistance including Pre-Authorizations, Provider Relations Call Center, COB, & Pharmacy Services)

 

Coventry/First Health
100 River Ridge Drive, Suite 101
Norwood, MA 02132
www.coventryhealth.com
www.firsthealth.com

Contact: Kate Petrone, Provider Contract Specialist
Phone: 781-762-5511, ext. 214
Fax: 781-762-5318
Email: katelahner@cvty.com

• Provider Relations Phone: 800-937-6824
• Phone Claims Issues: 800-937-6824
• Phone Credentialing Issues: 800-937-6824
• Phone Preauthorizations: Refer to member ID card

 

Great-West Healthcare
Stony Brook Office Park
130 Turner Street
Building 3, Suite 610
Waltham, MA 02453
www.greatwesthealthcare.com

Contact: Matthew Bancroft, Provider Relations Representative
Phone: 888-244-6264, ext. 76461
Fax: 781-894-2802
Email: matthew.bancroft@cigna.com

• Provider Relations Phone: 888-663-8081
• Phone Claims Issues: 800-966-8776
• Phone Credentialing Issues: 800-537-2033, ext. 72652
• Phone Preauthorizations: 888-663-8081

 

MultiPlan/PHCS
MultiPlan Service Operations Team
1100 Winter Street
Waltham, MA 02451
www.multiplan.com

Contact: Marie Doyle, Senior PPO Network Development Executive
Phone: 781-895-3392
Fax: 781-895-3455
Email: marie.doyle@multiplan.com

•  Provider line: 800-950-7040

 

National Preferred Provider Network
www.nppn.com

• Phone Claims Issues: 800-557-1656
• Fax Claim Issues: 845-343-6113
• Phone Credentialing Issues: 845-343-1600
• Phone Preauthorizations: See back of ID card

 

Northeast Health Direct
78 Eastern Boulevard
Glastonbury, CT 06033
www.nehealthdirect.com

Contact: Maureen Kelly, Provider Relations Manager
Phone: 860-657-1888
Fax: 860-657-1889
Email: maureen.kelly@chn.com

• Phone Claims Issues: Maureen Moran, 800-423-6619, ext. 15
• Phone Preauthorizations: Call the number on the patient’s card

 

Prime Health Services, Inc.
7110 Crossroads Blvd, STE 100
Brentwood, TN 37027
http://www.primehealthservices.com/

Contact: Rachel Vann, Provider Contractor
Phone: 615-565-8701
Fax: 615-329-4751
Email: rachel.vann@primehealthservices.com

• Provider Relations issues: Rachel Vann – 615-565-8701
• Phone Claims Issues: Sandi Olson – 615-565-9011
• Fax Claims Issues: Sandi Olson, fax is 615-329-4751
• Phone Credentialing Issues: Christina Hancock – 615-565-8226
• Phone Preauthorizations: Rachel Vann – 615-565-8701

 

Three Rivers Provider Network
1620 Fifth Avenue
Suite 900
San Diego, CA 62101
www.trpnppo.com

Contact: Jim Benuska, Account Manager
Phone: 619-230-0530
Fax: 619-230-8213
Email: jbenuska@trpnppo.com

• Provider Relations Phone: 800-966-8776
• Phone Claims Issues: 800-966-8776
• Phone Credentialing Issues: 619-230-8695
• Phone Preauthorizations: Call the number on the patient’s card

 

WellCare Medicare Advantage Plan
Wellcare of Connecticut, Inc.
127 Washington Avenue
East Building, 4th Floor
North Haven, CT 06473
www.wellcare.com

Contact: Lori McInnis, Provider Relations Representative
Phone: 203-239-7444
Fax: 813-262-2912
Email: LMcinnis@wellcare.com

• Provider Relations Phone: 800-925-3606
• Phone Claims Issues: 866-579-8006
• Fax Claim Issues Appeals & Grievances: 866-201-0657
• IP Fax Preauthorizations: 877-431-8860
• OP Fax Preauthorizations: 866-455-6529 

 

Non-Participating Health Plans:

Anthem Blue Cross and Blue Shield of Connecticut
370 Bassett Road
North Haven, CT 06473
www.anthem.com

Contact: Lilliam Garayua-Centeno, Network Relations Consultant
Phone: 203-985-6491
Fax: 203-654-3216
Email: Lilliam.Garayau-Centeno@anthem.com

• Provider Service Line: 800-828-2239

 

Anthem – National Governance Service
Contact: Donna Pisani, Medicare Provider Outreach & Education Consultant
Phone: 860-638-5822
Email: Donna.Pisani@anthem.com

 

Evercare
CT028-11SB
450 Columbus Blvd
Hartford, CT  06103
www.evercarehealthplans.com

 

Health Net of the Northeast, Inc.
One Far Mill Crossing
Shelton, CT 06484-0944
www.healthnet.com

Contact: Rosemarie Peclet
Phone: 203-225-8648
Fax: 203-225-4116
Email: rosemarie.x.peclet@healthnet.com

 

United Health Care – Oxford
www.uhc.com

Contact: Mary Archambault, Senior Network Account Manager
Phone: 860-702-8059
Email: mary_archambault@uhc.com

• Patient eligibility & benefits, check claim status, submit a practice-facility update, request information about joining our network, credentialing status, obtain (appeal, claim project, and notification) process information or review our privacy practices: 877-842-3210