Provider Support

Provider Relations

The MedStar Family Choice Provider Relations Department values our Provider Network, and our staff is available to assist network providers with education, inquiries, questions, problems and concerns.

Case Management Department

MedStar Family Choice has a dedicated staff of nurses and social workers that can assist your office in obtaining pre-authorization, care coordination, and case/disease management services.

Read our Clinical Practice Guidelines.

Case Management Services

Our highly qualified staff of nurses and social workers can assist in caring for your patients. We offer different types of telephonic case management services depending on the needs of your patient. Our staff may contact you to collaborate, share clinical information, or to verify that services were rendered. MedStar Family Choice case managers will forward you the Plan of Care for any of your patients enrolled in services and welcome your feedback. 

Outreach

MedStar Family Choice has a dedicated staff of Outreach Representatives that work with our members to ensure that they are receiving the care they need. The team assists in scheduling first doctor's appointments with MFC providers, arranging for transportation, and on specific quality initiatives.

Preauthorization and Utilization Management

MedStar Family Choice follows a basic pre-authorization process: A member's physician forwards clinical information and requests for services to MedStar Family Choice by phone, fax or infrequently by mail. Reviewers and Physician Advisors are also available to discuss any and all utilization management decisions, questions or issues.

Quality Improvement

The Quality Improvement Department works closely with the Maryland Department of Health to ensure our members receive optimum care.

Information current as of: 08/30/19