Provider Manual
The provider manual is a resource for working with our health plan. It communicates policies and programs and outlines key information such as claim submission and reimbursement processes, authorizations, member benefits and more to make it easier for you to do business with us.
View the Provider Manual
(coming soon)
Dental Provider Manual
TrueCare subcontracts with Avesis for dental coverage. The dental provider manual provides important information on topics such as: covered services, services that require prior authorization, claim submissions, and more!
VIEW THE AVESIS PROVIDER MANUAL
(coming soon)
Vision Provider Manual
TrueCare subcontracts with EyeMed for vision coverage. The vision provider manual provides important information on topics such as: covered services, services that require prior authorization, claim submissions, and more!
VIEW THE EYEMED PROVIDER MANUAL
(coming soon)
| Updates and Announcements | Provider Services |
|---|---|
We continually update information, and the content of the manual is subject to change without notice. TrueCare posts updates through network notifications on the Updates & Announcements page. | If you have any questions or would like more information, please call Provider Services at 1-833-230-2174. |
Transition of Care
When care transitions occur, TrueCare identifies members who require assistance as they transition from an inpatient stay. Our team works with members and their families to coordinate care needs and make the transition to home or a lower level of care as successful as possible.
Our Transitions of Care (TOC) program has focused outreach and discharge planning activities based on the Coleman Model, utilizing a team approach to coordinate post-discharge care needs for members at risk for readmission. Through these efforts, we strive to empower and educate members to help ensure all components of the member’s discharge plan are in place.
When an at-risk member is discharged from an inpatient stay, our team reaches out to ensure the member has a clear path to recovery, free from barriers to care. We can coordinate home care and medical equipment needs, assist with obtaining prescribed medications and coordinate other medical care and services, as needed.
We believe in the importance of partnership. That is why we collaborate with primary care providers (PCP) to provider our members with the services they need along the continuum of care.
When Members Transition from Previous Plan to TrueCare
Upon receipt of notification that a member is transferring from a former contractor to TrueCare, the form contractor shall be responsible for contacting us, the member and the member’s providers to transition existing care.
TrueCare will accept the prior authorization for 30 days or until the receipt or provider is contracted by us regarding the prior authorization. If the receipt and provider are not contracted by TrueCare, the existing prior authorization shall be accepted until expired.