Claims administration including intake, status checks, denials, remittance/EOBs, and reconsiderations or appeals is handled by Choice Physicians Network and MHM Health, our Management Services Organization, through the EZ-NET portal.
Payments come from MD Senior Care Medical Group, the IPA. Funds are released after claims are approved by the MSO according to our delegation. Therefore, please work with Choice/MHM Health for all claim submissions, status inquiries, remittance copies, denials, and appeals.
Note: MD Senior Care Medical Group handles contracting matters or clinical issues that are not related to claims processing.
MD Senior Care Medical Group, Inc.
P.O. Box 1205, Apple Valley, CA 92307.
Use the HCFA-1500 or UB-04 as applicable.
Include your TIN, NPI, patient name, member ID, date(s) of service, CPT/HCPCS with units, ICD-10, and billed charges.
Add the referral/authorization number and required clinical notes or itemized bill when applicable.
Write the claim number on all pages and keep copies.
Mail with tracking and retain the receipt.
Payor Code: MSCMG
Log in to Office Ally and select MD Senior Care Medical Group using Payor Code MSCMG.
Use the HCFA-1500 for professional services or the UB-04 for facility services.
Enter the provider legal name, TIN, billing and rendering NPIs, and billing address.Enter the patient full name, date of birth, and member ID exactly as shown on the card.Add the date(s) of service, place of service, CPT or HCPCS with units and modifiers, and ICD-10 codes.
Include the referral or authorization number when required by the plan.
Attach supporting documents as needed, such as clinical notes, operative report, pathology, imaging, itemized bill, COB or EOB, and NDC units with invoice for J-codes.
Mark a corrected claim when resubmitting and reference the original claim number.
Submit the claim and save the EDI control number or batch number for tracking.
Check claim status and remittances in the EZ-NET portal or through Office Ally reports.
If the MSO approves the claim, MD Senior Care releases payment.
Request EZ-NET access by submitting a “Request Access” form with your provider name, TIN, NPI, email, and user’s job title.
Wait for your credentials to be issued by the MSO and store them securely.Log in to the Choice Provider Portal with your assigned username and password.
Verify your practice profile (billing address, TIN, NPIs) before submitting claims.
For claim status, use Claim Inquiry and search by claim number or patient + date of service. To view payments, open Remittance/Payments and download the EOB/RA or search by check/EFT number.
If a claim is denied, submit a reconsideration in the portal and attach required documents (auth number, clinical notes, itemized bill, COB/EOB, NDC details for J-codes).
For corrected claims, resubmit as corrected and reference the original claim number.
For authorizations, submit requests in Auth/Referrals, include clinical rationale, and link the request to the upcoming claim.
If portal help is needed, open a portal ticket with TIN/NPI, patient/member ID, DOS, billed amount, and (if EDI) your batch/control number.