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WELCOME PROVIDERS!

Thank you for contracting with Coventry Health Care. Coventry Health Care provides coverage to millions of members across the country and offers products to a broad cross section of individuals, employers and government-funded groups, government agencies and other insurance carriers and plan administrators.  It is one of the nation’s largest providers of Medicare Advantage plans, offering value to Medicare beneficiaries on a local and national basis. 

We are glad you decided to partner with us in ensuring the best possible health outcomes for your patients who have chosen to become Coventry Health Care members!

  • As a Coventry contracted provider you will have access to a one-stop shop membership verification, prior authorization and claims payment research system through www.directprovider.com.  Providers have told us that this is one of the best features we have. 
  •  We can also pay you faster if you sign up for our Electronic Transfer Program which allows payments to be direct deposited into your designated provider bank account.  The form must be completed and returned to the address on the form along with a voided check if the account type is “C" checking or a deposit slip if the account type is “S” savings.


When you access this same provider website, www.directprovider.com, you will find the following important documents to help you serve our members:

  • Member ID card sample
  • Provider Manual
  • Prior Authorization List
  • Quick Reference Guide to important phone numbers, addresses, and websites
  • CMS (The Centers for Medicare & Medicaid Services) Ownership/Controlling Interest Worksheet


 

Clinical Practice and Preventive Services Guidelines

Coventry adopts evidence-based Clinical Practice Guidelines and Preventive Services Guidelines from nationally recognized sources. You can access the CPGs and PSGs here.

direct provider

Manage all your Coventry health plan needs at our secure, one-stop, multi-functional provider portal.

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Y0022_PDPCCP_2013_4006_1202b Approved
CMS Approved Date: 02/08/2013
Page Last Updated: 01/15/2016

© Copyright 2008-2016 Coventry Health Care

Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal.