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Whether you need convenient downloadable forms, provider-specific information, or answers to your questions, Encore is happy to be of service.

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A matter of process for our providers.

Here’s the process for identification cards without an Encore Health Network identifier.

If the member’s insurance ID card does not state Encore, you may request that the member make payment on the day services are rendered, or you may elect to bill the member for those services.

If the member returns with a new card, please refund any payment collected less any applicable co-payment or co-insurance and submit the claim to the address on the card.

If Encore Health Network is not on the card, we also ask that you do the following things:
Notify Encore Provider Relations. You may fax a copy of the front and back of the ID card to Encore at (317) 621-2388. We will verify if the employer and vendor are Encore participants, or if the member is carrying an old card. If the payor has omitted identifying Encore, we will request that new cards be printed, or an Encore sticker may be applied to all insurance ID cards.

If the member states that he/she is participating with the Encore Health Network, advise the member that the insurance card is not labeled appropriately. The member should contact his/her human resources department or insurance company for a new card.

The provider may handle the members according to the providers own established policy for such an occurrence. Such a policy must be in writing and available to the member and payor upon request.

If you have any questions regarding Encore Health Network’s “wrap” plans/travel networks, please contact Encore’s Provider Relations toll free at (888) 574-8180.

Please note: All payors must identify Encore on the insurance card.

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If you have any questions, please contact webmaster@encoreconnect.com
Special Authorization is required to access the Payor Updates.
Please contact one of the following Account Executives for access:
· Holly Joyce at (317) 621-4263 or hjoyce@encoreppo.com, or
· Kevin McShay at (317) 621-4264 or kmcshay@encoreppo.com

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Notice

Encore has entered into a new arrangement for chiropractic services with HSM, Inc. HSM, Inc., a Minnesota-based specialty network services organization, will administer the chiropractic network for our Encore and Encircle service areas.

HSM will directly hold contracts with all participating chiropractors; therefore, there are some changes of which you should be aware. Regarding billing, chiropractors will now send their claims directly to HSM. HSM will collect the data in their system, including treatment plans for case management, and forward claims to the appropriate Encore payor. The payor will send all payment directly to HSM, who will in turn reimburse the chiropractor according to the negotiated rates.

If you are interested in becoming a participating chiropractor in the Encore Health Network, please contact HSM at 800-432-3640 or visit their web-site at www.hsminc.com.

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Current Worker's Comp Payors

Arete USA D/B/A The Covenant Companies
HealthSmart
HFN, Inc
Indiana University
InterPlan Health Group
IU Health Plan
MCMC LLC
ASU Group
Major Hospital
ACS CompIQ Corporation, A Xerox Company

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Payor and Provider Resources

Payors please contact Account Executive Kevin McShay at (317)621-4264 or kmcshay@encoreppo.com for access.

For any provider issue, please contact Provider Contracting Coordinator, Tina Bilodeau at (317)621-4269 or tbilodeau@encoreppo.com.