Frequently Asked Questions (FAQs)

For questions about claims and EOB statements you should call your claims payor. Check your health plan card for the claims payor customer service telephone number. You can also locate this information on the Member Tab, under the Claims and Benefits Information link on the left, and selecting your employer. Or just click on this link and select your employer: Claims and Benefits Information

Prescription questions should be directed to the Pharmacy Benefit Manager (PBM). Check your health plan card for the PBM customer service telephone number. You can also locate this information on the Member Tab, under the Claims and Benefits Information link on the left, and selecting your employer. Or just click on this link and select your employer: Claims and Benefits Information

You should call your claims payor to request a new health plan card. Check your health plan card for the claims payor customer service telephone number. You can also locate this information on the Member Tab, under the Claims and Benefits Information link on the left, and selecting your employer. Or just click on this link and select your employer: Claims and Benefits Information

This information can be obtained from your claims payor. Check your health plan card for the claims payor customer service telephone number. You can also locate this information on the Member Tab, under the Claims and Benefits Information link on the left, and selecting your employer. Or just click on this link and select your employer: Claims and Benefits Information

Your employer uses precertification as a part of medical management to make sure that you receive suitable care. Trained nurses act as advocates for you and your employer to ensure that your care is appropriate and cost effective. The back of your health plan card notes the precertification requirements of your health plan and provides you with a toll free number to call when you need to receive any of the listed services. Many plans have a financial penalty applied to the patient if you do not follow the precertification process. Information on this program is also contained in your health plan document, which is available from your employer. Please read this information carefully so that you understand your health plan, and its rules, in order to avoid any penalties.

If your plan design is a Preferred Provider Organization (PPO), then you do not need a referral to see a specialist. If you have a Point of Service (POS) plan design, you will need referral authorization from your primary care physician to see a specialist. You can also check your health plan booklet to verify the plan requirements regarding referral authorizations.

MyMichigan Health and Northwood

As soon as you find out you are pregnant, please contact ConnectCare's customer service at 888-646-2429 (option 3) to precertify your pregnancy and to be enrolled in our Healthy Pregnancy Program.

Your baby's charges at birth are usually submitted as part of the mother's bill for the delivery. Most insurance plans require that you go to your Human Resources or Personnel department and register your newborn within 31 days of birth. You should check the health plan booklet provided by your employer for the exact requirements for this situation.

Each plan has different requirements on how families access their insurance benefits. You should check the health plan booklet provided by your employer to see how your coverage works under this situation.

All the physicians and facilities listed under your employer's pages on our Web site are part of your provider network. The Web site listings are updated frequently; however, as this information may also change frequently, it is wise to ask whether the provider is still participating with your employer's ConnectCare plan.

If you choose a provider who is not part of your ConnectCare PPO, you can expect to pay a larger portion of the costs. You must follow your provider's procedure for payment when they do not participate with or bill your claims payor. Typically you will be asked to pay for the services you received and you will be given a receipt to submit to your claims payor for reimbursement. All providers participating in ConnectCare will bill your claims payor and they will accept the amount paid as payment in full, with the exception of your copayments, coinsurance, or deductible amounts.

It is always important that you seek the medical care you need. Often, health plans cover emergency care at a benefit level that does not vary based on where your emergency occurs. Please check the health plan booklet provided by your employer for the coverage levels applied to emergency care.

ConnectCare uses a process to confirm the quality of our network providers. Any concerns you have about your experiences with our providers are important to us and we want to hear from you. Our complaint officer is available to discuss your concerns. You can contact us toll free at (888) 646-2429 and ask to speak to the complaint officer or send an email to the complaint officer at privacy@connectcare.com.

MyMichigan Health ONLY

A Tier 1 provider is enrolled in the ConnectCare network. A tier 2 provider is not enrolled in the ConnectCare network but participates with Blue Cross Blue Shield of Michigan. Tier 3 providers are all out of network providers. A directory of providers in the PPO network can be obtained online, or by contacting Human Resources.

MyMichigan Health and Northwood University

Call one of the nurse case managers at 989-839-1629, option 3.  If it is after hours, weekend, or holiday, call the pharmacy benefit manager customer service number listed on your medical card.