Maryland Physicians Care

MPC member and provider services share 1-800-953-8854; follow prompts for provider services (claims status, denials, eligibility). Fax listed is the provider services fax.

Availity payer ID 76498 for electronic claims. Timely filing 180 days from date of service. Overpayment refunds go to P.O. Box 22655, New York, NY 10087-2655.

Codes not found in the PA lookup tool: call Clinical Review. Scheduled inpatient/outpatient services and transplant PA requests fax 800-953-8856.

Fax MPC Prior Authorization forms with clinicals for scheduled inpatient/outpatient services and transplants.

Inpatient admission notifications.

Concurrent review clinical updates for inpatient stays.

Post-discharge services utilization management requests.

Leave member name, DOB, authorization number and caller contact information. Pharmacy peer-to-peer uses 1-888-258-8250; Evolent-reviewed denials use 1-800-424-4836.

Outpatient medication PA, non-formulary exceptions and pharmacy peer-to-peer. ePA via CoverMyMeds also accepted. Behavioral health and abuse-deterrent drugs are carved out to Maryland Medicaid fee-for-service.

Eviti handles oncology and radiation oncology regimen review; fax the Eviti checklist to 888-468-1423. Off-label oncology requests are processed by MPC.

High-tech radiology, outpatient cardiac procedures, and spine pain management authorizations via RadMD.com or Evolent call center.

Care management program referrals by phone, fax or email.

Send a letter of intent to join the MPC network.

Pharmacy benefit manager contact listed on MPC's contact page.