What's new at Delaware Physicians Care

Effective 01/01/2012, ALL providers are required to submit their annual Provider Disclosure Statement. Failure to submit the completed form by 02/17/2012 will result in suspension of your payments. If you ARE registered with State of Delaware Medical Assistance Program, please click on this link to complete the online DMAP form. If you ARE NOT registered with the State of Delaware Medical Assistance Program, please complete the Delaware Physicians Care Provider Disclosure Statement.

Electronic Remittance (ERA) Enrollment Form

Avoiding Medicare and Medicaid Fraud and Abuse

Long Term Care Provider Letter of Intent

Providers

Delaware Physicians Care Secure Provider Web Portal

Our convenient and secure HIPAA-compliant provider web portal provides a platform for Delaware Physicians Care to communicate health care information directly to providers. Our secure provider web portal allows you to verify member eligibility, submit authorization requests to the health plan, check authorization status, view member HEDIS intervention requirements, view and print panel rosters, check claims status, and view and print remittance advice claim payment information.

A user name and password are required to access the secure provider web portal. During the registration process, providers are asked to assign a primary representative from their office. User names and passwords are distributed by Delaware Physicians Care provider relations department.

To register, click here.

If you are already registered and would like to login to the secure site, please click here.

Secure provider web portal navigation guide

Provider relations representatives offer secure provider web portal training, if needed, in your office or at monthly provider orientation sessions held throughout the state.

We are committed to making the Delaware Physicians Care’s website and secure provider web portal easy and efficient for our provider network to use. To learn how to better use the site, or if you have questions or suggestions, contact a provider relations representative at 1-800-287-9860.

Provider Application Process

We are committed to the quality of health care services delivered to our members. In support of this commitment, we have a structured provider credentialing and contracting processes in place.

The following steps must be successfully completed for providers to be eligible to provide care to Delaware Physicians Care members:

Credentialing application must be submitted correctly and completely.
Provider must be fully credentialed by Delaware Physicians Care.
New providers will be mailed a Delaware Physicians Care contract. Providers joining an existing group must complete the applicable contract documents to be added to the existing contract.
Provider must sign and return the Delaware Physicians Care contract documents.
When credentialing is complete and contract documents have been fully executed, the provider will receive notice from Delaware Physicians Care network development department with the provider’s effective date of participation, along with the fully executed contract (if it is a new contract).
Providers should refrain from scheduling and seeing Delaware Physicians Care members until notified of participation effective date.

Please contact provider relations at 1-800-287-9860 with any questions about Delaware Physicians Care provider application and credentialing processes.