Providers
Claims Processing
Independent Care utilizes DST as its Third Party Administrator (TPA). Please utilize the address below for submission of all paper claims:
For claims customer service please contact us at:
1-877-333-6820
Click here for a sample copy of our new Explanation of Payment form. The Explanation of Payment form is the statement sent by the payer to the provider, listing services provided, amounts billed, and payments being made, which are included on an enclosed check.
Claims processing is based on the resolution of EX Pend codes. Any claim that does not auto adjudicate must be reviewed by a processor for resolution. Pend codes are utilized for data that could not be resolved by the system. Timeliness is calculated from the time the claim is received until the check cycle runs to pay the claim.
Click here for iCare EX Pend Codes.
Provider Resources
PDF Resources
- Abridged Formulary/iCare Medicare Plan 2010
- Abridged Formulary/iCare Partnership 2010
- Anti-Smoking Quit Line (English)
- Anti-Smoking Quit Line (Spanish)
- BadgerCare Plus Core Member Recertification Reminder
- CMS Appointment of Representative Form
- Community Activity Facilities and Programs
- Comprehensive Formulary/iCare Medicare Plan 2010
- Comprehensive Formulary/iCare Partnership 2010
- Coverage Determination Request Form
- Emergency Room Brochure
- Enrollment Form/iCare Medicare Plan 2010
- Evidence of Coverage (EOC)/Member Handbook - 2010 iCare Partnership
- Evidence of Coverage/ANOC/iCare Medicare Plan 2010
- Fraud, Waste and Abuse Compliance Training 2010
- Greivance and Appeals Process/iCare Partnership 2010
- iCare BadgerCare Plus Program Brochure
- iCare BadgerCare Plus Program Brochure/Hmong
- iCare Medicaid SSI Program Brochure
- iCare Medicaid SSI Program Brochure/Hmong
- iCare Medicaid SSI Program Brochure/Spanish
- iCare Medicare Plan 2010 Program Brochure
- iCare Medicare Plan 2010 Program Brochure/Spanish
- iCare Road to Independence Video Challenge Package
- iCare/Independent Care Health Plan Scholarship
- Letter of Medical Necessity
- Limited English Proficiency Policy/Procedures
- LIS 2010 Premium Summary Sheet
- Medicare Part D Coverage Determination Form
- Medication Request Form - Partnership Medicaid
- Member Handbook/iCare BadgerCare Plus
- Member Handbook/iCare BadgerCare Plus Core Plan
- Member Handbook/iCare BadgerCare Plus Core Plan/Spanish
- Member Handbook/iCare BadgerCare Plus/Hmong
- Member Handbook/iCare BadgerCare Plus/Spanish
- Member Handbook/iCare Medicaid SSI
- Member Handbook/iCare Medicaid SSI/Spanish
- Notice of Formulary Change/iCare Medicare SNP 2010
- Notice of Formulary Change/iCare Partnership 2010
- Over-the-Counter Drug Program Catalog/iCare Medicare Plan 2010
- Over-the-Counter Drug Program Catalog/iCare Medicare Plan 2010/Spanish
- Over-the-Counter Drug Program Catalog/iCare Partnership Plan 2010
- Parental Consent Form
- Partnership Program Brochure/iCare 2010
- Pharmacy Directory/iCare Medicare Plan/iCare Partnership 2010
- Pharmacy Listing/iCare Medicare Plan 2010
- Pharmacy Listing/iCare Partnership 2010
- Plan Comparison brochure/iCare Partnership 2010
- Power of Attorney brochure
- Prior Authorization Criteria/iCare Medicare SNP 2010
- Prior Authorization Criteria/iCare Partnership 2010
- Privacy Statement
- Provider Directory Supplement/BadgerCare Plus
- Provider Directory/iCare BadgerCare Plus-Medicaid SSI
- Provider Directory/iCare BadgerCare Plus-Medicaid SSI/Spanish
- Provider Directory/iCare Medicare Plan 2010
- Provider Directory/iCare Partnership 2010
- Provider Manual
- Provider Newsletter Fall 2008
- Report to the Community
- Road to Independence Video Challenge Flyer
- Self-Directed Supports Brochure/iCare Partnership 2010
- Self-Directed Supports Guide/iCare Partnership 2010
- Step Therapy Prescription Drug Criteria/iCare Medicare SNP 2010
- Step Therapy Prescription Drug Criteria/iCare Partnership 2010
- Summary of Benefits/iCare Medicare Plan 2010
- Summary of Benefits/iCare Partnership 2010
- Transition Process
Call 1-800-777-4376 (TTY: 1-800-947-3529), from 8:00 a.m to 8:00 p.m.,
7 days-a-week, for further information about iCare.