As a participating provider in the MedCost network, you are the backbone of our PPO product. The tools on this website are provided to support and assist you in working with MedCost on behalf of our patients. For your protection, and to ensure patient privacy, security measures are in place to monitor access to certain features.

Deadlines for Implementing HIPAA 5010 Electronic Transaction Standards and ICD-10 Code Sets
The deadline for implementing the HIPAA 5010 electronic transaction standards is
January 1, 2012. This implementation updates the current standards for electronic health care and pharmacy transactions, and sets the stage for expansion of ICD-9 diagnosis codes to ICD-10 codes, which has an October 1, 2013 compliance deadline. HIPAA requires covered entities (such as health plans, health care clearinghouses, physician practices, hospitals, rehab facilities, and Inpatient/ Outpatient facilities) to adopt these standards for electronic health care administrative transactions, which include claims, remittance, eligibility, and claims status requests and responses. MedCost is currently testing with our vendors and will be fully compliant by the January 1, 2012 deadline. Click here for more information and recommendations on how you can prepare for 5010.

Change to Reference Guide
Effective April 2010, benefit information has been eliminated from the Reference Guide, since most providers call the claim administrator directly to verify benefits prior to services being rendered. The new layout still includes information on group numbers, effective and termination dates, claim administrator names, etc. To access the Reference Guide, please click here to login.

Support Inclusive Health- State and Federal Options
If you are a North Carolina MedCost participating provider and would like more information about joining the Inclusive Health Network (North Carolina Health Insurance Risk Pool), click here.