SMG KC Participation. No YES YES. Yes. Yes Yes YES. No Yes Yes Yes Yes Yes Yes Yes Yes No. No Yes. No No. Yes Yes Yes Yes Yes Yes.
|
|
|
- Edmund Goodman
- 6 years ago
- Views:
Transcription
1 SMG KC Insurance Participation -TIN # rev Advantra Medicare_Coventry HMO, PPO, POS Aetna All Commercial Products Aetna Medicare Advantage- PPO, POS,HMO Aetna Work Comp Access Allwell Medicare Advantage (Through Sunflower/Centene) eff Ambetter Exchange (Through Sunflower in KS, Home State in MO BCBS Blue Advantage Plus (Medicaid) BCBS Blue Care - YBW BCBS Blue Advantage HMO BCBSKC Medicare Advantage HMO BC/BS of Kansas City PPO-Preferred Care,Preferred Care Blue, Traditional Plan, Freedom Network, Freedom Network Select - YBC YBU, YBF, YBA BCBS KC Blue Select Plus YBP - YBT, YBZ, YBM, YBD BC/BS of Kansas HMO-Blue Select - YBT, YBZ, YBM, YBD BC/BS of KS, -XSC, XSG, XSL, XSQ, XSR, BCBS KS Blue Choice - XSB, XSE, XSI BC/BS of Kansas City Blue Access PPO BC/BS of Kansas PPO-Traditional Plan BC/BS Federal - R Beech Street (MultiPlan) CAPP Care/Beech Street (MultiPlan) Care Improvement Plus - OUT OF NETWORK ONLY Central States SE/SW (BCBSKC) Cerner (Freedom Network-BCBSKC) Cerner KC Healthcare Initiative CIGNA CONNECT Cigna LocalPlus Exchange Cigna PPO Cigna HealthSpring Medicare Advantage Community Health Care CompResults Connecticut General (Cigna) CorVel Coventry Automobile Coventry Healthcare of KS (HMO, PPO, POS, ASO) Coventry National PPO Coventry Workers Comp Coventry One (ACA Exchange Products) Coventry FocusedCare Coventry Medicaid Embarq Choice or Select Plans (BCBSKC Freedom Network) Encompass Specialty Surgical Network The Epoch Group (BCBSKC Freedom Network) Family Health Partners - Medicaid First Guard-MEDICAID SMG KC Participation
2 First Health (Coventry) Focus Healthcare (Coventry product) Fortified Provider Network (FPN) Freedom Network (BCBSKC) Galaxy Healthcare (Medicaid) GEHA (Freedom Network BCBSKC) Great West (Cigna) HCA Wellcare (HMCC) Healthcare Preferred Healthcare USA - (New name is Aetna Better Health) HCA Wellcare (HMCC) Healthe Exchange -Cerner (Freedom Network BCBSKC) HMCC Home State Health Plan Humana Commercial PPO, HMO, POS, EPO Humana Medicare PPO, HMO, PFFS, HMO Humana/ChoiceCare Medicare Advantage Humana Exchange PPOx Mailhandlers (Coventry National) Managed Care Strategies (Medicaid) Matthews Richards Healthcare Management (w Key Health) Medicaid of Kansas Medicare MedSource National (Work Comp) MetroCare Missouri Care (Independence Women's Clinic only) MO HealthNet (Insure Missouri) (Medicaid Plan) MultiPlan (PHCS) New Century (Humana Plans HMO + PPO) OccuNet, LLC OHM (Occupational Health Management) Pref Health Prof (PHP & Options HMO)-(BCBSKC Freedom Ntwk) Preferred Care Blue (BCBSKC) Preferred Care (BCBSKC) Private HC Systems (PHCS)(POS) (MultiPlan) Private HC Systems PHCS+PPO (MultiPlan) St Joseph & St Mary's Medical Center (Prime Healthcare Services) SeeChange PPO (HMCC) Southcare Preferred PPO Sterling Health Care Plans Sunflower Health Plan (Allwell Medicare Advantage only) The Epoch Group (BCBSKC Freedom Network) Todays Options (Medicare Advantage PPO, HMO, PFFS) TriCare/ TriWest Prime or Standard PRIME NEEDS REFEERRAL (thru HNFS) UNICARE (KS Medicaid) Union Pacific - EHS (Coventry First Health) * *
3 United Healthcare (UHC) HMO, PPO United Healthcare (UHC) Medicare Complete, AARP United Healthcare (UHC) Medicare Advantage PFFS United Healthcare (UHC) Medicare Select United Healthcare (UHC) Workers Comp United Healthcare (UHC) Medicaid Universal American (Today's Options) University of Missouri (Coventry Nat l) Viant Network (Beech Street/MultiPlan) WorkWell Physical Medicine WPPA(PPO)/Community -KS WYJOCARE KS (Kansas City Bone & Joint only) KCB&J only ***For Medicare Advantage PPO plans not listed above, SMG KC can accept as out-of-network***
4
5 ONLY DR LATTEIE AS CASE BY CASE
Government Plans 2016
Government Plans 2016 Use the site Find a Doctor and contact your insurance provider to verify participation. Definitions MMAI Persons eligible for Medicaid and, also called dual eligible. FHP Medicaid
Accepted Health Plans
Accepted Health Plans Lakeland Regional Health Medical Center While the hospital contracts with the following health plans, the hospital may not be included in all of the products (i.e. HMO, PPO, Behavioral
ACCEPTED HEALTH INSURANCES Kissimmee Location As of: June, 2018
ACCEPTED HEALTH INSURANCES Kissimmee Location As of: June, 2018 CIGNA CORE SOURCE AETNA 1199 SEIU ALLIED BENEFIT SYSTEMS UNITED HEALTHCARE (Commercial) BCBS / Florida Blue (Commercial) CHAMPVA MEDICARE
Notes. Does Overlake Medical Center (Hospital) Participate? Clinics (OMC) Participate?
Health Plan Does Overlake Medical Center (Hospital) Participate? Does Overlake Medical Clinics (OMC) Participate? Notes Aetna Overlake Medical Clinics is NOT a designated Aetna Aexcel Physician Group Aetna
Medicare Advantage PFFS Products HFMA 2008 Spring Education Conference Kiet Lam Senior Manager, Triage Consulting Group
Medicare Advantage PFFS Products HFMA 2008 Spring Education Conference Kiet Lam Senior Manager, Triage Consulting Group In the news Medicare Audits Show Problems in Private Plans NY Times (Oct 2007) Medicare
Health Plans Accepted by the Hospital (Effective April, 2018)
Health Plans Accepted by the Hospital (Effective April, 2018) 1199 SEIU National Benefit Fund Home Care Benefit Fund Greater New York Benefit Fund AARP AARP Medicare Complete Plan 1 United HealthCare AARP
201 E. Main Suite 600 El Paso, TX (915) Fax: (915) ADDENDUM
20 E. Main Suite 600 El Paso, TX 7990 (95) 887-340 Fax: (95) 774-020 ADDENDUM To: All Interested Proposers From: Diana Billingsley Date: March 7, 206 Subject: Telemedicine Services RFA # 6-00 Addendum
Contracted Insurance Plans and Episodic Programs Accepted at NCHS
FQHC CHDP/FQHC Contracted Insurance Plans and Episodic Programs Accepted at Newborn FQHC 3 161 186 Medi-Cal Medi-Cal Fee-For-Service (FFS) 14 Medi-Cal (straight Medi-Cal) - eligibility is issued from the
RESIDENTIAL, INPATIENT, DETOX, & MEDICATION ASSISTED TREATMENT DIRECTORY
RESIDENTIAL, INPATIENT, DETOX, & MEDICATION ASSISTED TREATMENT DIRECTORY Suboxone: You can find a Suboxone provider at www.suboxone.com using the Find a Doctor function and entering your zipcode. This
Nonreimbursable Code List for Outpatient Hospitals
Nonreimbursable Code List for Outpatient Hospitals Some procedure codes are either reimbursed as part of a more comprehensive procedure or are deemed nonreimbursable by Tufts Health Plan. The following
for brand drugs) $15 $20
Reading AARP MedicareComplete HMO Premiums/month $14 Max Out of Pocket, In- $6,700 Primary Care Dr. Visits $15 Specialist Office Visit $45 Urgent Care $30-40 Mental Health, Subst Abuse $345 per day Out-patient
Steve Yedlin, MD Chief Medical Officer. Lenda Townsend-Williams, MBA Chief Operating Officer
2015 ANNUAL REPORT Steve Yedlin, MD Chief Medical Officer Lenda Townsend-Williams, MBA Chief Operating Officer 2015 Annual Report Shareholder s Meeting May 3, 2016 To Our Shareholders, 2015 has been a
Wound Care. Equipment & Supplies. HME Wound Care is available throughout Wisconsin.
HME Wound Care is available throughout Wisconsin. Wound Care Equipment & Supplies 2021 Riverside Drive Green Bay, WI 54301 (920) 465-3000 (800) 236-2619 Fax: (920) 465-3003 Hours of Operation: Monday-Friday
Building photos courtesy of LLT Building Corporation
Building photos courtesy of LLT Building Corporation Primary areas of prevention and health promotion High risk drinking and drug prevention Mental health Physical health (nutrition, physical activity,
UC SF Medical Group & Medical Center Active Contracts Report and LOA Training
UC SF Medical Group & Medical Center and LOA Training April 18, 2012 Agenda Letter of Agreement (LOA) Questions 1 2 Health Plans 3 Health Plans Column A contains all of the Health Plans that are contracted
2011 ANNUAL REPORT. SHAREHOLDERS MEETING April 24, Arnold Blustein, MD Board President. Steven Yedlin, MD Chief Medical Officer
2011 ANNUAL REPORT SHAREHOLDERS MEETING April 24, 2012 CHILDREN FIRST MEDICAL GROUP Arnold Blustein, MD Board President Steven Yedlin, MD Chief Medical Officer Lenda Townsend-Williams, MBA Chief Operating
MA Substance Use Disorder (SUD) Mandate MA Products
MA Substance Use Disorder (SUD) MA Products Coverage FAQs for Inpatient and Acute Residential Treatment (ART) SUD for Fee-for-Service Facilities (FFS) Product MA HMO- Capitated Members Yes 10/1/15 At their
Steve Yedlin, MD Chief Medical Officer. Lenda Townsend-Williams, MBA Chief Operating Officer
2016 ANNUAL REPORT Steve Yedlin, MD Chief Medical Officer Lenda Townsend-Williams, MBA Chief Operating Officer 2016 Annual Report Shareholder s Meeting April 25, 2017 To Our Shareholders, As your Independent
URGENT WAY WALK-IN MEDICAL CENTER. Affordable, Compassionate, & Convenient Care
URGENT WAY WALK-IN MEDICAL CENTER Affordable, Compassionate, & Convenient Care I found going to the clinic a very positive experience. Dr. Khan was very welcoming and friendly. The first thing she mentioned
ICD-10 Frequently Asked Questions for Providers Q Updates
ICD-10 Frequently Asked Questions for Providers Q4 2012 Updates What is ICD-10? International Classification of Diseases, 10th Revision (ICD-10) is a diagnostic and procedure coding system endorsed by
EVIDENCE OF COVERAGE. January 1 December 31, Your Medicare Health Benefits and Services as a Member of Cigna HealthSpring Advantage (PPO)
January 1 December 31, 2018 EVIDENCE OF COVERAGE Your Medicare Health Benefits and Services as a Member of Cigna HealthSpring Advantage (PPO) This booklet gives you the details about your Medicare health
Managing Illinois Medicaid Reform at Your Practice. May 2015
Managing Illinois Medicaid Reform at Your Practice May 2015 1 Outline For Discussion 1. Overview of the marketplace today and transformational forces in the industry 2. Review of new Medicaid managed care
Effective December 18, 2017, the Agency launched a new Medicaid complaint tracking system.
Effective December 18, 2017, the Agency launched a new Medicaid complaint tracking system. Complainants now choose an Allegation Statement that they feel best describes his/her issue. The complaint tracking
Get Your Medicare Questions Answered
Get Your Medicare Questions Answered Do you have questions about your Medicare coverage? 1-800-MEDICARE (1-800-633-4227) can help! TTY users should call 1-877-486-2048. What Should I Have Ready When I
2018 Medicare Advantage Chronic Condition & Institutional Special Needs Plans (SNP) in Maricopa County
2018 Medicare Advantage Chronic Condition & Institutional Special Needs Plans (SNP) in Maricopa County Special Needs Plans are either HMO or PPO plans that limit their membership to people with one of
In this issue: First Quarter, 2014
First Quarter, 2014 In this issue: MultiPlan Acquisition by Starr Investment Holdings Three MultiPlan Clients Awarded Texas Medicaid Contracts MultiPlan Invests in Online Scheduling Company Improved Online
Archived SECTION 19 - PROCEDURE CODES. Section 19 - Procedure Codes
SECTION 19 - PROCEDURE CODES 19.1 CPT CODES...2 19.2 PROCEDURE CODES...2 19.3 PROCEDURES REQUIRING A COPAY (TEXT DEL. PRIOR TO 7/08)...3 19.4 COVERED AMBULATORY SURGICAL CENTER PROCEDURE CODES...3 Ambulatory
Archived SECTION 19 - PROCEDURE CODES. Section 19 - Procedure Codes
SECTION 19 - PROCEDURE CODES 19.1 CPT CODES...2 19.2 PROCEDURE CODES...2 19.3 PROCEDURES REQUIRING A COPAY (TEXT DEL. PRIOR TO 7/08)...3 19.4 COVERED AMBULATORY SURGICAL CENTER PROCEDURE CODES...3 Ambulatory
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna Medicare Physician Marketing Program
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions 2017 Aetna Medicare Physician Marketing Program Provider Marketing Opportunities: Aetna has a strong network
Index. Index... Page 1. Welcome Letter... Page 2. Insurance Directory... Page 3. Timely Filing Requirements for Initial Claim Submission...
40 Exchange Place Suite 1705 New York, NY 10005 P: 718.369.0012 F: 718.228.9423 Policies and Procedures Index Administration@Accessintegra.com Remittance 6/23/14 Index Index........ Page 1 Welcome Letter......
PROVIDER NEWSLETTER ARTC18-H Arkansas Total Care, Inc. All rights reserved.
PROVIDER NEWSLETTER ARTC18-H-013 2018 Arkansas Total Care, Inc. All rights reserved. 1 A New Model of Care Provider-Led Arkansas Shared Savings Entity (PASSE) In 2018, Arkansas Medicaid created a new model
Your Medicare Health Benefits and Services as a Member of Cigna HealthSpring Advantage (HMO)
January 1 December 31, 2018 EVIDENCE OF COVERAGE Your Medicare Health Benefits and Services as a Member of Cigna HealthSpring Advantage (HMO) This booklet gives you the details about your Medicare health
COMPARING FULL SERVICE CALIFORNIA HMO ENROLLMENT FOR MARCH 31, 2014 AND MARCH 31, 2015 (see Notes, pg 8)
COMPARING FULL SERVICE CALIFORNIA HMO ENROLLMENT FOR MARCH 31, 2014 AND MARCH 31, 2015 (see Notes, pg 8) ALL HMO PRODUCT LINES ENROLLMENT HMO Plans 2014 HMO Plans 2015 Difference Percent Chg Commercial
Medicaid Managed Care Overview
Medicaid Managed Care Overview 2011 Medicaid Reform Law In 2011, the General Assembly passed PA 96-1501 to address increasing budget pressures in the Medicaid program, requiring Illinois to enroll 50%
2018 Full Dual (Medicare & Medicaid) Medicare Advantage Special Needs Plans (SNP) Maricopa County
2018 Full Dual (Medicare & Medicaid) Medicare Advantage Special Needs Plans (SNP) Maricopa County Special Needs Plans for Dual Eligible beneficiaries are an HMO plan that limits their membership to people
The Medicare Medicaid Alignment Initiative (MMAI): A Program for People with Medicare and Medicaid. updated July 2016
The Medicare Medicaid Alignment Initiative (MMAI): A Program for People with Medicare and Medicaid updated July 2016 1 1 What is the Medicare Medicaid Alignment Initiative (MMAI)? A managed care program
National ACO Summit. Third Annual. June 6 8, Follow us on Twitter and use #ACOsummit.
Third Annual National ACO Summit June 6 8, 2012 Follow us on Twitter at @ACO_LN and use #ACOsummit. Opening Plenary Session Welcome and Overview Mark McClellan, MD, PhD Director, Engelberg Center for Health
Specifically, we encourage CMS to consider and implement the following policies related to these requests for information, including:
January 16, 2018 Seema Verma Administrator Centers for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 Re: Medicare Program; Contract Year 2019 Policy and Technical Changes to
Pamela Hjerpe, Assistant to the Executive Director, Maricopa Health Centers Governing Council
Minutes Maricopa Health Centers Governing Council Finance Committee General Meeting Maricopa Medical Center, Administration Building, Auditorium 1 November 4, 2015 4:00 pm Voting Members Present: Gary
OptumInsight Eligibility Payer List ANSI HIPAA 270/271 (As of 02/28/2013)
Payers highlighted are new or have been altered in the last 90 days. Please verify that your system is setup correctly for this payer AARP-UnitedHealthcare Ins Co 36273 ALL Loop 2100B should contain Tax
Alphabet Soup of Provider Credentialing. Anne Hanzel Alta Partners, LLC
Alphabet Soup of Provider Credentialing Anne Hanzel Alta Partners, LLC Why is Credentialing Important? Patient Safety Build practice base Allow for discounted amounts Direct link to managed care systems
By selecting this website link, you will be redirected to a website outside of Coventry and Direct Provider. We encourage you to familiarize yourself
By selecting this website link, you will be redirected to a website outside of Coventry and Direct Provider. We the other. Explore our provider manuals to find resources about Aetna policy guidelines that
6/5/2014 ABOUT ME ORGANIZATIONS
ABOUT ME 1985-1990 Worked 5 years for CPA (client accounting & payroll for about 30 companies) 1990-2011 Worked 21 years for private practice 2005-2011 Did Medical Billing on the side 2011-2014 Started
Change Healthcare Real-Time Payer List
Real-Time Payer ID Table Column Descriptions: Change Healthcare Real-Time Payer List Updated: Date added since last publication. N = New Payer, U = Update to payer record. Those marked as 'Coming Soon'
Bin pcn meddaet
P ford residence southampton, ny Bin 610502 pcn meddaet (PA), Aetna Medicare, Aetna Medicare Plan w/rx CY (HMO), 610502, MEDDAET. 95, H0319, 001, UNITEDHEALTHCARE INSURANCE COMPANY, UnitedHealthcare, UnitedHealthcare
The Business of Medicine
The Business of Medicine Coding as a profession Objectives How the coder fits in Hospital vs. physician services Hierarchy of providers Reimbursement aspects Payers Medical necessity ABN 1 Regulations
Presentation Objectives
Managed Care Negotiation Strategies Using Transparency and Case Data to demonstrate to Payers How ASCs Save Money I. Naya Kehayes, M.P.H., Managing Principal & CEO R. Matthew Kilton, M.B.A., M.H.A., Principal
Report of the Connecticut State Medical Society-IPA, Inc. to the Connecticut State Medical Society House of Delegates September 30, 2015
Report of the Connecticut State Medical Society-IPA, Inc. to the Connecticut State Medical Society House of Delegates September 30, 2015 Each year the Connecticut State Medical Society IPA (CSMS-IPA) provides
PA/MND Review of Spine Surgery services Questions & Answers
PA/MND Review of Spine Surgery services Questions & Answers 1. What is the Musculoskeletal Program? Horizon BCBSNJ has expanded our Pain Management Program with evicore to include Pain Management and Spine
Commonwealth Coordinated Care Enrollment Application Form
Exhibit 1: Model Medicare-Medicaid Individual Enrollment Request Form Referenced in 10.3, 30.1.1, 30.1.2, 30.2, 30.2.1 Keep a copy of this form for your records Commonwealth Coordinated Care Enrollment
TRICARE West Region UnitedHealthcare Military & Veterans
TRICARE West Region UnitedHealthcare Military & Veterans Today s Action Plan TRICARE Basic Training PCM Validation Referrals & Authorizations Urgent Care Pilot Inpatient Notification Right of First Refusal
MANAGED CARE IS HERE
MANAGED CARE IS HERE Survive or Thrive Susie Mix CEO/President Mix Solutions Inc. 1 Nursing Home (NH) Industry Transformation Senior Care Industry Trends & Strategies Why do we care about change? Finances
Humana Physician Quality Rewards Program 2014
Humana Physician Quality Rewards Program 2014 Medicare Glen Champlin MSO Director March 28, 2014 1430ALL0114-B What is CMS Stars and Why Should Providers Be Concerned? CMS Program of Quality & Performance
Access to health care is a national crisis affecting many Americans.
Access to health care is a national crisis affecting many Americans. It is a complex issue with a large array of special interests, but those most impacted by the health care crisis are those who are uninsured
Restructuring Healthcare The Role of Technology
Restructuring Healthcare The Role of Technology Philip Gaziano, MD October 11, 2012 2 Physician Owned & Lead Organizations Accountable Care Associates, LLC (ACA): Founded in 2010, it is physician owned
Professional Practice Medical Record Documentation Guidelines
Professional Practice Medical Record Documentation Guidelines INTRODUCTION Consistent and complete documentation in the medical record is an essential component of quality patient care. All Participating
State of New Jersey DIVISION OF INSURANCE CONSUMER PROTECTION SERVICES OFFICE OF MANAGED CARE PO BOX 329 TRENTON, NJ
CHRIS CHRISTIE Governor KIM GUADAGNO Lt. Governor State of New Jersey DEPARTMENT OF BANKING AND INSURANCE DIVISION OF INSURANCE CONSUMER PROTECTION SERVICES OFFICE OF MANAGED CARE PO BOX 329 TRENTON, NJ
Overall Learning Objectives How large is the specialty pharmaceutical market? Drug Trends Source: CVS Caremark 2013 Drug Trend Focus Report
What s So Special About Specialty Pharmacies? Overview and Role of Pharmacists and Pharmacy Technicians Implementation of a Specialty Pharmacy Program Overall Learning Objectives For Pharmacists and Pharmacy
What is an Organized Delivery System (ODS) from a Filing and Legal Perspective?
What is an Organized Delivery System (ODS) from a Filing and Legal Perspective? Presented By: Kevin Joyce: VP, Network & Delivery Systems, QualCare, Inc. Carol Grelecki: Esq, Brach Eichler, LLC July 16,
BLUE CROSS AND BLUE SHIELD OF ILLINOIS FAQS
BLUE CROSS AND BLUE SHIELD OF ILLINOIS FAQS BCBSIL TERMINATED OSF Q: Why did Blue Cross and Blue Shield of Illinois (BCBSIL) terminate OSF? A: On October 2, BCBSIL terminated the contracts with three OSF
9/11/15. Reimbursement for Non- Physician Providers Real Life Practice Objectives
Reimbursement for Non- Physician Providers Real Life Practice 2015 John F. Bishop, PA, CPC, CPMA, CGSC, CPRC AAPA National Chair Reimbursement and ICD-10 Work Groups Principle, John Bishop and Associates,
Managed care consulting services
Managed care consulting services WeiserMazars Health Care Consulting Services WeiserMazars LLP is an independent member firm of Mazars Group. WeiserMazars Health Care Group Managed Care consulting services
MANAGED CARE CONSULTING SERVICES
CONSULTING SERVICES WeiserMazars Health Care Consulting Services THE NEW JERSEY HOSPITAL ASSOCIATION April 30,2013 WeiserMazars LLP is an independent member firm of Mazars Group. WEISERMAZARS HEALTH CARE
PBGH ANALYSIS. Highlights: Aetna Strengths and Weaknesses
Methods Description: Health Plan Shopping Services Evaluation PBGH ANALYSIS Executive Summary: Aetna This report evaluates Aetna s online medical care and provider shopping services that are intended to
Flexible Network FAQs
Flexible Network FAQs A tiered PPO network for self-insured national accounts Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is working with other Blue Cross and Blue Shield Plans (Blue Plans)
The Comprehensive Primary Care Initiative: New Payment Models Will Rely on Use of Health IT
The Comprehensive Primary Care Initiative: New Payment Models Will Rely on Use of Health IT Richard J. Baron, MD, MACP Group Director, Seamless Care Models Innovation Center, CMS Advancing Primary Care
REPORT OF THE COUNCIL ON MEDICAL SERVICE. Acceptance of TRICARE Health Insurance
REPORT OF THE COUNCIL ON MEDICAL SERVICE CMS Report - I-0 Subject: Presented by: Referred to: Acceptance of TRICARE Health Insurance David O. Barbe, MD, Chair Reference Committee J (Jack J. Beller, MD,
Value-Based Care Contracting and Legal Issues
Session 4b Value-Based Care Contracting and Legal Issues Presented by: Janet Walker Farrer General Counsel and Insurance Legal Department Chair Ascension Health Leah Stewart Associate Vice President for
Partnership for Patients The Innovation Center Perspective
Partnership for Patients The Innovation Center Perspective Dodjie B. Guioa, MBA Hospital/ASC Program Lead Division of Survey & Certification CMS Region VI Thank You We re ready as never before to create
TEN MINUTES CAN SAVE THOUSANDS OF DOLLARS Presented by Alliance Ambulance, Inc. (713)
TEN MINUTES CAN SAVE THOUSANDS OF DOLLARS Presented by Alliance Ambulance, Inc. (713) 682-2273 http://www.alliance-ambulance.com FORMS OF PAYMENT FOR AMBULANCE SERVICES: MEDICARE MEDICARE HMO MEDICARE
North Carolina Emergency Department Visit Data - Data Dictionary FY2012 Alphabetic List of Variables and Attributes Standard Research File
North Carolina Emergency Department Visit Data - Data Dictionary FY2012 Alphabetic List of Variables and Attributes Standard Research File One of these three variables must be suppressed (diag1, fac, or
June 13, Dear NCVHS Members:
June 13, 2016 Dear NCVHS Members: CAQH CORE is the designated operating rule authoring entity for the Affordable Care Act (ACA) operating rules, which includes two sets of mandated operating rules. As
TRICARE West Region Authorizations and Referrals
TRICARE West Region Authorizations and Referrals March 2018 last updated March 19, 2018 TRICARE is a registered trademark of the Department of Defense, Defense Health Agency. All rights reserved. 1 Welcome
Florida s Medicaid 1115 Managed Medical Assistance Waiver Post Award Forum
Florida s Medicaid 1115 Managed Medical Assistance Waiver Post Award Forum Agency for Health Care Administration November 1, 2017 Public Meeting 1115 Research and Demonstration Waivers Section 1115 of
UnitedHealthcare Medicare Readmission Review Program for Medicare Advantage Plans Frequently Asked Questions
UnitedHealthcare Medicare Readmission Review Program for Medicare Advantage Plans Frequently Asked Questions Key Points The UnitedHealthcare Medicare Readmission Review Program reviews readmissions at
Contracted Insurance Plans
Contracted Insurance Plans As of March 1, 2018, Children s Health SM has contracts with the following health care insurance plans for the following locations: Children s Medical Center Dallas Children
Re: Non-participation in the new Horizon Medicare Blue Patient-Centered w/rx (HMO) product
Three Penn Plaza East Newark, NJ 07105-2200 HorizonBlue.com October 2014 Re: Non-participation in the new Horizon Medicare Blue Patient-Centered w/rx (HMO) product
May Non-Physician Practitioner (NPP) Nurse Practitioners and Physician Assistants. Collaborating Together as a Team
May 2015 Non-Physician Practitioner (NPP) Nurse Practitioners and Physician Assistants Collaborating Together as a Team What is a Non-Physician Practitioner (NPP) or Physician Extender } Physician Assistant
The road to well-being. Vision Care
The road to well-being Vision Care Tools Tools Dear Employer, Are you ready to lead your employees on the road to well-being? One way to do it is by focusing on vision care for the next four months. We
My Path to Good Health
My Path to Good Health Get health insurance for you/your family - page 2 How to choose a doctor - page 7 Use your health insurance - page 8 Go to the Doctor - page 9 Keep your health insurance - page 13
Contracted Insurance Plans
Contracted Insurance Plans As of September 1, 2018, Children s Health SM has contracts with the following health care insurance plans for the following locations: Children s Medical Center Dallas Children
Financial and Data Analytics to Support Risk Based Models of Care
Financial and Data Analytics to Support Risk Based Models of Care 2014 LEADING AGE OF MICHIGAN LEADERSHIP INSTITUTE Betsy Rust, CPA, Partner and Beth Sullivan, Senior Manager www.plantemoran.com 0 1 Session
California Pay for Performance: A Case Study with First Year Results. Tom Williams Integrated Healthcare Association (IHA) March 17, 2005
California Pay for Performance: A Case Study with First Year Results Tom Williams Integrated Healthcare Association (IHA) March 17, 2005 Agenda National Perspective California Program Overview Data Collection
Palmetto GBA Frequently Asked Questions - Medicare Enrollment Requirement for Dentists Ordering Part D Medicare Drugs Teleconference
Palmetto GBA Frequently Asked Questions - Medicare Enrollment Requirement for Dentists Ordering Part D Medicare Drugs Teleconference Q1. I am trying to decide whether to opt-out of Medicare or to complete
MMW Topical Brief: Medicaid Managed Long Term Services and Supports (MLTSS)
June 10, 2016 MMW Topical Brief: Medicaid Managed Long Term Services and Supports (MLTSS) Dear MMW Members, We wanted to share with you important information about a new program, the Medicaid Managed Long
Medicare Advantage PPO participation Termination - Practice Name (Tax ID #: <TaxID>)
July xx, 2013 INDIVDUAL PRACTICE VERSION RE: Medicare Advantage PPO participation Termination - Practice Name (Tax ID #: ) Dear :
Introduction to the Provider Care Management Solutions Web Interface
Introduction to the Provider Care Management Solutions Web Interface Release 0.2 Introduction to the Provider Care Management Solutions Web Interface Purpose Provider Care Management Solutions (PCMS) is
Evolution of ACOs in California. Accountable Care Congress Los Angeles November 11, 2014 Jill Yegian, Ph.D.
Evolution of ACOs in California Accountable Care Congress Los Angeles November 11, 2014 Jill Yegian, Ph.D. Integrated Healthcare Association Statewide multi stakeholder leadership group that promotes quality
MO HealthNet Primary Care Health Home Initiative
MO HealthNet Primary Care Health Home Initiative Community Health Workers (CHWs): A Bridge to Value-Based Care Timothy Kling MD, FACOG Assistant Medical Director, MO HealthNet Kathy Brown, MPA Primary
Care Provider Demographic Information Update
Care Provider Demographic Information Update Please use this form for a single care provider practitioner update. Incomplete forms will not be processed. Fields with an asterisk (*) are required for practitioners
Blue cross blue shield prefix assignments nj
Blue cross blue shield prefix assignments nj The Borg System is 100 % Blue cross blue shield prefix assignments nj Bcbs nj address based on prefix. Find BCBS address by alpha prefix id Blue Cross Blue
Developing Community-Based Pediatric Health Services By Tackling Financials First
Emerging Practices Profile Developing Community-Based Pediatric Health Services By Tackling Financials First Children s Mercy Hospitals and Clinics (Kansas City) Case Study Fall 2012 Profile Snapshot Children
Blue Shield of California: Consumer Initiatives
Blue Shield of California: Consumer Initiatives UC/CHCF California ecare Conference January 15, 2003 Los Angeles Alan Gellman Jeff Rideout, M.D., M.A. Valli Bowman Vice President, ebusiness President Director,
Entering Private Practice or Primary Care in West Virginia: A Guide For Registered Dietitian Nutritionists
Entering Private Practice or Primary Care in West Virginia: A Guide For Registered Dietitian Nutritionists CO-AUTHORS: MEREDITH CHAPMAN & LACY DAVIDSON MAY 12, 2017 Objectives 1. Supplement the AND s Toolkit:
MEDICAID REFORM HEALTH PLANS AND NETWORKS AS OF JULY 1, 2006
MEDICAID REFORM HEALTH PLANS AND NETWORKS AS OF JULY 1, 2006 CHRISTY HARRIS LEMAK LILLIANA L. BELL R. PAUL DUNCAN ALLYSON G. HALL PREPARED BY THE DEPARTMENT OF HEALTH SERVICES RESEARCH, MANAGEMENT AND
Frequently Asked Questions: HEDIS Attestations
November 2016 Frequently Asked Questions: HEDIS Attestations What is HEDIS? (Healthcare Effectiveness Data and Information Set) HEDIS stands for Healthcare Effectiveness Data and Information Set which
Medicare Plus Blue SM Group PPO
2018 Medicare Plus Blue SM Group PPO Evidence of Coverage Your Medicare Health Benefits and Services as a Member of Medicare Plus Blue SM Group PPO This booklet gives you the details about your Medicare
LAMMICO One Galleria Blvd., Ste. 700 Metairie, LA / Copyright 2012 LAMMICO. All rights reserved.
LAMMICO One Galleria Blvd., Ste. 700 Metairie, LA 70001 800/452-2120 www.lammico.com Copyright 2012 LAMMICO. All rights reserved. Table Of Contents Introduction...2 Preparation...3 Disaster Toolkit Checklist...7
Aetna Medicaid. Special Needs Plans. What Works; What Doesn t
Aetna Medicaid Special Needs Plans. What Works; What Doesn t Topics Aetna Medicaid Overview Special Needs Plan (SNP) Overview Mercy Care experience as Medicare Advantage Dual SNP and ALTCS Medicaid MCO
Annual Notice of Coverage
CHRISTUS Health Plan Generations (HMO) Annual Notice of Coverage Finally, access to the doctor and hospital you know and trust. christushealthplan.org CHRISTUS Health Plan Generations (HMO) offered by