Member Services
If you have any questions or concerns, please call our Member Services Representatives toll-free at 1-800-311-9529, Monday through Friday, 8:00 A.M. to 5:00 P.M. (TTY users please dial 1-866-322-7357) Unique Features of CCA’s Commonwealth Care Connection ProgramCommonwealth Care Alliance will work in partnership with you and the Primary Care Physician (PCP) to coordinate all appropriate services. All covered services are provided through CCA’s extensive contracted network, including specialists, hospitals, community-based home care providers, and skilled nursing facilities. The PCP will arrange hospital and nursing home care through CCA’s contracted facilities. CCA only contracts with physicians who have considerable experience in serving those with disabilities. Your Primary Care Physician (PCP) is responsible for coordinating your medical care, and calling upon additional specialists, if necessary. CCA contracts with community based health centers that are experienced in caring for those with disabilities. If your care requires it, you will be assigned a Primary Care Team (PCT). Your Primary Care Team (PCT) will work together with your Primary Care Physician (PCP) to coordinate medical support service needs. Your PCT will include a nurse practitioner, registered nurse, or physicians’ assistant. Each member of the PCT will have experience in caring for those with disabilities. The PCP and Primary Care Team (PCT) will work together with you and others, such as family members or caregivers, to construct a comprehensive Individual Care Plan (IPC), designed for your specific needs. The Individualized Care Plan (IPC) includes all health care, health-related, or social support services that the PCP or PCT has authorized or recommended you to receive. The PCP will coordinate these services. In order to ensure the most appropriate services, the PCP will review and approve any changes to the ICP, whether adding, altering, or discontinuing a service. Other advantages to participating in the CCC program include:
CCA is able to provide its’ members with a wide array of health and health-related services. You will have the convenience of a single point of contact (the PCP or PCT) for problems, questions, and access to care 24 hours a day, 7 days a week. Also, if anyone has any questions or concerns on the member's care, please do not hesitate to call our Member Services Representatives toll-free at 1-800-311-9529, available Monday through Friday, 8:00 A.M. to 5:00 P.M. (TTY users please dial 1-866-322-7357) Member Responsibilities
Member Rights to Exceptions and AppealsWe encourage you to let us know right away if you have questions, concerns, or problems related to your covered services or the care that you receive. Please call Member Services at 1-800-311-9529, (TTY users please call 1-866-322-7357). Federal law guarantees your right to make complaints if you have concerns or problems with any part of your medical care as a plan member. The Medicare program has helped set the rules about what you need to do to make a complaint and what we are required to do when we receive a complaint. Please refer to pages 84 – 107 in the Evidence of Coverage for the Commonwealth Care Connection Program. Commonwealth Care Alliance Member Services Department
*Filing a complaint will not negatively affect your CCC plan or coverage. |
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Our Commonwealth Care Connection (CCC) Program allows the Primary Care Physician (PCP) to coordinate a comprehensive range of health care, health-related, and social support services tailored to fit the individual's needs. The PCP is dedicated to providing a personalized approach you and the CCA network providers are able to fluidly work together on your behalf. Commonwealth Care Alliance (CCA) provides access to nurses, services, and information on a 24-hour basis, 7 days a week.