ECPHO Eastern Connecticut Physicians Hospital Organization, Inc.

Health Plans

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:

healthplansAetna
CIGNA HealthCare
ConnectiCare
Coventry Health/First Health
Harvard Pilgrim
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
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: 860-273-6520
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

 

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

Contact: Janet Mead, HealthCare Professional Engagement Experience Consultant
Phone: 888-244-6264, ext. 76644
Fax: 860-687-9637
Email: janet.mead@cigna.com

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

Contact: Majesta Love, Provider Education and Service Representative
Phone: 860-674-2057
Fax: 860-674-2849
Email:  MLove@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
77 S. Bedford Street
Burlington, MA 01803
www.coventryhealth.com
www.firsthealth.com

Contact: Kimberly Hughes, Provider Contract Specialist
Phone: 781-906-6199
Fax: 781-906-6176
Email: KimberlyHughes@firsthealth.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

 

Harvard Pilgrim Health Care Inc.
City Place II
185 Asylum Street, 2nd Floor
Hartford, CT 06103
www.harvardpilgrim.org

Contact: Verronica Barrows, Provider Relations consultant
Phone: 860-757-6865
Fax: 860-757-6901
Email: Verronica_Barrows@harvardpilgrim.org

  • Provider Relations Consultants (PRC) CT: 877-594-7190
  • Connecticut Provider Service Center: 866-691-8882
  • Provider Service Center: 800-708-4414
  • Referral & Authorization Requests: 800-708-4414
  • Behavioral Health Care Resources: 888-777-4742
  • Care Management: 888-888-4742 Ext. 31035
  • E-Services: 800-708-4414

 

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

Contact: Stephanie Payette, Network Development Specialist
Phone: 781-895-5795
Fax: 781-895-3455
Email: Stephanie.Payette@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
2842 Main Street, Suite 175
Glastonbury, CT 06033
www.nehealthdirect.com

Contact: Jamie Cole, Director of Northeast Network Development
Phone: 860-730-2689
Fax: 609-631-0476
Email: Jamie.Kirdzik@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: Matt Tyson, Hospital Contracting Executive
Phone: 866-348-3887, ext. 238
Cell: 615-477-6677

  • Provider Relations issues: Matt Tyson – 866-348-3887, ext. 238
  • 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: Matt Tyson – 866-348-3887, ext. 238

 

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 Health Plans, Inc.
902 Chapel Street
New Haven, CT 06510
www.wellcare.com

Contact: Charlene Allen, Senior Provider Relations Representative
Phone: 203-497-2816
Fax: 203-675-2707
Email: Charlene.Allen@wellcare.com
Contact: Tara Maloney (credentialing questions or issues)
Email: Tara.Maloney@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, Network Relations Consultant
Phone: 203-985-6491
Fax: 203-654-3216
Email: Lilliam.Garayau@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

United Health Care – Oxford
www.uhc.com

Contact: Susan Loiacano, Provider Advocate – Northeast Region
Phone: 203-924-2006
Email: sloiacano@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

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