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Welcome Provider!

Learn about the benefits and services you obtain as a provider.

  • Proveedor contratado
    Contracted Provider

    If you already belong to our network, register on the provider portal.

  • Our Provider Network
    Our Provider Network

    Learn how MSO collaborates with your medical practice.

  • Join our network
    Join our network

    Learn how you can become part of our provider network.

  • Non-contracted provider claims

    Learn how to request a claims adjustment and what your appeal rights are.

  • Report Fraud

    Do the right thing, help us stop healthcare fraud.

  • Coordinated Care Model

    This tool improves the quality of life of members with special needs.

Have a question?

Contact Provider Services

Monday to Friday7:00 a.m. to 7:00 p.m.

Non-contracted Provider Claims

If your payment claim as a non-contracted provider was denied by MMM Healthcare, LLC, you may file a Claims Adjustment and exercise your Appeal Rights. Here’s how.

 

If MMM Healthcare, LLC denied your payment claim, you have the right to request an adjustment of your claim within 365 days from the date the service was provided. In addition, you have appeal and dispute rights depending on your situation. We have provided a questions and answers document so you can obtain more information and clarify any doubts. For your reference, the different forms to be completed according to your request are also included.

For more information, you may contact our Provider Relations Department:


 

1-866-676-6060 Monday to Friday from 7:00 a.m. to 7:00 p.m.

 

Send us a letter by fax to: 787-625-3375

 

Send a letter by email to: Appeals&GrievanceNotifications@mmmhc.com

Or by postal mail to one of the following addresses according to the plan:

For Adjustments to your Claim:

Medicare y Mucho Más

Claims Dept.
PO BOX 71114
SAN JUAN PR 00936-8014

For Appeals and Grievances:

Medicare y Mucho Más

Appeals and Grievances
PO BOX 71114
SAN JUAN PR 00936-8014

Important documents

  • Frequently asked questions about Provider Rights to Appeals and Disputes.Download
  • Provider Network FormDownload
  • AuthorizationsDownload
  • CMS Interoperability MandateDownload
  • Register your location in the Medicaid Provider Enrollment Portal (PEP)Download

Note

If you are a contracted provider for MMM Healthcare, LLC, please refer to the InnovaMD Portal.

Dear Provider:

Register today in the Puerto Rico Medicaid Program Provider Enrollment Portal (PEP).

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