Are my McLaren Health Plan Medicaid, Community, Medicare, or Health Advantage benefits still in effect?
- Yes. You still have your same benefit coverage through McLaren Health Plan/McLaren Health Plan Community/McLaren Medicare Advantage/McLaren Health Advantage.
Can I access my information on the McLaren Health Plan portal, McLaren Connect?
- Yes. You can see your claims history, look at your explanation of benefits, change your PCP, request a new ID card and more.
What if I still have questions?
- You can reach Customer Service by calling (888) 327-0671, our Customer Service Representatives are available and are answering calls, Monday – Friday from 8 a.m. to 6 p.m. and for McLaren Medicare Advantage, we are available Monday – Friday from 8 a.m. to 8 p.m.
Provider Specific Information
How are Pre-Authorization Requests being handled?
- For all lines of business, we are temporarily waiving inpatient hospital, NICU, LTAC, inpatient rehab, and SNF stay auth requirements until further notice. SNFs should fax clinical documentation to 855-377-3653 within 3 days of admission for Medicaid admits. For Hospital stays greater than 48 hours, you may fax clinical documentation to 855-377-3653. All hospital inpatient stays less than 48 hours are considered observation. Hospital observation stays do not require prior authorization or submission of clinical documentation.
- Outpatient authorization requirements are still in place. Outpatient authorization requests may be faxed to 855-377-3653. Providers will be notified verbally of auth decisions by Medical Management staff. We reserve the right to retrospectively review cases for medical necessity. If you have any questions, please contact Customer Service at 888-327-0671.
Are Claims still being processed?
- At this time, we are unable to receive any inbound claims files or access our claims adjudication system.
Have Pharmacy pre-authorizations been impacted?
- MedImpact, our Pharmacy Benefit Manager, is fully operational, and there is no disruption in services as it pertains to the pharmacy benefit.
As this situation evolves, we will continue to post updates on our website, McLarenHealthPlan.org.
Thank you for your patience and cooperation as we navigate this situation.