Accepted Health Plans

Size: px
Start display at page:

Download "Accepted Health Plans"

Transcription

1 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 Health) offered by that plan. Please note that medical professionals providing services at Lakeland Regional Health may or may not be contracted with the same insurance plans as the hospital. Additionally, they may not participate with all of the products (i.e. HMO, PPO, Behavioral Health) offered by the plan. Patients should contact the healthcare practitioner who will provide services in the hospital to determine which health plans the practitioner participates in as a network provider. Always check with your health plan to confirm hospital participation. Click the health plan name below to visit the plan website. Commercial Plans Aetna HMO, PPO, POS, EPO, Global, LRH Employee Plan Allianz Global/Mondial (fka Mondial Assistance and World Access) Travel Avmed HMO, POS Beechstreet - a Multiplan company PPO Network Cigna Health Plan (GWH) HMO, PPO, POS (Except BayCare Plan) Coventry Health Care (an Aetna Company) HMO, PPO, POS First Health (a Coventry Company) Evolutions Healthcare Systems PPO Network

2 Commercial Plans Continued Florida Blue - HMO, myblue HMU, PPO, Options, FEP, PHS/Traditional except Blue Select Named Plans Galaxy Health Network Global Excel, PPO HealthSmart Payors Organization, Inc. HealthSmartPayorsOrganization.aspx Humana - HMO, HMO Priemer, PPO, POS, EPO Integrated Health Plan - PPO MultiPlan Networks Multiplan/PHCS PPO Network Three Rivers Provider Network United Health Care HMO, PPO, Choice/Choice Plus PPO, Navigate/Navigate Plus HMO, United One, UMR, Oxford, Definity, NHP Plan PediCare/CMS Plan Polk Health Plan Medicaid - Traditional, Florida and other states Medicaid HMO Amerigroup - HMO, including Healthy Kids Plan Better Health - HMO Clear Health Alliance - HMO Humana Family Plan Florida HMO

3 Medicaid HMO Continued Magellan Complete Care HMO Molina Healthcare HMO Sunshine Health Plan HMO (a Centene Company) except Healthy Kids Plan Staywell HMO (a Wellcare Company) United Healthcare Community Plan HMO Medicaid - Traditional, Florida and other states Medicare Advantage Aetna HMO/PPO Care Plus (a Humana Company) HMO/PPO Coventry Health Care HMO (Summit Ideal) Florida Blue Plans HMO/PPO Humana - HMO, Gold Plus HMO, Regional PPO, PPO Plans Simply Healthcare HMO United Health Care - HMO, PPO, and Supplemental plans including: (Includes WellMed/Network) AARP Medicare Complete Medicare Solutions Supplemental Plans United Dual Complete Special Needs

4 Medicare Advantage Continued Wellcare Health Plans HMO Mental Health Lakeland Regional Health Behavioral Health practitioners do provide services in the in the hospital s mental health unit; however, they may or may not participate in the same health plans as the hospital. Aetna Behavioral Health Aetna Behavioral Health (Horizon) Employee Assistance Plan Beacon / Value Options Commercial and Tricare Cigna Behavioral Health Magellan Healthcare Behavioral Health Services New Directions For Florida Blue United Behavioral Health/Optum

5 Workers Compensation Choice Managed Networks Corvel, Inc. Galaxy Health Network Networks Heritage Summit Health, Inc. Integrated Health Plan Three Rivers Provider Network Other Insurance Tricare (Certified, not contracted in Network) Veteran s Administration ChampVA

ACCEPTED HEALTH INSURANCES Kissimmee Location As of: June, 2018

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

More information

Notes. Does Overlake Medical Center (Hospital) Participate? Clinics (OMC) Participate?

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

More information

Health Plans Accepted by the Hospital (Effective April, 2018)

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

More information

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.

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. SMG KC Insurance Participation -TIN # 45-3074284 rev 01-15-18 Advantra Medicare_Coventry HMO, PPO, POS Aetna All Commercial Products Aetna Medicare Advantage- PPO, POS,HMO Aetna Work Comp Access Allwell

More information

Government Plans 2016

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

More information

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. 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

More information

RESIDENTIAL, INPATIENT, DETOX, & MEDICATION ASSISTED TREATMENT DIRECTORY

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

More information

UC SF Medical Group & Medical Center Active Contracts Report and LOA Training

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

More information

Florida s Medicaid 1115 Managed Medical Assistance Waiver Post Award Forum

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

More information

201 E. Main Suite 600 El Paso, TX (915) Fax: (915) ADDENDUM

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

More information

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) 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

More information

Building photos courtesy of LLT Building Corporation

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,

More information

Post Award Forum for Florida s 1115 Managed Medical Assistance Waiver. Presented at the September 2014 Medical Care Advisory Committee Meeting

Post Award Forum for Florida s 1115 Managed Medical Assistance Waiver. Presented at the September 2014 Medical Care Advisory Committee Meeting Post Award Forum for Florida s 1115 Managed Medical Assistance Waiver Presented at the September 2014 Medical Care Advisory Committee Meeting Statewide Medicaid Managed Care (SMMC) Program The SMMC program

More information

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) 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

More information

Steve Yedlin, MD Chief Medical Officer. Lenda Townsend-Williams, MBA Chief Operating Officer

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

More information

Florida s Medicaid 1115 Managed Medical Assistance Waiver Extension Request. Agency for Health Care Administration October 18, 2016 Public Meeting

Florida s Medicaid 1115 Managed Medical Assistance Waiver Extension Request. Agency for Health Care Administration October 18, 2016 Public Meeting Florida s Medicaid 1115 Managed Medical Assistance Waiver Extension Request Agency for Health Care Administration October 18, 2016 Public Meeting 1115 Research and Demonstration Waivers Experimental, pilot,

More information

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 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

More information

Contracted Insurance Plans and Episodic Programs Accepted at NCHS

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

More information

Medicaid Managed Care Overview

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%

More information

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 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

More information

Nonreimbursable Code List for Outpatient Hospitals

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

More information

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, 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

More information

Wound Care. Equipment & Supplies. HME Wound Care is available throughout Wisconsin.

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

More information

Steve Yedlin, MD Chief Medical Officer. Lenda Townsend-Williams, MBA Chief Operating Officer

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

More information

Contracted Insurance Plans

Contracted Insurance Plans Contracted Insurance Plans As of December 1, 2017 Children s Health SM has contracts with the following health care insurance plans for the following locations: Children s Medical Center Dallas Children

More information

PROVIDER TRAINING NOTICE OF MEDICARE NON-COVERAGE (NOMNC)

PROVIDER TRAINING NOTICE OF MEDICARE NON-COVERAGE (NOMNC) PROVIDER TRAINING NOTICE OF MEDICARE NON-COVERAGE (NOMNC) 2015 NOMNC OVERVIEW In this training module, you will learn about: What a Notice of Medicare Non-Coverage (NOMNC) is When you are required to deliver

More information

Statewide Medicaid Managed Care Long-term Care Program. Judy Jacobs Agency for Health Care Administration Area 7 Field Office Manager April 9, 2013

Statewide Medicaid Managed Care Long-term Care Program. Judy Jacobs Agency for Health Care Administration Area 7 Field Office Manager April 9, 2013 Statewide Medicaid Managed Care Long-term Care Program Judy Jacobs Agency for Health Care Administration Area 7 Field Office Manager April 9, 2013 Overview Part 1: What is Managed Care? Part 2: Legislation

More information

Managing Illinois Medicaid Reform at Your Practice. May 2015

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

More information

Implementing Coordinated Care for Dual Eligibles: Conflicts and Opportunities Prepared by James M. Verdier Mathematica Policy Research

Implementing Coordinated Care for Dual Eligibles: Conflicts and Opportunities Prepared by James M. Verdier Mathematica Policy Research Implementing Coordinated Care for Dual Eligibles: Conflicts and Opportunities Prepared by James M. Verdier Mathematica Policy Research Workshop on Effectively Integrating Care for Dual Eligibles World

More information

Lessons Learned from MLTSS Implementation in Florida Where Have We Been and Where Are We Going?

Lessons Learned from MLTSS Implementation in Florida Where Have We Been and Where Are We Going? Lessons Learned from MLTSS Implementation in Florida Where Have We Been and Where Are We Going? David Rogers Assistant Deputy Secretary for Medicaid Operations Agency for Health Care Administration 2016

More information

MEDICAID REFORM HEALTH PLANS AND NETWORKS AS OF JULY 1, 2006

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

More information

Contracted Insurance Plans

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

More information

Executive Message COLUMBIA HOSPITAL BOARD OF TRUSTEES

Executive Message COLUMBIA HOSPITAL BOARD OF TRUSTEES Executive Message Dear Neighbors, During 2005 Columbia Hospital once again proved it was a year of tremendous achievement for our patients and the community. For a second year in a row, hospital employees

More information

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. 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

More information

Independent Consumer Support Program (ICSP)

Independent Consumer Support Program (ICSP) Independent Consumer Support Program (ICSP) AN OVERVIEW OF FLORIDA S LONG -TERM CARE (LTC) CONSUMER SUPPORT PROGRAM RICK SCOTT, GOVERNOR FLORIDA DEPARTMENT OF ELDER AFFAIRS CHARLES T. CORLEY, SECRETARY

More information

PA/MND Review of Spine Surgery services Questions & Answers

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

More information

Dual Eligible Special Needs Plans For 2015

Dual Eligible Special Needs Plans For 2015 Dual Eligible Special Needs Plans For 2015 Introduction: Amerigroup Community Care is offering Dual Eligible Special Needs Plans (D-SNPs) to people who are eligible for both Medicare and Medicaid benefits

More information

SMMC: LTC and MMA. Linda R. Chamberlain, P.A. Member Firm Florida Elder Lawyers PLLC

SMMC: LTC and MMA. Linda R. Chamberlain, P.A. Member Firm Florida Elder Lawyers PLLC SMMC: LTC and MMA Linda R. Chamberlain, P.A. Member Firm Florida Elder Lawyers PLLC 727.443.7898 Why should you care about SMMC Florida has 7M+ people 50 y/o + 4M+ Social Security beneficiaries 3.5M+ Medicare

More information

Medicare Plus Blue Group PPO. We have the solution.

Medicare Plus Blue Group PPO. We have the solution. Medicare Plus Blue Group PPO We have the solution. 1 What is Medicare Advantage? Plans offered by private insurance companies that contract with The Centers for Medicare and Medicaid Services (CMS). The

More information

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 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

More information

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 Transforming Physician Practices: Evolution of ACOs in California National Association of ACOs - Washington, DC October 2015 Integrated Healthcare Association Statewide multi-stakeholder leadership group

More information

Contracted Insurance Plans

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

More information

Network Participation

Network Participation Network Participation Learn about joining the BCBSNC provider network and start the application process today! An independent licensee of the Blue Cross and Blue Shield Association. U7430b, 2/11 Overview

More information

Providers who see Empire Medicare Advantage HMO members also are considered contractually eligible to see Empire D-SNP members.

Providers who see Empire Medicare Advantage HMO members also are considered contractually eligible to see Empire D-SNP members. Empire BlueCross BlueShield FAQs for 2017 D-SNP Plans Introduction: Empire BlueCross BlueShield is offering Special Needs Plans (SNPs) to people who are eligible for both Medicare and Medicaid benefits

More information

In this issue: First Quarter, 2014

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

More information

Statewide Medicaid Managed Care Long-term Care Program

Statewide Medicaid Managed Care Long-term Care Program Statewide Medicaid Managed Care Long-term Care Program Justin Senior Deputy Secretary for Medicaid Agency for Health Care Administration July 25, 2013 Presentation Overview Current Medicaid Snapshot and

More information

Bin pcn meddaet

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

More information

Value-Based Care Contracting and Legal Issues

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

More information

SFY EXTERNAL QUALITY REVIEW TECHNICAL REPORT

SFY EXTERNAL QUALITY REVIEW TECHNICAL REPORT Florida Agency for Health Care Administration SFY 2011 2012 EXTERNAL QUALITY REVIEW TECHNICAL REPORT January 2013 3133 East Camelback Road, Suite 300 Phoenix, AZ 85016 Phone 602.264.6382 Fax 602.241.0757

More information

State of New Jersey DIVISION OF INSURANCE CONSUMER PROTECTION SERVICES OFFICE OF MANAGED CARE PO BOX 329 TRENTON, NJ

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

More information

MENTAL HEALTH ASSOCIATION IN NEW JERSEY MANAGED CARE NETWORK ADEQUACY REPORT JULY 2013

MENTAL HEALTH ASSOCIATION IN NEW JERSEY MANAGED CARE NETWORK ADEQUACY REPORT JULY 2013 MENTAL HEALTH ASSOCIATION IN NEW JERSEY MANAGED CARE NETWORK ADEQUACY REPORT JULY 2013 Background The Mental Health Association in New Jersey (MHANJ) is a statewide private, nonprofit organization dedicated

More information

Good Samaritan Free Clinic at Talbot House Ministries. Judy Snow, DNP, ARNP May 19, 2017

Good Samaritan Free Clinic at Talbot House Ministries. Judy Snow, DNP, ARNP May 19, 2017 Good Samaritan Free Clinic at Talbot House Ministries Judy Snow, DNP, ARNP May 19, 2017 Services Provided Primary Care Dental Care Well Woman Care Podiatry Services Diabetic Clinic STI/Hepatitis/HIV testing

More information

Commonwealth Coordinated Care Enrollment Application Form

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

More information

Florida Healthy Kids Program Performance Improvement Project Validation Reporting on PIPs Implemented During the Evaluation Period

Florida Healthy Kids Program Performance Improvement Project Validation Reporting on PIPs Implemented During the Evaluation Period Florida Healthy Kids Program Performance Improvement Project Validation Reporting on PIPs Implemented During the 2011-2012 Evaluation Period Prepared for the Florida Healthy Kids Corporation Prepared by

More information

Index. Index... Page 1. Welcome Letter... Page 2. Insurance Directory... Page 3. Timely Filing Requirements for Initial Claim Submission...

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......

More information

Get Your Medicare Questions Answered

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

More information

Welcome to the Agency for Health Care Administration (AHCA) Training Presentation for Potential Long-term Care Providers.

Welcome to the Agency for Health Care Administration (AHCA) Training Presentation for Potential Long-term Care Providers. Welcome to the Agency for Health Care Administration (AHCA) Training Presentation for Potential Long-term Care Providers. The presentation will begin momentarily. Please dial in to hear audio: 1-888-670-3525

More information

RE: Centers for Medicare & Medicaid Services: Innovation Center New Direction Request for Information (RFI)

RE: Centers for Medicare & Medicaid Services: Innovation Center New Direction Request for Information (RFI) November 20, 2017 Ms. Seema Verma Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services 7500 Security Boulevard Baltimore, MD 21244 Ms. Amy Bassano Director Center

More information

Overall Learning Objectives How large is the specialty pharmaceutical market? Drug Trends Source: CVS Caremark 2013 Drug Trend Focus Report

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

More information

Working with Anthem Subject Specific Webinar Series

Working with Anthem Subject Specific Webinar Series Working with Anthem Subject Specific Webinar Series Special Session 2015 Medicare Advantage Dual Eligible Special Needs Plans Access to Audio Portion of Conference: Dial-In Number: 877-497-8913 Conference

More information

MMW Topical Brief: Medicaid Managed Long Term Services and Supports (MLTSS)

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

More information

for brand drugs) $15 $20

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

More information

MA Substance Use Disorder (SUD) Mandate MA Products

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

More information

OptumInsight Eligibility Payer List ANSI HIPAA 270/271 (As of 02/28/2013)

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

More information

OF FLORIDA MEDICAID PROVIDERS PRODUCT CATALOG EBOOK

OF FLORIDA MEDICAID PROVIDERS PRODUCT CATALOG EBOOK 27 February, 2018 OF FLORIDA MEDICAID PROVIDERS PRODUCT CATALOG EBOOK Document Filetype: PDF 117.39 KB 0 OF FLORIDA MEDICAID PROVIDERS PRODUCT CATALOG EBOOK Fillable apply for medicaid florida. Call the

More information

Frequently Asked Questions

Frequently Asked Questions Frequently Asked Questions Central Florida HMO Medical Options WHAT TO PRIMARY Eligible Disney employees and Cast Members in Central Florida* who want to enroll in an HMO for will have a choice of two

More information

Your Retired Health Benefits and Medicare Part A & B

Your Retired Health Benefits and Medicare Part A & B HR-0116-0317 Fact Sheet #23 A PUBLICATION OF THE NEW JERSEY DIVISION OF PENSIONS AND BENEFITS Your Retired Health Benefits and Medicare Part A & B State Health Benefits Program School Employees Health

More information

Last Name: First Name: Middle Initial: City: State: Zip Code: City: State: Zip Code:

Last Name: First Name: Middle Initial: City: State: Zip Code: City: State: Zip Code: 1240 South Loop Road Alameda, CA 94502 1-877-585-PLAN (7526) TTY 1-800-735-2929 8 a.m. - 8 p.m., 7 days a week www.alliancecompletecare.org I wish to enroll in the Alliance CompleteCare (HMO SNP) Medicare

More information

Heather Leschinsky Administrator II, Managed Care and HCBS Nebraska Department of Health and Human Services Medicaid and Long-Term Care

Heather Leschinsky Administrator II, Managed Care and HCBS Nebraska Department of Health and Human Services Medicaid and Long-Term Care Heather Leschinsky Administrator II, Managed Care and HCBS Nebraska Department of Health and Human Services Medicaid and Long-Term Care 1 2 Total Medicaid and CHIP population- 235,000 Currently approximately

More information

Choosing a Managed Care Plan for Medicaid Long-Term Care

Choosing a Managed Care Plan for Medicaid Long-Term Care A Guide for Florida Advocates Choosing a Managed Care Plan for Medicaid Long-Term Care How Is Florida Medicaid Changing its Long-Term Care Services? From August 2013 through March 2014, the Florida Medicaid

More information

Billing Information. Patient Billing Information Patient Demographic Client / Ordering Physician Information Ordering Tests/Panels

Billing Information. Patient Billing Information Patient Demographic Client / Ordering Physician Information Ordering Tests/Panels Billing Information Patient Billing Information Patient Demographic Client / Ordering Physician Information Ordering Tests/Panels This section provides instructions on how to process a patient and fill

More information

Impacting Polk County through community-based integrated behavioral health care and support services

Impacting Polk County through community-based integrated behavioral health care and support services Bill Gardam, CEO presenting Impacting Polk County through community-based integrated behavioral health care and support services Behavioral Health Services Integrated Medical & Mental Health Services -

More information

Table of Contents. ii 2016 New Jersey HMO & PPO Performance Report

Table of Contents. ii 2016 New Jersey HMO & PPO Performance Report Table of Contents Commissioner s Letter... 1 Introduction... 2 Quality Matters... 3 Staying Healthy... 4 Breast Cancer Screening... 5 Cervical Cancer Screening... 6 Colorectal Cancer Screening... 7 Childhood

More information

Opportunities to Advance Lifespan Respite: Managed Long-Term Services and Supports and Affordable Care Act Options

Opportunities to Advance Lifespan Respite: Managed Long-Term Services and Supports and Affordable Care Act Options Opportunities to Advance Lifespan Respite: Managed Long-Term Services and Supports and Affordable Care Act Options October 18, 2013 Joe Caldwell Director of Long-Term Services and Supports Policy 1 Overview

More information

MULTI-STAKEHOLDER APPROACH TO VALUE-BASED HEALTHCARE

MULTI-STAKEHOLDER APPROACH TO VALUE-BASED HEALTHCARE MULTI-STAKEHOLDER APPROACH TO VALUE-BASED HEALTHCARE Randa Deaton, MA Corporate Director, UAW/Ford Community Healthcare Initiative Co-Executive Director, Kentuckiana Health Collaborative 1 WHO is the KHC?

More information

Benefits and Entitlements for Guard and Reserves. Presented by Transition Assistant Advisor Amy Eagen

Benefits and Entitlements for Guard and Reserves. Presented by Transition Assistant Advisor Amy Eagen Benefits and Entitlements for Guard and Reserves Presented by Transition Assistant Advisor Amy Eagen Tricare Reserve Select Available for purchase by qualified members of the selected Reserve when they

More information

MANAGED CARE IS HERE

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

More information

Enrollment, Eligibility and Disenrollment

Enrollment, Eligibility and Disenrollment Section 2. Enrollment, Eligibility and Disenrollment Enrollment: Enrollment in Medicaid Programs: The State of Florida (State) has the sole authority for determining eligibility for Medicaid and whether

More information

COMMUNICATING WITH YOU

COMMUNICATING WITH YOU Patient Intake Form Appointment Date and Time: Patient Account#: *Initial Visit Deposit of $60 is required before securing your initial appointment. Refer to Cornerstone Psychiatric Services, Inc. David

More information

A University of Hawai'i Cooperative Extension Service Project.

A University of Hawai'i Cooperative Extension Service Project. A University of Hawai'i Cooperative Extension Service Project www.ctahr.hawaii.edu/tcym Increase your knowledge about Course Objectives financial planning Improve your ability to make informed decisions

More information

PROVIDER ONBOARDING TRAINING

PROVIDER ONBOARDING TRAINING PROVIDER ONBOARDING TRAINING April 2017 Contents Module 1: Orientation... 3 Module 2: Authorization/Registration Process... 10 Module 3: Claims Submission & Payment... 25 Process Flows for Claims Processing...

More information

Health in Handbook. a guide to Medicare rights & health in Pennsylvania #6009-8/07

Health in Handbook. a guide to Medicare rights & health in Pennsylvania #6009-8/07 Health in Handbook a guide to Medicare rights & health in Pennsylvania #6009-8/07 Tips for Staying Healthy works hard to make sure that the health care you receive is the best care possible. There are

More information

ICD-10 Frequently Asked Questions for Providers Q Updates

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

More information

Welcome to the Agency for Health Care Administration (AHCA) Training Presentation for Managed Medical Assistance Specialty Plans

Welcome to the Agency for Health Care Administration (AHCA) Training Presentation for Managed Medical Assistance Specialty Plans Welcome to the Agency for Health Care Administration (AHCA) Training Presentation for Managed Medical Assistance Specialty Plans The presentation will begin momentarily. Please dial in to hear audio: 1-888-670-3525

More information

The Future of Integrated Care. Neftali Serrano, PsyD Executive Director

The Future of Integrated Care. Neftali Serrano, PsyD Executive Director The Future of Integrated Care Neftali Serrano, PsyD Executive Director Photo Credit: Barbara Davidson, New York Times Objectives To identify the major trends in health information technology and healthcare

More information

REFERENCE MANUAL. American Therapy Administrators of Florida

REFERENCE MANUAL. American Therapy Administrators of Florida 2018 REFERENCE MANUAL American Therapy Administrators of Florida Table of Contents Authorization Process........................... 1 Claims & Reimbursement........................ 3 Supplies & Equipment..........................

More information

19. Covered California Quality Improvement Strategy (QIS) - INSTRUCTIONS FOR DATA TEMPLATE

19. Covered California Quality Improvement Strategy (QIS) - INSTRUCTIONS FOR DATA TEMPLATE 19. Covered California Quality Improvement Strategy (QIS) - INSTRUCTIONS FOR DATA TEMPLATE Section 19.2 of the QIS requires applicants to submit data for each initiative area. Some questions can be completed

More information

Statewide Medicaid Managed Care (SMMC) Managed Care Plan Report Guide Effective

Statewide Medicaid Managed Care (SMMC) Managed Care Plan Report Guide Effective Statewide Medicaid Managed Care (SMMC) Managed Care Plan Report Guide Effective 4-1-17 THIS PAGE INTENTIONALLY LEFT BLANK Table of Contents SECTION ONE: OVERVIEW AND REPORTING REQUIREMENTS 5 Chapter 1:

More information

EVIDENCE OF COVERAGE. January 1 December 31, Your Medicare Health Benefits and Services as a Member of Cigna HealthSpring Advantage (PPO)

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

More information

Make sure you have health cover for your family. Allianz Global Assistance OVHC offers three types of policies:

Make sure you have health cover for your family. Allianz Global Assistance OVHC offers three types of policies: Overseas Visitors Health Cover Pregnancy Fact Sheet This fact sheet aims to help you understand the Australian healthcare system when having a baby. During your pregnancy Make sure you have health cover

More information

[EPUB] OF FLORIDA MEDICAID PROVIDERS SERVICE MANUAL ARCHIVE

[EPUB] OF FLORIDA MEDICAID PROVIDERS SERVICE MANUAL ARCHIVE 12 February, 2018 [EPUB] OF FLORIDA MEDICAID PROVIDERS SERVICE MANUAL ARCHIVE Document Filetype: PDF 168.28 KB 0 [EPUB] OF FLORIDA MEDICAID PROVIDERS SERVICE MANUAL ARCHIVE Temporary Cash Assistance Income

More information

Press Release: CMS Office of Public Affairs, Monday, January 31, 2005 MEDICARE "PAY FOR PERFORMANCE (P4P)" INITIATIVES

Press Release: CMS Office of Public Affairs, Monday, January 31, 2005 MEDICARE PAY FOR PERFORMANCE (P4P) INITIATIVES Press Release: CMS Office of Public Affairs, 202-690-6145 Monday, January 31, 2005 MEDICARE "PAY FOR PERFORMANCE (P4P)" INITIATIVES Medicare has various initiatives to encourage improved quality of care

More information

Accountable Care Organizations American Osteopathic Association Health Policy Day September 23, 2011

Accountable Care Organizations American Osteopathic Association Health Policy Day September 23, 2011 Accountable Care Organizations American Osteopathic Association Health Policy Day September 23, 2011 Cary Sennett MD PhD Cary Sennett, MD, PhD Managing Director, Engelberg Center for Health Care Reform

More information

Evaluation of Pharmacy Delivery Models

Evaluation of Pharmacy Delivery Models Evaluation of Pharmacy Delivery Models As Required By House Bill 1, 84th Legislature, Regular Session, 2015 (Article II, Health and Human Services Commission, Rider 83) Health and Human Services Commission

More information

Medicare Medicaid Alignment Initiative (MMAI) November 14, 2014

Medicare Medicaid Alignment Initiative (MMAI) November 14, 2014 Medicare Medicaid Alignment Initiative (MMAI) November 14, 2014 MMW work is supported by grants from: The Chicago Community Trust Michael Reese Health Trust The Retirement Research Foundation Who We Are:

More information

PCMH: How small practices can leverage HIT to make it work

PCMH: How small practices can leverage HIT to make it work PCMH: How small practices can leverage HIT to make it work NYS MiniHIMSS 2014 Conference April 23, 2014 Sal Volpe MD FAAP FACP CHCQM svolpe@svolpemd.com twitter.com/salvolpe Agenda What is a Patient-Centered

More information

FORGING SUCCESSFUL PARTNERSHIPS BETWEEN HEALTH PLANS AND STATES

FORGING SUCCESSFUL PARTNERSHIPS BETWEEN HEALTH PLANS AND STATES FORGING SUCCESSFUL PARTNERSHIPS BETWEEN HEALTH PLANS AND STATES James M. Verdier Second Annual Conference on Reaching, Retaining, and Serving Low Income Beneficiaries Las Vegas, NV July 24, 2007 Introduction

More information

REPORT OF THE COUNCIL ON MEDICAL SERVICE. Acceptance of TRICARE Health Insurance

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,

More information

Presentation Objectives

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

More information

Volume 24, No. 07 July 2014

Volume 24, No. 07 July 2014 State of New Jersey Department of Human Services Division of Medical Assistance & Health Services Volume 24, No. 07 July 2014 TO: SUBJECT: All Providers For Action For Managed Care Organizations For Information

More information