As a trusted provider in the MedCost Network, we want to make you aware of an unforeseen situation involving some employers in your area. Cherokee County, Community Action Opportunities, Van Wingerden International/Valley Chilled Transportation, and Irene Wortham Center recently experienced a disruption in their health plan TPA services through Crescent Health Solutions. As a result, these groups are transitioning to MedCost Benefit Services for administration of their health benefits with an effective date of 3/1/25.
Current plan members of these groups have been assured by their employers that they have coverage (without lapse). MedCost is working diligently to enter each group’s health plan and member eligibility information into our system as it is received from the employer in order to issue ID cards and adjudicate claims. This process could take up to 4-6 weeks from the date of this notice to fully implement; claims submitted to MedCost for these groups during the implementation period may be rejected. Should you receive a rejection, you can contact MedCost as indicated below. Once the member is confirmed in our system, you can refile the claim.
If a patient with coverage under one of these groups arrives in your office prior to receiving their new MedCost ID card, you may call MedCost Customer Service at 1-800-795-1023 to verify benefits and eligibility; however, it is important to note that any information provided at the time of the call will be based on the information available in our system, may be subject to change, and is not a guarantee of payment until all member information has been loaded and benefits are finalized.
We appreciate your understanding and patience as we work to onboard these groups and their plan members. And, we respectfully ask that you extend that same understanding and patience to the health plan members affected by this disruption in TPA services through no fault of their own.