We know that some members have had difficulty finding a provider in the Nationwide Provider Network (NPN) for their World Trade Center (WTC)-related care. In response, Managed Care Advisors (MCA)-Sedgwick is expanding the NPN network to significantly increase the number of providers available to over 1 million.
This will greatly improve access to physical and mental health care throughout the United States and its territories. All current providers will remain in the network.
No. No action is needed if your current provider is already in network. You may continue to see them as usual. No providers have been removed from the network as part of this change.
Possibly. Many previously out-of-network providers are now in network. Please contact us at 1-800-416-2898 to see if your previous provider is now in network and available to provide your WTC-related care.
If they are now in network, we will work with you if you wish to schedule an appointment with them. You can also choose to stay with your current provider if you already changed.
For select members with a known out-of-network provider, MCA-Sedgwick is proactively making phone calls to set up appointments with providers that are now in network. Letters with additional information are also being sent to these members. Additional calls are planned for members with other known provider issues, such as a temporary approval to see an out of network provider or a need for diagnostic support.
Please contact NPN Member Services at 1-800-416-2898 to determine if your provider is in the network.
There will be, but not right away. As of now, you should contact NPN Member Services at 1-800-416-2898 for assistance in locating a provider or checking a provider’s status.
We are updating our provider search tool with the expanded network information and expect this to take a few months. This is the same provider search tool that was previously available in the NPN Member Portal. We will let you know as soon as it is available.
IMPORTANT: Do not use a provider search tool from the health networks that make up the MCA-Sedgwick network (e.g., First Health, Aetna, Prime Health Services). These tools are not customized to WTC-related care and will not accurately present providers available to you through the NPN.
You will receive an updated ID card in the coming weeks. This new card will have additional information included related to the expanded network.
If we schedule you for an appointment before then, you will receive a temporary ID card to take to the appointment.
The MCA-Sedgwick NPN network has always been made up of a few different health provider networks. To expand the network, we entered into an agreement with another major provider network known as First Health. First Health is a subsidiary of Aetna.
Prime Health Services, which made up a large part of the existing network, continues to a part of the MCA-Sedgwick network.
First Health is a national healthcare provider network we have added to improve access to care. First Health is a subsidiary of Aetna.
IMPORTANT: Do not contact First Health or Aetna directly for WTC-related care or questions. You also should not use First Health or Aetna online provider search tools to try to find in-network NPN providers. They are not customized for WTC-related care and will not accurately present providers available to you through the NPN.
If you have a question related to the expanded network or need to check the status of a provider, call the MCA-Sedgwick NPM Member Services Services team at 1-800-416-2898.
• If your provider(s) is already in network, you do not need to take any action. Continue seeing your provider(s) as usual.
• If your provider(s) is out of network and you have not already spoken to an MCA-Sedgwick representative about finding an in-network provider, please contact us at 1-800-416-2898.
• If you don’t know the status of your provider, please contact us at 1-800-416-2898.
The MCA-Sedgwick Member Services team is here to help. You may reach the NPN at 1-800-416-2898, Monday – Friday, 8:00 AM – 8:00 PM ET.