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Frequently Asked Questions from Payor

General Questions

What is Signature Care?

Signature Care is a statewide network of healthcare providers located in Indiana and northwest Ohio that can be accessed through an employer's group health plan. Signature Care is a Preferred Provider Organization (PPO). When an employer chooses Signature Care as its PPO network, health plan participants receive medical services at a negotiated rate from contracted providers.

How large is the Signature Care network?

Signature Care includes over 8,500 physicians, healthcare providers and hospitals throughout Indiana and northwest Ohio.

How can I find a physician or hospital in the Signature Care network?

The Signature Care Provider Directory can be found on the Signature Care website, www.SignatureCarePPO.com. You can also call a Signature Care customer service representative at 800-666-4449. Spanish-speaking representatives are available.

How do you decide which providers are included in Signature Care?

Signature Care is an "open access" PPO that contracts directly with private office physicians and other healthcare providers to assure care for its members. Members may choose any network specialty provider without a primary care physician referral. Only select hospitals, physicians, and healthcare providers who have met credentialing standards are contracted to participate in the PPO network. Signature Care considers provider nominations based upon business need and credentialing approval.

Credentialing Questions

What is credentialing?

Credentialing, as it applies to Signature Care, is the process of validating the qualifications of health care professionals.

Are all providers credentialed for Signature Care?

The following health care professionals who provide care to Signature care members are credentialed: Doctors of Medicine (MD); Doctors of Osteopathic Medicine (DO); Doctors of Podiatric Medicine (DPM.); Doctors of Chiropractic (DC); Doctors of Dental Surgery (DDS); Nurse Practitioners (NP); Clinical Nurse Specialists (CNS); Certified Nurse Midwives (CNM); Certified Registered Nurse Anesthetists (CRNA); Psychologists (PsyD, PhD, EdD in Clinical Psychology); Licensed Mental Health Counselor (LMHC); Licensed Marriage and Family Therapist (LMFT) and Licensed Clinical Social Worker (LCSW).

What is verified when a health care professional is credentialed?

Verifications are appropriate for certain specialties and include all or some of the following: education, training, experience, competence, board certification, professional license(s), malpractice insurance and, if applicable, hospital affiliation and authorization to prescribe medication.

Claims Questions

How does Signature Care interact with my claims system?

Signature Care provides all claims re-pricing for network providers. Claims are received and transmitted electronically through EDI, or may be received via mail. Ninety-five percent of EDI claims are re-priced within 24 hours. Paper claims are re-priced within 48-72 hours. Please see the Provider Manual for specific information about claims submission.