We ll take care of i t. The only answer that counts.
|
|
|
- Silvia Watkins
- 6 years ago
- Views:
Transcription
1 Q U A L I T Y C A R E S O L U T I O N S We ll take care of i t. The only answer that counts.
2 Service. Service. Service. The New Adage Everyone says it, few deliver. How hard is it? Answer the phone, determine the need, and take care of it. With just one phone call or you can schedule all of your ancillary healthcare needs. You ll find all the support you need, anywhere you need it, to speed the recovery of your injured worker. From decision makers to the recovering patient, it s the only answer that counts. We ll take care of it. Direct Contact No telephone tag or voice system chains. Proficient Staff No lengthy explanations for inexperienced operators. Ready Supplies, Timely Delivery No back orders or delays. Why Choose Orchid Medical? Orchid Medical manages the complex details of patient care and recovery with an extraordinary level of efficiency and the highest standard of excellence. From routine supplies and equipment to state-of-the-art prosthetics, we deliver the products and services that will expedite successful outcomes for your injured workers. Time The Perpetual Standard Trendy jargon can t replace the reality that time saved is money saved. Reduced contacts, increased product availability and nationwide coverage by knowledgeable, responsive staff assure the best use of time and the highest level of cost containment. That s the kind of practical service that will impact your bottom line, and it s the kind of quality medical care that will speed your injured worker s return to health, work and life. Fingertip Reporting for Business Performance Our exclusive reporting system delivers the precise information you need in the format you want. Specifically designed for claims tracking and management, OMNI (Orchid Medical Network Integration) is versatile, powerful and readily adapts to your business model. Customized reporting and secure, full-time access enable you to effectively analyze and make the decisions that improve business performance. Custom Fit Track workloads, cost savings, turnaround time; widely variable sorting by order type, physician, adjuster, case manager, branch office you choose. Live Web Access Log in, submit and track orders, retrieve documents (reports, progress notes, delivery tickets, invoices) for current and past assignments. Data Exchange Customize OMNI to interact with your company s system to achieve electronic billing and submission of assignments a valuable savings in time and paper.
3 Medical Products When and Where You Need Them Orchid Medical wants your injured worker to have the full range of therapeutic and mobility products to promote rapid recovery and maximum accessibility. From TENS Units and custom wheelchairs to complex orthotic and prosthetic devices, every product we offer has a twofold purpose: Speedy recovery, convenience and comfort for your injured worker. Comprehensive and cost-effective network of products for clients. Electrotherapy Products Bone Growth Stimulators Muscle Stimulators TENS Units Other Specialty Items Mobility Products Automobile Lifts Canes Crutches Custom Wheelchairs Patient Lifts - Home Modifications Ramps Scooters Shower Seats Orthotics & Prosthetic Products & Services One of the first to bring bionic technology to our industry, Orchid Medical offers skillful service and selection through hundreds of board-certified professionals in all 50 states. Custom and Off-the-shelf Orthotics Bionic Technology High-tech Prosthetics Specialist Evaluation, Selection, Fitting, Adjustment and Training
4 Medical Services Across-the-Board Medical Services & Solutions Diagnosis, therapy, care and comfort Returning your injured worker to health is the overriding goal of Orchid Medical. From diagnostic imaging solutions to inclusive home health services, we support the complete personal care and recovery management for your injured workers. We take pride in delivering exceptional service and detailed patient training for all products and services. Home Health Services Certified nursing and care coordination staff Catastrophic care Physical therapy Home health aides Speech therapy LPN s IV therapy Drug compounding Pain management Diagnostic Imaging MRI - magnetic resonance imaging CT Scan - computed tomography 48-hour results reduce cost of claims Physical Therapy Services Physical Therapy Occupational Therapy Functional Capacity Exams Work Hardening Therapeutic management to control over-utilization and impact cost Transportation & Translation Services Over 7,000 ATA certified providers Interpretation by a network of over 3000 translators Over 200 languages Ambulatory critical care, Advanced Life Support Ambulance, Basic Life Support Ambulance, and Air Ambulance Stretchers Nationwide service
5 Custom Client Reporting Track workloads, cost savings and turnaround time with a broad selection of variables. Adjuster Assignment Status Branch Office Case Manager Employer Physician Vendor Client-defined Variables SM What is OMNI? The information you want in the format you need. Complete and accurate information drives the expedient business decisions that make the difference between profit and loss. We developed our proprietary reporting system to minimize hassle and maximize your ability to make those decisions. Live Web Access Secure log in, submit and track orders and retrieve current and past documents. Delivery Tickets Invoices Progress Notes Reports Data Exchange Customize OMNI SM to interact with your system to save paperwork, time and money. Add electronic billing and electronic submission of assignments. Improve analysis and business performance.
6 Orchid Medical delivers client support with a clear, get-down-to-business approach. Injured workers need to return to health and work. Your business needs diverse services and detailed cost control to accomplish that goal. Orchid Medical is your link between caring support and business efficiency. Service, Performance and Clear Communication The foundation that drives our value and customer satisfaction. Through the entire chain of care for recovering workers, dedicated customer service offers the greatest opportunity for speedy recovery and reduced compensation costs. Start with direct phone contact and clear communication with trained staff. Access our nationwide network of medical services and products. Take advantage of effective negotiations for the lowest prices available. Add customized reporting to improve your business performance. The end result? Premium service, accelerated recovery and bottom-line results. We ll take care of i t. The only answer that counts.
7 We ll take care of i t. The only answer that counts. From the outset, we ve mastered business simple with a balance of service, technology, pricing and convenience. What that means for top management is comprehensive reporting, effective cost control and the kind of customer satisfaction that drives profits and grows your business. DME allmedicalsupplies prosthetics&orthotics homehealthservices physicaltherapy diagnosticimaging transportation/translation
The right ancillary services can be as important as the right medication.
The right ancillary services can be as important as the right medication. Ancillary Services When a claimant requires ancillary services, turn to the Workers Comp and Auto No-Fault division of Optum.
Choice PPO Retired Employees Health Program Non-Medicare Eligible Retired Members
Choice PPO Retired Employees Health Program Non-Medicare Eligible Retired Members DEDUCTIBLE (per calendar year) Annual in-network deductible must be paid first for the following services: Imaging, hospital
For Large Groups Health Benefit Summary Plan 05301
This is a lower premium plan that offers comprehensive insurance coverage. These plans are designed to help you know your costs upfront with a copayment for the services you use most. Your cost share will
HMO West Pennsylvania Employees Benefit Trust Fund Benefit Highlights Active Eligible Members. Providers None $6,850 single / $13,700 family
Benefit Provision HMO Network Providers None $6,850 single / $13,700 family DEDUCTIBLE (Per Calendar Year) OUT-OF-POCKET MAXIMUM (includes costs for medical, mental health and substance abuse benefits
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
Medical Plan Options - Retirees Age 65 or Over/ Disabled Participants with Medicare Coverage
Program Name U of M Retiree Plan with Group MedicareBlue SM Rx Group Platinum Blue SM Plan C with Group MedicareBlue SM Rx Freedom Plan & Freedom Plan & Type of Policy Coordinates with Medicare and includes
ColoradoPAR Program Durable Medical Equipment. August 2015
ColoradoPAR Program Durable Medical Equipment August 2015 Agenda Introduction to eqhealth Solutions Scope of Services Overview of the PAR process eqsuite Contacts and resources at eqhealth Solutions Key
Your Plan Explained. MetLife. UnitedHealthcare Group Medicare Advantage (PPO) Group Number: 12359
2016 Your Plan Explained MetLife UnitedHealthcare Group Medicare Advantage (PPO) Effective: January 1, 2016 through December 31, 2016 Group Number: 12359 Benefit highlights MetLife 12359 Effective January
Kaiser Permanente Washington - Pre-Authorization requirements:
Kaiser Permanente Washington - Pre-Authorization requirements: Kaiser Permanente Washington requires pre-authorization for most services to be covered. The information below outlines pre-authorization
For Large Groups Health Benefit Single Plan (HSA-Compatible)
Financial Features (DED 1 ) (PBP 2 ) (DED is the amount the member is responsible for before Florida Blue pays) Out-of-Network Inpatient Hospital Facility Services Per Admission (PAD) Coinsurance (Coinsurance
Disability Support Program Subject Technical Aids and Assistive Devices Policy # 8-1 Effective Date: October 1, 2001.
Program Disability Support Program Subject Technical Aids and Assistive Devices Policy # 8-1 Effective Date: October 1, 2001 Revised Date: July 4, 2013 Authorized by: Deputy Minister, Carol Anne Duffy
Irvine Unified School District ASO PPO /50
An Independent member of the Blue Shield Association Irvine Unified School District ASO PPO 500 90/50 Benefit Summary (For groups of 300 and above) (Uniform Health Plan Benefits and Coverage Matrix) THIS
Blue Cross Premier Bronze
An individual PPO health plan from Blue Cross Blue Shield of Michigan. You will have a broad choice of doctors and hospitals within BCBSM s unsurpassed statewide PPO network including nationwide coverage.
LSU First & WebTPA: Working Together
LSU First & WebTPA: Working Together 2016 LSU First Health Plan Changes 2016 LSU First Health Plan Changes New ID Card Specialty drug copay $150 90 day timely filing period (medical and pharmacy) Home
Academic Year Is from 12:00am on August 16 th to 11:59pm on August 15 th. This is the coverage period for CampusCare.
CampusCare A self-funded student health benefit plan for the students at the University of Illinois at Chicago including the Rockford and Peoria campuses. *Please note: The Urbana-Champaign and Springfield
Services That Require Prior Authorization
Services That Require Prior Authorization Some of the services listed in the Medical Benefits Chart are covered only if your doctor or other network provider gets approval in advance (sometimes called
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
Patriot Health Plus Plan
Patriot Health Plus Plan Move towards peace-of-mind... 1-800-292-3797 M-F 9a.m. - 7p.m. EST. Discount Medical Plans are provided by Patriot Health Florida, Inc., a discount medical plan organization. The
Basic Covered Benefits and Services
Basic Covered Benefits and A prior authorization is when UnitedHealthcare Community Plan gives the doctor permission to perform certain services. Bed Liners Coverage Covered for members age 4 and up; Prior
ST. TAMMANY PARISH SCHOOL BOARD SCHEDULE OF BENEFITS
PLAN NAME ST. TAMMANY PARISH SCHOOL BOARD SCHEDULE OF BENEFITS St. Tammany Parish School Board Active Employee Plan PLAN'S ORIGINAL BENEFIT PLAN DATE PLAN'S AMENDED BENEFIT PLAN DATE GROUP NUMBER 78B03ERC
Blue Shield Gold 80 HMO
Blue Shield Gold 80 HMO Uniform Health Plan Benefits and Coverage Matrix Blue Shield of California Effective January 1, 2017 THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND
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
Blue Shield $0 Cost-Share HMO AI-AN
Blue Shield $0 Cost-Share HMO AI-AN This plan is only available to eligible Native Americans 1 Uniform Health Plan Benefits and Coverage Matrix Blue Shield of California Effective January 1, 2017 THIS
Blue Choice PPO SM Physician, Professional Provider, Facility and Ancillary Provider - Provider Manual Table of Contents (TOC)
THIS MANUAL CONTAINS A REQUIRED DISCLOSURE CONCERNING BLUE CROSS AND BLUE SHIELD OF TEXAS CLAIMS PROCESSING PROCEDURES Blue Choice PPO SM Physician, Professional Provider, Facility and Ancillary Provider
CUSTODIAL NURSING HOME CARE
CUSTODIAL NURSING HOME CARE Chiropratic Services Custodial Nursing Home Care DME Equipment and Supplies Incontinence Supplies: Diapers, briefs, wipes, gloves, pads Infusion (IV, Enteral) Services Outpatient
Your Choice 3-Tier Network Option Plan
. Your Choice 3-Tier Network Option Plan Your Top Questions What is Your Choice? Are my doctors in the plan? Are my medications covered by the plan? If I get sick, what do I do? How much will I pay out
NEIGHBORHOOD HEALTH PARTNERSHIP POS SUMMARY OF BENEFITS
XV-2 $30/$60/$200/$1,000/80% R NEIGHBORHOOD HEALTH PARTNERSHIP POS SUMMARY OF BENEFITS A quick glance at this Summary of Benefits will introduce you to the Point of Service (POS) Plan you have with Neighborhood
FACILITY BASED SERVICES
FACILITY BASED SERVICES Inpatient Hospital Care Elective Inpatient Admission or Elective Inpatient Surgery Inpatient Rehabilitation Care Skilled Nursing Facility Admission Non-Custodial Nursing Home Care
Summary of Benefits CCPOA (Basic) Custom Access+ HMO
Blue Shield of California is an independent member of the Blue Shield Association Summary of Benefits CCPOA (Basic) Custom Access+ HMO CCPOA Effective January 1, 2019 HMO Benefit Plan This Summary of Benefits
Gold Access+ HMO 500/35 OffEx
An Independent Member of the Blue Shield Association Gold Access+ HMO 500/35 OffEx Benefit Summary (For groups 1 to 100) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective
SERVICES REQUIRING PRIOR AUTHORIZATION
S REQUIRING PRIOR AUTHORIZATION All Hospital Admissions (All Place of service 21 services require authorization.) ELECTIVE ADMISSIONS All hospital admissions require review by Gold Coast Health Plan Health
Summary of Benefits Platinum Full PPO 0/10 OffEx
Blue Shield of California is an independent member of the Blue Shield Association Summary of Benefits Platinum Full PPO 0/10 OffEx Group Plan PPO Benefit Plan This Summary of Benefits shows the amount
Blue Options. Health Plan Information Guide. What should I know about my benefits? What happens next? Where do I go to get assistance?
Blue Options Health Plan Information Guide What happens next? What should I know about my benefits? Where do I go to get assistance? Welcome At Florida Blue, we provide you with guidance and support because
CLASSIC BLUE SECURE/BLUE CROSS BLUE SHIELD COMPLEMENTARY Monroe County Benefit Summary/Comparison (Over 65 Retirees)
WHO IS COVERED Enrollment Requirement Members must be enrolled in both Medicare Parts A and B Members must be enrolled in both Medicare Parts A and B Type of Tier Single only Single only Dependent/Student
BCBSNC Best Practices
BCBSNC Best Practices Thank you for attending today! We value your commitment of caring for our members your patients and our shared goals for their improved health An independent licensee of the Blue
FACILITY BASED SERVICES
CUSTODIAL NURSING HOME CARE Chiropratic Services Custodial Nursing Home Care DME Equipment and Supplies Incontinence Supplies: Diapers, briefs, wipes, gloves, pads Infusion (IV, Enteral) Services Outpatient
Centennial Care Provider Notification Grid
Page 1 of 5 Ablative Procedure for Venous Insufficiency & Varicose Veins Accredited Residential Treatment Center (ARTC) Acute Inpatient Medical (incl. Detoxification services & LTACH)) Acute Inpatient
Platinum Trio ACO HMO 0/20 OffEx
Platinum Trio ACO HMO 0/20 OffEx Benefit Summary (For groups 1 to 100) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective January 1, 2017 THIS MATRIX IS INTENDED TO
Summary of Benefits [Silver Access+ HMO 1750/55 OffEx] [Silver Local Access+ HMO 1750/55 OffEx]
![Summary of Benefits [Silver Access+ HMO 1750/55 OffEx] [Silver Local Access+ HMO 1750/55 OffEx]](/thumbs/86/94175655.jpg "Summary of Benefits [Silver Access+ HMO 1750/55 OffEx] [Silver Local Access+ HMO 1750/55 OffEx]")
Blue Shield of California is an independent member of the Blue Shield Association Summary of Benefits [Silver Access+ HMO 1750/55 OffEx] [Silver Local Access+ HMO 1750/55 OffEx] Group Plan HMO Benefit
Amerigroup Kansas Provider Training Program
Amerigroup Kansas Provider Training Program Agenda About NIA The Provider Partnership The Program Components How the Program Works: The Precertification Process The Precertification Appeals Process The
January 1, 2015 December 31, Maintenance Organization (HMO) offered by HEALTHNOW NEW YORK INC. with a Medicare contract)
BLUECROSS BLUESHIELD SENIOR BLUE 601 (HMO), BLUECROSS BLUESHIELD SENIOR BLUE HMO SELECT (HMO) AND BLUECROSS BLUESHIELD SENIOR BLUE HMO 651 PARTD (HMO) (a Medicare Advantage Health Maintenance Organization
IPN s credentialing/recredentialing program has been certified by NCQA as of August 12, 2014.
Credentialing is primary source verification of a health care practitioner s education, training, work experience, license, etc. A variety of resources are used to verify the information provided by the
Summary of Benefits Platinum Trio HMO 0/25 OffEx
Blue Shield of California is an independent member of the Blue Shield Association Summary of Benefits Platinum Trio HMO 0/25 OffEx Group Plan HMO Benefit Plan This Summary of Benefits shows the amount
Horizon PPO. HorizonBlue.com
Horizon PPO HorizonBlue.com Get to Know Horizon Blue Cross Blue Shield of New Jersey Horizon Blue Cross Blue Shield of New Jersey is transforming health care. We re New Jersey s largest and most experienced
Covered Services List
CAREPLUS Covered Services List For CeltiCare Health with MassHealth CarePlus Coverage This is a list of all covered services and benefits for MassHealth CarePlus enrolled in CeltiCare Health. The list
2017 Summary of Benefits
H5209 004_DSB9 23 16 File & Use 10/14/2016 DHS Approved 10 7 2016 This is a summary of drug and health services covered by Care Wisconsin Medicare Dual Advantage Plan (HMO SNP) January 1, 2017 to December
Meeting Date: July 26, 2017 Action: Decision Topic: Item 13.0 Grand River Hospital MRI and Nuclear Medicine Replacement Pre-Capital Submission
BRIEFING NOTE Mission: To make it easy for you to be healthy and to get the care and support you need. Vision: Healthy People. Thriving Communities. Bright Futures. Core Value: Acting in the best interest
CALIFORNIA Small Group HMO Aetna Health of California, Inc. Plan Effective Date: 04/01/2007. Aetna Value Network* HMO $30/$40
PLAN FEATURES Deductible (per calendar year) Member Coinsurance Lifetime Maximum Primary Care Physician Selection Referral Requirement PHYSICIAN SERVICES CALIFORNIA Small Group HMO Primary Care Physician
BCBSM provides administrative claims services only. Your employer or plan sponsor is financially responsible for claims.
Michigan Catholic Conference Group Number: 71755 Package Code(s): 010 Section Code(s): 1000, 2000 PPO - PPO1, Hearing, Vision ( Exam only) Effective Date: 01/01/2018 Benefits-at-a-glance This is intended
Blue Shield Gold 80 HMO 0/30 + Child Dental INF
Blue Shield Gold 80 HMO 0/30 + Child Dental INF Benefit Summary (For groups 1 to 100) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective January 1, 2017 THIS MATRIX
HEALTH PLAN BENEFITS AND COVERAGE MATRIX
HEALTH PLAN BENEFITS AND COVERAGE MATRIX THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. THE EVIDENCE OF COVERAGE AND PLAN CONTRACT SHOULD BE CONSULTED FOR
Platinum Local Access+ HMO $25 OffEx
Platinum Local Access+ HMO $25 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
Highlights of your Health Care Coverage
Highlights of your Health Care Coverage Any deductibles, copays, and coinsurance percentages shown are amounts for which you're responsible. Medical Benefits apply after the calendar-year deductible is
Health Alliance. Utilization Management Changes Overview. Maxine Wallner Director Provider Services. February 2017
Health Alliance Utilization Management Changes Overview February 2017 Maxine Wallner Director Provider Services Agenda Decision Overview Utilization Management Program Changes Expansions and modifications
This plan is pending regulatory approval.
Bronze Full PPO 3000 OffEx Benefit Summary (For groups 1 to 50) (Uniform Health Plan Benefits and Coverage Matrix) Blue Shield of California Effective October 1, 2015 THIS MATRIX IS INTENDED TO BE USED
Your Choice. 3-Tier Network Option Plan
Your Choice 3-Tier Network Option Plan What is Your Choice? Click Here to Watch Video Your Top Questions What is Your Choice? Are my doctors in the plan? Are my medications covered by the plan? If I get
Summary of Benefits Full PPO Savings Two-Tier Embedded Deductible 1500/2700/3000
Summary of Benefits Full PPO Savings Two-Tier Embedded Deductible 1500/2700/3000 Group Plan PPO Savings Benefit Plan This Summary of Benefits shows the amount you will pay for Covered Services under this
Summary of Benefits. January 1, 2018 December 31, Providence Medicare Dual Plus (HMO SNP)
Summary of Benefits January 1, 2018 December 31, 2018 Providence Medicare Dual Plus (HMO SNP) This plan is available in Clackamas, Multnomah and Washington counties in Oregon for members who are eligible
MyHPN Solutions HMO Gold 7
MyHPN Solutions HMO Gold 7 HIOS ID: 95865NV0030074 Attachment A Benefit Schedule Calendar Year Deductible (CYD): $3,000 of EME per Member and $6,000 of EME per family. The Calendar Year Out of Pocket Maximum
MMA Benefits at a Glance
MMA Benefits at a Glance You must get covered services by providers that are part of the Molina plan. You must also make sure that approval is obtained if needed. Ambulance Art Therapy Assistive Care Services
CHAPTER Committee Substitute for House Bill No. 1071
CHAPTER 2013-93 Committee Substitute for House Bill No. 1071 An act relating to health care accrediting organizations; amending ss. 154.11, 394.741, 397.403, 400.925, 400.9935, 402.7306, 408.05, 430.80,
Homecare Salary & Benefits Report Job Descriptions. Salary Positions
Salary Positions 01 EXECUTIVE DIRECTOR/CEO Top level position in the agency. Is owner or reports to Board of Directors. Responsible for profitability, planning and overall administration. Accountable for
RE: Important Information Regarding Prior Authorization for High Tech Imaging Services
Name Address City, St Zip RE: Important Information Regarding Prior Authorization for High Tech Imaging Services Dear Provider: Blue Cross and Blue Shield of Louisiana and HMO of Louisiana, Inc., (HMOLA),
2016 OPEN ENROLLMENT MEDICAL PLANS
2016 OPEN ENROLLMENT MEDICAL PLANS Table of Contents Section I. Enrollment Guidelines Page 3 Health Plan Comparison Chart Page 4 Health Plan Premiums and Employee Cost-Sharing Page 5 Section II. Blue Shield
Covered (blood, blood components, human blood products, and their administration) Covered (Some restrictions)
Washington Apple Health Medical Benefits Allergy Services (Antigen/Allergy Serum/Allergy Shots) Ambulance Services (Air Transportation) by FFS* Ambulance Services (Emergency Transportation) Ambulatory
FREEDOM BLUE PPO R CO 307 9/06. Freedom Blue PPO SM Summary of Benefits and Other Value Added Services
FREEDOM BLUE PPO R9943 2007 CO 307 9/06 Freedom Blue PPO SM Summary of Benefits and Other Value Added Services Introduction to Summary of Benefits for Freedom Blue January 1, 2007 - December 31, 2007 California
SUMMARY OF BENEFITS. Hamilton County Department of Education Network Copay Plan. Connecticut General Life Insurance Co.
SUMMARY OF BENEFITS Connecticut General Life Insurance Co. Hamilton County Department of Education Annual deductibles and maximums Lifetime maximum Pre-Existing Condition Limitation (PCL) Coinsurance All
2018 Summary of Benefits. HMO Plan REHP H3907
2018 Summary of Benefits HMO Plan REHP H3907 UPMC for Life HMO Plan (HMO) REHP SUMMARY OF BENEFITS January 1, 2018 December 31, 2018 This Summary of Benefits booklet gives you a summary of what UPMC for
Clinical Medical Policy Department Clinical Affairs Division DESCRIPTION
Inpatient Rehabilitation Facilities (IRFs) [For the list of services and procedures that need preauthorization, please refer to www.mcs.pr Go to Comunicados a Proveedores, and click Cartas Circulares.]
HERE ARE THE TOP 3 MOST COMMON BENEFIT ISSUES:
Medical Benefits What You Should Know MEDICALBENEFITS HEALTH INSURANCE TERMS YOU SHOULD KNOW Balance Billing This is practice where a provider charges full fees in excess covered amounts, bills you for
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
CA Group Business 2-50 Employees
PLAN FEATURES Network Primary Care Physician Selection Deductible (per calendar year) Member Coinsurance Copay Maximum (per calendar year) Lifetime Maximum Referral Requirement PHYSICIAN SERVICES Primary
Our service area includes these counties in: North Carolina: Durham, Wake.
2018 SUMMARY OF BENEFITS Overview of your plan AARP MedicareComplete (HMO) H5253-039 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer Service or go
Chiropractic Services Amendment of the Kaiser Foundation Health Plan, Inc., Evidence of Coverage for SOUTHERN CALIFORNIA IBEW-NECA HEALTH TRUST FUND
EOC #5 - Kaiser Foundation Health Plan, Inc. Southern California Region Chiropractic Services Amendment of the Kaiser Foundation Health Plan, Inc., Evidence of Coverage for SOUTHERN CALIFORNIA IBEW-NECA
Integrity Accountability Collaboration Trust Respect
S REQUIRING PRIOR AUTHORIZATION Only valid codes will be reviewed. Please refer to CMS/MC guidelines to verify validity. All Hospital Admissions (All Place of service 21 services require authorization.)
managed care solutions
Sedgwick connects care and claims management solutions with one team operating in one system. Our multi-disciplinary team provides guidance and support to help achieve the best and fastest recovery outcome
2019 Summary of Benefits
2019 Summary of Benefits H6345 This is a summary of drug and health services covered by January 1, 2019 - December 31, 2019. is Medicare Advantage HMO Plan (HMO stands for Health Maintenance Organization)
ProviderNews2014 Quarter 3
TEXAS ProviderNews2014 Quarter 3 Our Quality Improvement program The Amerigroup* Quality Improvement (QI) program is committed to excellence in the quality of service and care our members receive and the
The Hartford Select Network Medical Provider Network (MPN) for California Workers Compensation
The Hartford Select Network Medical Provider Network (MPN) for California Workers Compensation Employer Notification Guide - Topics Include: The Hartford Select Network Workers Compensation Medical Provider
GOLD 80 HMO NETWORK 1 MIRROR
GOLD 80 HMO NETWORK 1 MIRROR Summary of Benefits Group An independent member of the Blue Shield Association (Intentionally left blank) Gold 80 HMO Network 1 Mirror Summary of Benefits The Summary of Benefits
Our service area includes the following county in: Florida: Miami-Dade.
2018 SUMMARY OF BENEFITS Overview of your plan Medica HealthCare Plans MedicareMax (HMO) H5420-001 Look inside to learn more about the health services and drug coverages the plan provides. Call Customer
We re Tufts Health Plan, and our goal is better health and wellness for you.
We re Tufts Health Plan, and our goal is better health and wellness for you. Thank you for taking the time to read this short overview of Tufts Health Plan. Being willing to learn about your healthcare
STROKE REHAB PROGRAM
STROKE REHAB PROGRAM Allied Rehab Hospital is part of Allied Services Integrated Health System, the premier post-acute health-care system in Northeast Pennsylvania, and is the region s leading provider
Program Overview
2015-2016 Program Overview 04HQ1421 R03/16 Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health Service
Overview monthly plan premium
2018 Overview monthly plan premium Peoples Health Choices Gold (HMO) Welcome! Thank you for your interest in Peoples Health. We ve heard many times from our plan members that their health means everything
Benefits. Benefits Covered by UnitedHealthcare Community Plan
Benefits Covered by UnitedHealthcare Community Plan As a member of UnitedHealthcare Community Plan, you are covered for the following MO HealthNet Managed Care services. (Remember to always show your current
CHAPTER 3: EXECUTIVE SUMMARY
INDIANA PROVIDER MANUAL EXECUTIVE SUMMARY Indiana Family and Social Services Administration (FSSA) contracts with Anthem Insurance Companies, Inc. (dba Anthem Blue Cross and Blue Shield) for the provision
First Look: Plan Benefit Filings
July 30, 2014 First Look: Plan Filings Maryland and Washington, D.C. 1 Disclaimers MedStar does not currently have a contract with CMS for the State of MD nor any special needs plans in Washington, D.C.
Anthem Blue Cross Your Plan: Custom Premier HMO 10/100% Your Network: California Care HMO
Anthem Blue Cross Your Plan: Custom Premier HMO 10/100% Your Network: California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process. This
PROVIDER PARTICIPATION REQUEST FORM
PROVIDER PARTICIPATION REQUEST FORM Thank you for your interest in becoming a participating provider with Quartz. Your request will be evaluated for participation in all Quartz affiliate networks. In order
2018 CareOregon Advantage Plus (HMO-POS SNP) Summary of Benefits
2018 CareOregon Advantage Plus (HMO-POS SNP) Summary of Benefits For Oregon counties: Clackamas, Clatsop, Columbia, Jackson, Josephine, Multnomah, Tillamook, Washington and Yamhill H5859_1099_CO_1018 CMS
MIT Student Extended Insurance Plan Benefit Description
Preferred Provider Plan A PPO Health Plan administered by Blue Cross and Blue Shield of Massachusetts, Inc. MIT Student Extended Insurance Plan Benefit Description Welcome! This benefit booklet provides
Medicare Plus Blue SM Group PPO. Summary of Benefits. Michigan Public School Employees Retirement System
2018 Medicare Plus Blue SM Group Summary of Benefits January 1, 2018 December 31, 2018 Michigan Public School Employees Retirement System www.bcbsm.com/mpsers This information is a summary document and
CONRAD INDUSTRIES, INC. S2489 NON GRANDFATHERED PLAN BENEFIT SHEET
BENEFIT SHEET GENERAL PLAN INFORMATION Coordination of Benefits Standard COB Dependents Children to age 26 Filing Limit 12 months from date of service Mailing Address & PPO Company. PPO Co.: PPO CIGNA
Summary of Benefits. New York: Bronx, Kings, New York, Queens and Richmond Counties
Summary of Benefits New York: Bronx, Kings, New York, Queens and Richmond Counties January 1, 2006 - December 31, 2006 You ve earned the right to live life on your own terms. And that includes the right
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..........................
DDP: PPO, CDHP, and EPO (EPO for PA residents only) DDNY: PPO and CDHP. Effective January 1, plans: HIGHLIGHTS Medical benefits 11
2016 plans: DDP: PPO, CDHP, and EPO (EPO for PA residents only) DDNY: PPO and CDHP Effective January 1, 2016 HIGHLIGHTS Medical benefits 11 How to find a provider 12 Programs and services 13 Benefit summaries
Complete Senior Care Enrollment Agreement
Complete Senior Care Enrollment Agreement I have received the Enrollment Handbook and a copy of the Provider Network and have had the opportunity to ask questions. Name: Address: (First) (Middle) (Last)
2019 Summary of Benefits
2019 Summary of Benefits H6351 This is a summary of drug and health services covered by January 1, 2019 - December 31, 2019. is Medicare Advantage HMO Plan (HMO stands for Health Maintenance Organization)
2018 MGMA COST AND REVENUE SURVEY
(*Asterisks denote required questions) *Note: The Practice Profile must be completed before beginning any of the MGMA Surveys* Time is a valuable thing! We ve created a tiered participation benefit structure