Blue Shield of California: Consumer Initiatives
|
|
|
- Brook Armstrong
- 6 years ago
- Views:
Transcription
1 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, CBU Product Management Blue Shield of California Blue Shield of CA Foundation Blue Shield of California
2 What We ll Cover Our products and services Improving the quality of care The role of technology
3 About Blue Shield Not-For-Profit 2.6 million members (3rd largest in California) Products include PPO, HMO, ASO, POS Lines of business include Large Group, Small Group, Individuals and Families, and Medicare Our Mission: Ensure that Californians have access to high quality care at an affordable price
4 About Blue Shield Delivering on the mission History of Firsts - We were first to: cover preexisting conditions (1943) cover a heart transplant (1984) offer online benefits and enrollment (1996) offer HMO members direct access to specialists (1996) offer discounts on complementary medicine (1997) offer guided imagery program to pre-surgical patients (2000)
5 About Blue Shield Delivering on the mission (cont d) 2002 awards: ehealthcare Leadership Awards Gold for Best Intranet Site Silver for Best Interactive Site CEO ehealthcare Commitment award (special mention) Best of Blues - Best Practice in: Health Management (Reach Your Peak, Asthma program) Partnerships (Alliance Working for Antibiotic Resistance Program)
6 It s the Consumer, Stupid Our strategy: Provide the support, products and information our members need, throughout the varied stages and events of their lives The How: Through products, services, quality programs Be a competitive health plan with excellent customer service Deliver information, tools, resources Channel is secondary Technology is an enabler
7 This presentation Initiatives that deliver on our strategy and mission. Products and services Quality programs How they leverage technology
8 Products & Services Objectives Lifepath Advisers Network Choice Consumer Driven Health Plans
9 Product Strategy Objectives Deliver on our non-profit mission and vision of ensuring Californians have access to quality care at an affordable price through innovative solutions. Offer broad network choices through access to a statewide network of credentialed providers. Access and Choice in products, services and providers Integrate informed consumers within their healthcare decisions Products and services that raise consumer awareness around the true cost of care
10 Lifepath Advisors Integrated, comprehensive services from a single, easy to use resource 24/7 call access to registered nurses and master s level counselor Face-to-face mental health assessment visits EAP services Member decision support through multiple channels
11 Lifepath Advisors
12 Network Choice Charge average premium for a given geography Charge average premium that covers outlier cost providers Don t overtly disclose variation in provider costs Premium increases or provider disengagement
13 Network Choice We asked consumers: Lose access to provider selections as a result of disengagement Pay a higher copayment that reflects the higher cost of specific providers Key Finding: Consumers prefer informed options in their provider choices (reduced network, higher rates).
14 Network Choice Two new categories of Participating Providers with consumer out-of-pocket tied to category of provider: Choice Affiliate Categorization through cost and quality index that takes into consideration: Outlier cost providers The importance of quality reporting and measurement (PEP-C, Leapfrog)
15 Consumer Driven Healthcare Benefit plans that expose the member to the true cost of care Out-of-pocket costs that requires the consumer to engage in thoughtful spending without compromising essential care Consumer decision support that support consumers within their healthcare decisions
16 Consumer Driven Healthcare The Consumer Decision Support process involves predictable steps... Recognition of Need Information Search Evaluation of Alternatives & Preferences Decision/ Commitment Post-Decision Behaviors and Actions
17 Consumer Driven Healthcare and is a significant member touchpoint with the health plan Member contacts health plan to: Get Info Make a Decision Complete a Transaction Get Care Resolve an issue Touchpoint Examples Health content, cost info., benefit details, network info, ask ques. Rx decisions, facility choice, treatment options Change PCP, request new mbr. card, add dependent Enter DM program, talk to case manager, seek advice & support Grievance/Appeal, solve a problem
18 Consumer Driven Healthcare A lifespan model helps to identify and anticipate member needs for decision support, plan targeted marketing and build operational processes Consumer key events and episodes of care across lifespan Determine Insurance Needs Choose Providers & Settings Health Mgmt Treatment Options Rx Decisions Chronic Condition Mgmt Health Plan Support
19 What Happens When Patients can Communicate with their Doctors Online? Results of the Blue Shield RelayHealth webvisit SM Study
Commercial. Health Net. Group Retiree Plans. HMO Medicare Coordination of Benefits (COB) Pam White, We help members make informed decisions.
Commercial Health Net Group Retiree Plans HMO Medicare Coordination of Benefits (COB) Pam White, Health Net We help members make informed decisions. Health Net HMO Medicare Coordination of Benefits At
Transforming Physician Practices: Evolution of ACOs in California. National Association of ACOs - Washington, DC October 2015
Transforming Physician Practices: Evolution of ACOs in California National Association of ACOs - Washington, DC October 2015 Integrated Healthcare Association Statewide multi-stakeholder leadership group
Commercial. Health Net. Group Retiree Plans. PPO Medicare Coordination of Benefits (COB) Pam White, We help members make informed decisions.
Commercial Health Net Group Retiree Plans PPO Medicare Coordination of Benefits (COB) Pam White, Health Net We help members make informed decisions. Health Net PPO Medicare Coordination of Benefits At
MEMBER HANDBOOK. Health Net HMO for Raytheon members
MEMBER HANDBOOK Health Net HMO for Raytheon members A practical guide to your plan This member handbook contains the key benefit information for Raytheon employees. Refer to your Evidence of Coverage booklet
Click to edit Master title style. Caterpillar Health Alliance HMO. Plan Year starting January 1, 2013
Click to edit Master title style Caterpillar Health Alliance HMO Plan Year starting January 1, 2013 Click to edit Master title style Who is Health Alliance? Began in 1979; based in Urbana, IL Founded by
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
Medicare Coverage. You Can Count On. A simple guide to your University of California benefit choices. Medicare
Medicare Group Plans Medicare Coverage You Can Count On A simple guide to your University of California benefit choices Health Net Seniority Plus (Employer HMO) H0562_18_2989EGBROC_08232017 Health Net
Managed Care 101: Understanding the Basics and Opportunities for Partnership. Bruce A. Chernof, M.D. President & CEO
TSF Webinar January 8, 2013 Managed Care 101: Understanding the Basics and Opportunities for Partnership Bruce A. Chernof, M.D. President & CEO Presentation Overview: Managed Care 101 Background Goals
Draft Covered California Delivery Reform Contract Provisions Comments Welcome and Encouraged
TO: FROM: RE: State Based Marketplaces State Medicaid Directors Delivery Reform/Value Promoting Colleagues Peter V. Lee, Executive Director Draft Covered California Delivery Reform Contract Provisions
Medicare Coverage That Works for You
Medicare Coverage That Works for You A simple guide to your University of California benefits Health Net Seniority Plus (Employer HMO) CA_19_8249EGBROC_C 08132018 Helping You Make the Right Choice For
CareFirst BlueChoice. District of Columbia
CareFirst BlueChoice District of Columbia Welcome We are pleased to offer you enrollment in our CareFirst BlueChoice Health Maintenance Organization (HMO) plan. Designed for today s health conscious and
YOUR TRUSTED HEALTH COMPANION. A plan for life.
YOUR TRUSTED HEALTH COMPANION A plan for life. Being healthy is about more than preventing illness. It s achieving the best possible quality of life, physically and emotionally. That s what CDPHP is all
when you feel great, you're unstoppable.
Enrollment Guide when you feel great, you're unstoppable. Health Plan Choices: Access+ HMO plan Trio HMO plan Effective: January 01, 2018 We want to help you better understand your health plan options.
when you feel great, you're unstoppable.
Enrollment Guide when you feel great, you're unstoppable. Health Plan Choices: Access+ HMO plan Trio HMO plan Effective: January 01, 2018 County of San Mateo We want to help you better understand your
Health plans for New Hampshire small businesses Available through the Health Insurance Marketplace
Health plans for New Hampshire small businesses Available through the Health Insurance Marketplace 1 38476NHEENABS Rev. 09/14 We can help you navigate the health care road We re here to help. In fact,
How to Promote Wellness and 360 Health Programs in the Workplace. Ted Carter
How to Promote Wellness and 360 Health Programs in the Workplace Presenter: Blanche Callahan Ted Carter Today s Agenda Goal: Learn how to promote wellness and available health programs in the workplace.
EVIDENCE OF COVERAGE Molina Medicare Options Plus HMO SNP
Molina Medicare Options Plus HMO SNP Member Services CALL (800) 665-0898 Calls to this number are free. 7 days a week, 8 a.m. to 8 p.m., local time. Member Services also has free language interpreter services
member handbook blueshieldca.com/bscbluegroove
member handbook blueshieldca.com/bscbluegroove With Main Groove, you get a Personal Physician from our medical provider network, and predictable, lower outof-pocket costs than with Basic Groove, plus access
a community model case study
a community model case study Juan Davila Senior Vice President, Network Management Blue Shield of California National Medicare Readmissions Summit June 14, 2011 1 agenda Background Structure Strategies
Humana Group Medicare
Humana Group Medicare Presentation to East Baton Rouge Parish School System Health Insurance Advisory Committee Meeting - May 1, 2013 Scott Westbrook, Shane Swenson and Jeff Fernandez Humana Group Medicare
San Francisco Health Service System (SFHSS) Trio HMO Plan Frequently Asked Questions
San Francisco Health Service System (SFHSS) Trio HMO Plan Frequently Asked Questions Frequently Asked Questions (FAQs) If you have any questions about your health plan benefits, call your dedicated Shield
Evidence of Coverage January 1 December 31, 2014
L.A. Care Health Plan Medicare Advantage (HMO SNP) Evidence of Coverage January 1 December 31, 2014 Your Medicare Health Benefits and Services and Prescription Drug Coverage as a Member of L.A. Care Health
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
Welcome to Health Net
Welcome to Health Net When it comes to Medicare coverage, the right choice depends on your health, your budget and your lifestyle. Health Net makes choosing quality, cost-effective health care coverage
Issue Brief. Device Costs, Total Costs, and Other Characteristics of Knee ReplacementSurgery in California Hospitals, 2008
BERKELEY CENTER FOR HEALTH TECHNOLOGY Issue Brief Device Costs, Total Costs, and Other Characteristics of Knee ReplacementSurgery in California Hospitals, 2008 The Berkeley Center for Health Technology
Self-Insured Schools of California: Schools Helping Schools
Self-Insured Schools of California: Schools Helping Schools Blue Shield of California Access+ HMO Plan 2016/2017 Enrollment Guide Blue Shield of California offers health benefits to school districts that
community clinic case studies professional development
community clinic case studies professional development LFA Group 2011 Prepared by: Established in 2000, LFA Group: Learning for Action provides highly customized research, strategy, and evaluation services
Chapter 2 Provider Responsibilities Unit 6: Behavioral Health Care Specialists
Chapter 2 Provider Responsibilities Unit 6: Health Care Specialists In This Unit Unit 6: Health Care Specialists General Information 2 Highmark s Health Programs 4 Accessibility Standards For Health Providers
Health Care Reform 1
Health Care Reform 1 Health Care Reform Covered California (Health Benefit Exchange) Medi-Cal Expansion Bridge Plan Proposal Gold Coast Readiness Outreach to the Eligible 2 Health Care Reform: What is
Self-Insured Schools of California: Schools Helping Schools
Self-Insured Schools of California: Schools Helping Schools Blue Shield of California Access+ HMO SaveNet SM Plan 2016/2017 Enrollment Guide Blue Shield of California offers health benefits to school districts
Breaking Down Silos of Care: Integration of Social Support Services with Health Care Delivery
Breaking Down Silos of Care: Integration of Social Support Services with Health Care Delivery Betty Shephard Lead VP, Care Management HealthCare Partners National Health Policy Forum October 19, 2012 HCP
working together for our members
working together for our members Employer Guide for small businesses with 1 to 50 employees At Blue Shield of California, we ve put our powerful connections to work for your employees to create a new family
Medicare / Accountable Care Organization CHS Finance Division CPE Day November 2, 2015
Medicare / Accountable Care Organization CHS Finance Division CPE Day November 2, 2015 Steve Neorr Chief Administrative Officer, Triad HealthCare Network Jeff Jones Chief Financial Officer, Cone Health
Accountable Care Organization in California: Lessons for the National Debate on Delivery System Reform
Accountable Care Organization in California: Lessons for the National Debate on Delivery System Reform James Robinson Professor and Director, Berkeley Center for Health Technology University of California,
2019 Select HMO. Benefit guide. One of the most affordable CalPERS HMO plans CAMENABC Rev. 07/18
2019 Select HMO Benefit guide One of the most affordable CalPERS HMO plans 40184CAMENABC Rev. 07/18 Why choose the Select HMO plan? We re glad you re taking time to check out all that Anthem has to offer
2019 Health Net Seniority Plus Amber I (HMO SNP) H0562: 055 Fresno, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco
2019 Health Net Seniority Plus Amber I (HMO SNP) H0562: 055 Fresno, Kern, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Francisco and Tulare Counties, CA H0562_19_7837SB_055_M_Accepted
Payment and Delivery System Reform in Vermont: 2016 and Beyond
Payment and Delivery System Reform in Vermont: 2016 and Beyond Richard Slusky, Director of Reform Green Mountain Care Board Presentation to GMCB August 13, 2015 Transition Year 2016 1. Medicare Waiver
arizona health net a better decision sm Putting you at the center of everything we do.
arizona health net a better decision sm Putting you at the center of everything we do. Nothing s more important than your health. When you re healthy, you want to stay healthy. When you re sick or have
MEDICAL HOMES Arkansas Hospital Association
MEDICAL HOMES Arkansas Hospital Association Framing our discussion Environmental snapshot of health care Hospitals and the PCMH Arkansas Medical Homes Patients/Consumers 2 1 Health Policy is changing Budget
Care Compact Guide Patient-Centered Specialty Care (PCSC) A Component of Medical Neighborhood Initiatives
Compact Guide Patient-Centered Specialty (PCSC) A Component of Medical Neighborhood Initiatives Anthem Blue Cross and Blue Shield is the trade name of: In Colorado: Rocky Mountain Hospital and Medical
Blue Shield of California
An independent member of the Blue Shield Association City of San Jose Custom ASO PPO 100 90/70 Active Employees Benefit Summary (For groups of 300 and above) (Uniform Health Plan Benefits and Coverage
Chapter 7. Unit 1: Overview - Fee-for-Service Payment
Chapter 7 Unit 1: Overview - Fee-for-Service Payment In this unit Topic See Page Unit 1: Overview Fee-For Service Payment Introduction to the QualityBLUE Program Fee-for- 2 Service Payment QualityBLUE
HMO-POS. BCN Advantage SM. Group. Resource Guide. Put your coverage to work.
BCN Advantage SM Group HMO-POS Resource Guide Put your coverage to work www.bcbsm.com/medicare You have a new plan. Now what? We want you to know we re happy you chose our plan. Whether you joined for
Intelligent Healthcare. Intelligent Solutions for Achieving Clinical Integration & Accountable Care. Case Study: Advocate Physician Partners
Solutions for Achieving Clinical Integration & Accountable Care Case Study: Advocate Physician Partners Provide physicians with the right information, and they will make the right decisions. Paul Katz,
California s Chronically Ill: Coping with Rising Health Care Costs
California s Chronically Ill: 2005 Introduction As health plan coverage continues to move towards member cost sharing, particular concern has been raised about the impact of these changes on those with
Medical Plans Benefit Guide
Medical Plans Benefit Guide Employers with 1-50 employees 1.1.01 Provider network built for value and quality... Wellness rewards...3 Medical Travel Support and Air or Surface Transportation... Support
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
Welcome to Regence! Meet your employer health plan
is an Independent Licensee of the Blue Cross and Blue Shield Association Regence BlueCross BlueShield of Utah Welcome to Regence! Meet your employer health plan 1 Health insurance is a big, wonderful benefit.
Blue Shield Trio HMO Plan Frequently Asked Questions
Blue Shield Trio HMO Plan Frequently Asked Questions If you have any questions about your health plan benefits, call your dedicated Shield Concierge team at (855) 747-5800. The team is available to assist
Strategic Alignment in Health Care
Strategic Alignment in Health Care Presented to CAJPA Fall Conference 9/15/16 1 Transforming Care Delivery Value-Based Pay for Performance Oncology Practice of the Future Maternity Care Focus - C-Sections
HMO Plan Option. Your Commercial. Health Net of California, Inc. (Health Net) Edison
Commercial Edison Your 2018 HMO Plan Option of California, Inc. () Carol Kim, We focus on getting you the health information you need, when you need it. Welcome to We created this guide to help members
Medi-Cal Performance Measurement: Making the Leap to Value-Based Incentives. Dolores Yanagihara IHA Stakeholders Meeting October 3, 2018
Medi-Cal Performance Measurement: Making the Leap to Value-Based Incentives Dolores Yanagihara IHA Stakeholders Meeting October 3, 2018 Why Standardization? MEDI-CAL CROSS PRODUCT San Francisco Health
Federal Employee Program Service Benefit Plan An independent licensee of the Blue Cross and Blue Shield Association
Federal Employee Program Service Benefit Plan 2009 An independent licensee of the Blue Cross and Blue Shield Association Federal Employee Program Two PPO Products Basic Option with (in-network benefits
total health and wellness Programs exclusively for our Blue Shield members For small businesses with 2 to 50 eligible employees
total health and wellness Programs exclusively for our Blue Shield members For small businesses with 2 to 50 eligible employees total health and wellness Whether you want to ease stress, lose weight, or
Benefits Handbook CHIP of Pennsylvania. Free or low-cost health coverage through Keystone Health Plan East HMO. Look inside for...
Commonwealth of Pennsylvania chipcoverspakids.com Look inside for... Services covered Services not covered Using your child s insurance How to file a complaint or grievance Seeing a specialist Benefits
AMBULATORY SURGERY FACILITY GENERAL INFORMATION
AMBULATORY SURGERY FACILITY GENERAL INFORMATION I. BCBSM s Ambulatory Surgery Facility Programs Traditional BCBSM s Traditional Ambulatory Surgery Facility Program includes all facilities that are licensed
Technology Driven Strategies for Enhancing Patient Engagement Within an ACO Model. ACO Congress November 5, 2013 Charles Kennedy
Technology Driven Strategies for Enhancing Patient Engagement Within an ACO Model ACO Congress November 5, 2013 Charles Kennedy Aetna s values drive ACS strategy apple 2 Changing the emphasis from volume
Minnesota Perspective: Fairview Health Services. National Accountable Care Organization Congress October 25, 2010
Minnesota Perspective: Fairview Health Services National Accountable Care Organization Congress October 25, 2010 Fairview Overview Not-for-profit organization established in 1906 Partner with the University
The Health Plan with you in mind. AmeriHealth HMO
The Health Plan with you in mind. AmeriHealth HMO Put AmeriHealth to work for you. With AmeriHealth, you get more than just health care benefits. We provide you with the information, tools and resources
Confidence comes with every card. BCN Advantage SM HMO-POS and HMO. Resource Guide. Put your coverage to work.
Confidence comes with every card. 2017 BCN Advantage SM HMO-POS and HMO Resource Guide Put your coverage to work www.bcbsm.com/medicare You have a new plan. Now what? We want you to know we re happy you
Healthcare 2015: Win-win or lose-lose?
IBM Institute for Business Value Healthcare 2015: Win-win or lose-lose? A portrait and a path to successful transformation Presented at Disease Management Colloquium May 19, 2008 Jim Adams, IBM Center
The following benefit is being added: Behavioral health treatment applied behavior analysis (ABA)
Customer No.: Dear , Thank you for your business. We re writing to let you know of changes to
Advanced Medical Homes: Bending the Trend. Alan Glaseroff, MD Co-Director Stanford Coordinated Care
Advanced Medical Homes: Bending the Trend Alan Glaseroff, MD Co-Director Stanford Coordinated Care aglasero@stanford.edu 1 Hot Spotting in Employed Populations 1. Humboldt County, CA : Priority Care Partnered
Confidence comes with every card. MEMBER GUIDE
Confidence comes with every card. MEMBER GUIDE Blue Cross Personal Choice PPO Personal Choice PPO is Blue Cross Blue Shield of Michigan s new, innovative product that provides access to the entire PPO
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
Value Based Care Emergent Care Services
Value Based Care Emergent Care Services If this is an emergency, dial 911 or go to the Emergency Room About the Speakers Cliff Frank cliff.frank@partnerapartners.com Co founder of Partnera, specializes
VALUE-BASED HEALTH CARE
1 Value-Based Health Care VALUE-BASED HEALTH CARE How Florida Blue is using Accountable Care Organizations and Patient-Centered Medical Homes to help businesses and consumers save money and improve their
total health and wellness
total health and wellness Programs exclusively for our Blue Shield members total health and wellness Whether you want to ease stress, lose weight, or quit smoking we ll help you reach your goals. Our 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
CITY OF LOS ANGELES. January 1, Your Anthem Blue Cross Vivity HMO Plan. RT /100% (Mod) Vivity
CITY OF LOS ANGELES January 1, 2018 Your Anthem Blue Cross Vivity HMO Plan RT280612-3 2018 10/100% (Mod) Vivity Combined Evidence of Coverage and Disclosure Form Anthem Blue Cross 21555 Oxnard Street Woodland
California Program on Access to Care Findings
C P A C February California Program on Access to Care Findings 2008 Increasing Health Care Access for the Medically Underserved in Four California Counties Annette Gardner, PhD, MPH Some of the most active
Evidence of Coverage:
January 1 December 31, 2013 Evidence of Coverage: Your Medicare Health Benefits and Services as a Member of Health Net Aqua (PPO) This booklet gives you the details about your Medicare health care coverage
Implementing Medicaid Value-Based Purchasing Initiatives with Federally Qualified Health Centers
Implementing Medicaid Value-Based Purchasing Initiatives with Federally Qualified Health Centers Beth Waldman, JD, MPH June 14, 2016 Presentation Overview 1. Brief overview of payment reform strategies
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
Wellness on the Run. Show Me the Money- Help your employees lower their cost of care
Wellness on the Run Show Me the Money- Help your employees lower their cost of care Agenda 3 Keys to helping employees be better health care consumers Tools and Tips for saving money Health plan programs
PPO. Preferred Provider Organization. Flexible. Easy to use. No Referrals.
PPO Preferred Provider Organization Flexible. Easy to use. No Referrals. PPO is issued by Capital Advantage Assurance Company (pending approval of its licensing application) or by Capital Advantage Insurance
Self-Insured Schools of California: Schools Helping Schools
Schools Helping Schools SISC III SELF-INSURED SCHOOLS OF CALIFORNIA ACCESS+ HMO PLAN Self-Insured Schools of California: Schools Helping Schools 2012 Enrollment Guide 2012 Enrollment Guide Schools Helping
INFORMATION ABOUT YOUR OXFORD COVERAGE REIMBURSEMENT PART I OXFORD HEALTH PLANS OXFORD HEALTH PLANS (NJ), INC.
OXFORD HEALTH PLANS (NJ), INC. INFORMATION ABOUT YOUR OXFORD COVERAGE PART I REIMBURSEMENT Overview of Provider Reimbursement Methodologies Generally, Oxford pays Network Providers on a fee-for-service
Frequently Asked Questions (FAQ) The Harvard Pilgrim Independence Plan SM
Frequently Asked Questions (FAQ) The Harvard Pilgrim Independence Plan SM Plan Year: July 2010 June 2011 Background The Harvard Pilgrim Independence Plan was developed in 2006 for the Commonwealth of Massachusetts
Good health is part of the plan.
Good health is part of the plan. Presbyterian Health Plan has a long tradition of providing quality health care to State of New Mexico employees and their families. For 108 years, Presbyterian has been
Get access to health care around the world. Blue Shield and UC help expats, their families, and travelers access health care abroad
Get access to health care around the world Blue Shield and UC help expats, their families, and travelers access health care abroad Effective January 1, 2016 A plan for your personal state of health Get
Value Proposition: Tiered Network Plan Design for Navigator by Tufts Health Plan
Value Proposition: Tiered Network Plan Design for Navigator by Tufts Health Plan John D. Freedman, MD, MBA National Health Policy Forum July 28, 2005 Outline Objectives Understand market dynamics and rationale
CMS Quality Initiatives: Past, Present, and Future
CMS Quality Initiatives: Past, Present, and Future Jeff Flick Regional Administrator CMS, Region IX June 29, 2007 Slide -1 Learning Objectives Value Driven Health Care CMS Quality Initiatives Premiere
Evidence of Coverage. Tufts Medicare Preferred HMO GIC (HMO) Employer Group. July 1 December 31, 2018
July 1 December 31, 2018 Evidence of Coverage Your Medicare Health Benefits and Services as a Member of: Tufts Medicare Preferred HMO GIC (HMO) Employer Group This booklet gives you the details about your
YOUR PERSONALIZED COMPENSATION STATEMENT. making the most of your employment rewards. This page is generated by Fringe Facts.
YOUR PERSONALIZED COMPENSATION STATEMENT making the most of your employment rewards. This page is generated by Fringe Facts. ABCHospital ABCHospital June 9, 2015 Dear ABC Hospital Employee: Employees are
Value-Based Care Emergent Care Services. Presented by Cliff Frank Partnera Partners LLC
Value-Based Care Emergent Care Services Presented by Cliff Frank Partnera Partners LLC Problem Un-doctored consumers are driving $575 billion inappropriate emergent care Fee-for-service ER visits add another
Specialty Care Approaches to Accountable Care: A Panel Discussion. Allen R. Nissenson, MD, FACP Chief Medical Officer, DaVita
Specialty Care Approaches to Accountable Care: A Panel Discussion Allen R. Nissenson, MD, FACP Chief Medical Officer, DaVita 1 Panel Lara M. Khouri, MBA, MPH VP, Health System Development and Integration,
For fully insured groups of 100 or more eligible employees. HealthyOutcomes. A fully-integrated health management solution that works for you
For fully insured groups of 100 or more eligible employees HealthyOutcomes wellness case management condition care maternity A fully-integrated health management solution that works for you HealthyOutcomes
Issue Brief. Volumes, Costs, and Reimbursement for Cervical Fusion Surgery in California Hospitals, 2008
BERKELEY CENTER FOR HEALTH TECHNOLOGY Issue Brief Volumes, Costs, and Reimbursement for Cervical Fusion Surgery in California Hospitals, 2008 The Berkeley Center for Health Technology (BCHT) has been working
Report Summary. Identifying the Problem
Hospital Costs in California: Wide Variations in Charges Raise Questions on Pricing Policies January 14, 2008 (An Executive Summary of Cost Efficiency at Hospital Facilities in California: A Report Based
Gold Access+ HMO $30 OffEx Benefit Summary (For groups 1 to 50) (Uniform Health Plan Benefits and Coverage Matrix)
Gold Access+ HMO $30 OffEx Benefit Summary (For groups 1 to 50) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective January 1, 2015 THIS MATRIX IS INTENDED TO BE USED
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
HEALTH PLANS FOR PARTICIPANTS
Kern County 2018 Retiree HEALTH PLANS FOR PARTICIPANTS OVER AGE 65 (Must have BOTH Medicare Parts A & B) For current participating physician information, please contact each plan directly. This summary
Blue Essentials SM, Blue Advantage HMO SM and Blue Premier SM Provider Manual - Support Services
Blue Essentials SM, Blue Advantage HMO SM and Blue Premier SM Provider Manual - Support Services In this Section there are references unique to Blue Essentials, Blue Advantage HMO and Blue Premier. These
Chapter 2 Provider Responsibilities Unit 5: Specialist Basics
Chapter 2 Provider Responsibilities Unit 5: Specialist Basics In This Unit Topic See Page Unit 5: Specialist Basics Participation in the Highmark s Networks as a Specialist 2 Specialist and Personal Physician
We can never insure one-hundred percent of the population against one-hundred percent of the hazards and vicissitudes of life. Franklin D.
Medicare Explained We can never insure one-hundred percent of the population against one-hundred percent of the hazards and vicissitudes of life. Franklin D. Roosevelt comments on signing The Social Security
Anthem BlueCross and BlueShield
Quality Overview BlueCross and BlueShield Accreditation Exchange Product Accrediting Organization: Accreditation Status: NCQA Health Plan Accreditation (Commercial HMO) Accredited Accreditation Commercial
Basic, including 100% Part B coinsurance. Basic, including coinsurance. Basic, including coinsurance* Basic, including
CIGNA HEALTH AND LIFE INSURANCE COMPANY PO Box 26580, Austin, TX 78755-0580 866-459-4272 Outline of Medicare Supplement Coverage - Benefit Plans A, F, High-Deductible F, G, and N This chart shows the benefits
NAVIGATING THE BILLING MAZE: THE BASICS OF MEDICARE PART B BILLING JULY 13, :00 10:00 AM
NAVIGATING THE BILLING MAZE: THE BASICS OF MEDICARE PART B BILLING JULY 13, 2017 9:00 10:00 AM ACPE UAN: 0107-9999-17-079-L04-P 0.1 CEU/1.0 hr Activity Type: Knowledge-Based Learning Objectives for Pharmacists:
Reports Glossary. Enhanced Personal Health Care
Enhanced Personal Health Care Reports Glossary This glossary is a reference for providers participating in Enhanced Personal Health Care. It is organized to allow the user to quickly find the definition