New Rochelle Radiology TIN: Precertification Requirements
|
|
|
- Rose Edwina Clarke
- 8 years ago
- Views:
Transcription
1 New Rochelle Radiology TIN: Precertification Requirements 175 Memorial Highway NPI: Lockwood Avenue NPI: PET/ Aetna through CareCore Aetna Golden icare through CareCore Affinity Health Plan 11 digit ID Affinity Health Plan Affordable Care/ObamaCare ID begins with H Precert required for all imaging studies Ray Fluoroscopy Affinity Health Plan icare ID has an M in the middle Anthem Blue Cross Blue Shield Through AIM Beech Street PPO BlueCard SWSCHP Prefix TUR Through Coordinated Health/Care
2 PET/ Blue Cross/Blue Shield Most Plans Require Precert Through AIM Blue Cross/Blue Shield Senior Plan/ VOF plans Through AIM Blue Cross/Blue Shield Federal Plan ID begins with R No Precert required CenterLight Healthcare Formerly CCM Christian Brothers CIGNA HMO Through Solutions Cigna.medsolutionsonlin e.com CIGNA PPO Precert required for some plans. If not indicated on back of card, you must check Connecticare Through NIA When more frequent than 1 in 23 mos Elderplan- Only 175 office par Through Care To Care EmblemHealth EPO, PPO,
3 PET/ Empire Government Plan United HealthCare Benefits Management Fidelis Care Precert req for Hysterosalpingograms Inj CPT when not being done for cancer not req when cancer diagnosis (140.x 239.x) First Health Precert Varies from plan to plan GHI through CareCore GHI HMO through CareCore HIP through CareCore Req. referral for all radiology studies that do not require precert - except screening mammo Referral not required for: Access 1 and II, EPO, PPO, VIP HIP Montefiore IPA Through the IPA Referral not required Needed for MRI Only. (Not ) Health First - 3
4 PET/ Health Republic Through NIA eff 8/1/15 Health Republic of NJ x Hudson Health Plan eff 7/1/ Humana/ChoiceCare Comm and Mcare plans Updated 9/14/13 RadConsult Local 1199 Through Care To Care Must Have Patient s SS#! Cardiology Eff 11/1/12 Locals Varies from plan to plan. Contact number on card. MVP all plans 4/1/12 Through CareCore MagnaCare precertification varies from plan to plan Must Have Patient s SS# and the phone number of the local! MagnaCare/Pavers and Builders
5 PET/ icaid-through RadConsult or fax MultiPlan precertification varies from plan to plan Oxford PHCS varies from plan to plan Pavers and Builders/ MagnaCare POMCO varies from plan to plan. To check requirements Authorization Precert strongly advised SWSCHP BlueCard TUR Through Coordinated Health/Care Touchstone Through Care to Care Touchstone Through Touchstone Tricare/US Family Health Pre-certification varies based on C.P.T. code referral required for some studies. No precert req 70,000 series Diagnostic Mammo 5
6 PET/ United Healthcare Pre-notification through UHC eff 8/13/12 To determine if required: United Healthcare Community Plans Pre-certification through UHC United Healthcare Navigate Through UHC WellCare Effective 3/2/09 6
Health Plans Accepted by the Hospital (Effective 1/18/2016)
1199SEIU National Benefit Fund Home Care Benefit Fund Greater New York Benefit Fund Health Plans Accepted by the Hospital (Effective 1/18/2016) AARP AARP Medicare Complete Plan 1 United HealthCare AARP
CONTINUUM HEALTH PARTNERS Physician Profile Fact Sheet
CONTINUUM HEALTH PARTNERS Physician Profile Fact Sheet All physicians affiliated with any one of the Continuum Health Partners hospitals are invited complete this Profile Fact Sheet. The information on
Crystal Run Healthcare Insurance 1199 NBF (MVP) AARP Products AARP Medicare Complete HMO 1 and 2 AARP Medicare Complete Essential HMO Aetna Products
Crystal Run Healthcare Insurance 1199 NBF (MVP) AARP Products AARP Medicare Complete HMO 1 and 2 AARP Medicare Complete Essential HMO Aetna Products Aetna Standard Plans: Aetna Affordable Health Choices
Working with Anthem Subject Specific Webinar Series
Working with Anthem Subject Specific Webinar Series E-Tools for Providers Access to Audio Portion of Conference: Dial-In Number: 877-497-8913 Conference Code: 1322819809# Please Mute Your Phone This presentation
Commercial Insurance Plan Contracts
Commercial Insurance Plan Contracts At Mayo Clinic's campus in Arizona, Mayo Clinic providers and Mayo Clinic Hospital are contracted with the organizations listed below. Your benefit coverage for care
2016 Practice Information Disclosure Sheet For Patients and Prospective Patients
2016 Practice Information Disclosure Sheet For Patients and Prospective Patients New York State requires medical practices to disclose to current and prospective patients information regarding health plan
Health Insurance/Managed Care
To meet the healthcare needs in our region, Hospital, and (Cadence Health-employed physician group) is contracted with the following health insurance and managed care plans (unless otherwise noted). This
Useful Websites for Office Managers and Staff
VALLEY HOSPITAL Valley Hospital website exclusively our physicians office staff Valley ms, general Hospital info, other internet resources, legal issues info, Medicare internet links, managed care, medical
Overview -Listing of Provider Agreements-
-Listing of s- CORAL GABLES SPECIALTY PHYSICIANS "UHZ" SPORTS MEDICINE PRACTICE Dr. Uribe Dr. Hechtman Dr. Zvijac Dr. San Completed- -In Process Incomplete / Non- # 63-1071721 63-1071721 63-1071721 63-1071721
THE 2007 DRA UPDATE. By RSVP Consulting An Outsourcing Solution
THE 2007 DRA UPDATE By An Outsourcing Solution President & Founder Current Hot Topics The 8 Musts Know your cost and your billings & collections Charts DRA Contrast Q codes Customers not patients Billing
Accepted Insurance Providers*
AARP Accepted Insurance Providers* AARP Medicare Advantage PPO AARP Personal Health Insurance Plan Aetna Aetna Choice POS (Aetna HealthFund) Aetna Choice POS II (Aetna HealthFund) Aetna Choice POS Aetna
Issuers Owing Rebates for 2012
AK Premera Blue Cross $709,464 Time Insurance Company $227,600 Trustmark Life Insurance Company $645,743 UnitedHealthcare Insurance Company $62,894 AL The MEGA Life and Health Insurance Company $62,541
Virginia Mason Insurance Grid (2014-2015)
Aetna HMO Plans: Aetna Select Aexcel Plus Elect Choice EPO Open Access Managed Choice * *Insurance approved specialty care referral is not required if patient has PCP. POS Plans: QPOS Managed Choice POS
Issuers Owing Rebates for 2012 Data as of August 1, 2013 Rebates in the Individual Market
AK Premera Blue Cross $709,464 Time Insurance Company $227,600 Trustmark Life Insurance Company $645,743 UnitedHealthcare Insurance Company $62,894 AL The MEGA Life and Health Insurance Company $62,541
ACCEPTED INSURANCE PLANS
ACCEPTED INSURANCE PLANS The University of Chicago Medicine currently participates in the health insurance products listed below. Patients are advised to contact their insurance company to confirm the
UC Health Contracted Insurance Plans
CONTRACT NAME INSURANCE CARD TYPICAL NAME PRODUCT TYPE UCMC TDC WCH UCPC PSYC IN 3-Hab 3-hab Ohio Worker's Comp ID Card Worker's Comp YES YES YES YES AARP Medicare Advantage AARP Medicare Complete (underwritten
Commercial Insurance Plan Contracts
Commercial Insurance Plan Contracts At Mayo Clinic campus in Rochester, Minnesota, Mayo Clinic providers and hospitals are contracted with the organizations listed below. Your benefit coverage for care
UC Health Accepted Insurance Plans
INSURANCE CARD TYPICAL NAME PRODUCT TYPE UCMC TDC WCH UCPC 3-hab Ohio ID Card AARP Medicare Advatage Complete (underwritten by United Health Care Medicare Advantage AARP (Supplemental underwritten by United
Radiology Quality Initiative (RQI) Program Answers to Frequently Asked Questions
Radiology Quality Initiative (RQI) Program Answers to Frequently Asked Questions Program Overview... 2 Program Requirements... 4 Claims... 7 Online Tools... 7 Standards for Imaging Guidelines... 8 Page
EVIDENCE-BASED HEALTHCARE SOLUTIONS. CareCore National. Prepared for. Prepared for. October 23, 2009
EVIDENCE-BASED HEALTHCARE SOLUTIONS CareCore National Radiology CARECORE Program NATIONAL RADIOLOGY Frequently BENEFIT Asked MANAGEMENT Questions PROPOSAL Prepared for Prepared for October 23, 2009 March
Compass Dermpath Arizona ACPN - PPO Aetna AHCCCS Ameriplan Discount Card Ameriben APIPA AZFMC Beech Street AP Plan Beech Street Auto Beech Street PPO
Compass Dermpath Arizona ACPN - PPO Aetna AHCCCS Ameriplan Discount Card Ameriben APIPA AZFMC Beech Street AP Plan Beech Street Auto Beech Street PPO Beech Street Worker's Comp Blue Cross Blue Shield of
UC Health Accepted Insurance Plans
3-hab Ohio Worker's Comp ID Card Worker's Comp YES YES YES YES AARP Medicare Complete (underwritten by United Health Care Medicare Advantage AARP (Supplemental underwritten by United Healthcare) Commercial
2015 HEALTH INSURANCE OPTIONS
INSURANCE PLUS Rose Gagliardi 15 West Main Street President Oyster Bay, NY 11771 516-922-1200 / 212-268-4473 516-922-2801 fax rose@insuranceplusny.com www.insuranceplusny.com September 16, 2015 2015 HEALTH
PRE-CERTIFICATION CHEAT SHEET
PRE-CERTIFICATION CHEAT SHEET For any/all questions related to pre-cert call 603-740-2224 & ask for Pre-Cert This is strictly a GUIDE for pre-cert requirements. If an insurance or outpatient test is not
IBM Benefits Plan Administrator Contacts April 1, 2012
IBM Benefits Plan Administrator Contacts April 1, 2012 IBM Self Insured Medical Plan Administrators by State AK WA ME OR CA HI NV ID AZ UT MT WY CO NM ND SD NE KS OK TX MN WI IA IL MO AR MS LA MI IN KY
empireblue.com Empire Dual Advantage (HMO SNP) Dental-Yes Identification Number: Group: Issuer (80840): Rx Group: RX Bin: RxPCN:
Empire Dual Advantage (HMO SNP) H3370-028-000 X19690192400001 Freedom I (PPO) $20/$50 $40/$75 H3342-019-000 X19716256700001 Medicare limiting charges apply. Customer Service: 1-866-395-5175 Provider Service:
Anthem Secure Email Mailbox Setup
Anthem Secure Email Mailbox Setup What is Secure e-review Secure e-review is a way for providers and facilities to relay information electronically to Anthem for pre-authorizations No need to fax or phone.
1-800-783-1008 www.theptgroup.com
Scheduling and Billing NPI#1780614453 1-800-783-1008 www.theptgroup.com PHYSICAL THERAPY MANAGED CARE BENEFITS/PRIOR AUTHORIZATION Outpatient Physical Therapy Centers Apollo, Blairsville, Derry, Greensburg-Pellis
GHI-COMPREHENSIVE BENEFITS PLAN/EMPIRE BLUECROSS BLUESHIELD HOSPITAL PLAN (GHI-CBP)
GHI-COMPREHENSIVE BENEFITS PLAN/EMPIRE BLUECROSS BLUESHIELD HOSPITAL PLAN (GHI-CBP) GHI-CBP option consists of two components: GHI, an EmblemHealth company, offering benefits for medical/physician services,
Covered Services: All plans offered on the Marketplace cover 10 Essential Health Benefits:
Introduction The NY State of Health 2015 Plan Compare provides information about health plans offered on the Individual Marketplace. Here's some general information to get you started. Metal Levels: Plans
Blue Cross Blue Shield of Georgia. Frances Phillips Senior Network Relations Consultant And Ron Lawrence Director of Network Management
Blue Cross Blue Shield of Georgia Frances Phillips Senior Network Relations Consultant And Ron Lawrence Director of Network Management Agenda Availity - Frances Functionality Shut-Down November 8 th ICR
Recons Partly Overturned %
1 TABLE 1 Annual Report of Medicare ideration Results: National Summary of Final Decisions and Value of Contested Claims for Cases During, by Service Appealed Service Partly Total $ $ $ $ $ W/drawn Practitioner
Neurology. Medical Staff: Children s Access Center. Outpatient Referral. Neurology Office Numbers
Neurology The Neurology Practice at Children s Hospital Central California provides diagnostic services, medical treatment, and follow-up care to infants, children, and adolescents who have suspected or
NYU Program for Surgical Weight Loss Fees and Policy Outline
NYU Program for Surgical Weight Loss Fees and Policy Outline Financial Policy Healthcare benefits and coverage options are becoming increasingly complex. We have developed this policy to detail our financial
NCQA's Health Insurance Plan Rankings 2010-11 Medicare Plans October 18, 2010
1 Capital Health Plan HMO 89 Yes FL http://www.capitalhealth.com 2 Kaiser Foundation Health Plan of Colorado HMO 88.9 Yes CO http://www.kp.org 3 Fallon Community Health Plan HMO 88.9 Yes MA http://www.fchp.org
BASIC FACTS & FIGURES: NONPROFIT HEALTH PLANS 1
BASIC FACTS & FIGURES: NONPROFIT HEALTH PLANS 1 Of the 154 health plans in the United States with at least 100,000 enrollees, 97 (or 63%) are nonprofit, 41 are for-profit (27%), and 16 (10%) are government.
Patient or Guardian Signature
Co Payment Policy According to the regulations of individual insurance carriers, patients are responsible for paying co payments at the time of each office visit. PAYMENT POLICY FOR SERVICES RENDERED If
The Big Picture V: New York s Private and Public Insurance Markets, 2012
M A Y 2 0 1 4 The Big Picture V: New York s Private and Public Insurance Markets, 2012 M A Y 2 0 1 4 The Big Picture V: New York s Private and Public Insurance Markets, 2012 Prepared by Peter Newell HEALTH
MEDICARE COVERED ITEMS
MEDICARE COVERED ITEMS CANES COMMODES HOYER LIFT GROUP I SURFACE NEBULIZER DIABETIC SHOES DIABETIC SUPPLIES REHAB POWER CHAIRS ( GROUP 3) TILT IN SPACE WHEELCHAIRS ULTRA LIGHT WHEELCHAIRS BRACES ( ARMS,
INSURANCES ACCEPTED BY SUPERIOR HOME HEALTH
INSURANCES ACCEPTED BY SUPERIOR HOME HEALTH Aetna (PFFS) Austin Las Vegas Aetna PPO, POS, HMO & Worker s Comp Austin Las Vegas AmeriVantage (Medicare) Amerigroup HMO (Medicaid) Anthem (PFFS) Las Vegas
2014 Provider Expo. Karen Geiger Associate General Counsel, Anthem Blue Cross and Blue Shield of Wisconsin
Change 2014 Provider Expo Karen Geiger Associate General Counsel, Anthem Blue Cross and Blue Shield of Wisconsin This presentation contains proprietary information of Anthem Blue Cross and Blue Shield.
Telephone Directory FAX NUMBER. BlueCare Service Representatives (Customer Service) - for Providers
Telephone Directory BlueCare Service Representatives (Customer Service) - for Providers BlueCare HMO 1-800-822-8752 BlueCare Traditional (Blue Cross & Blue Shield) 1-888-827-7117 BlueCare PPO 1-866-262-5635
Frequently Asked Questions
Healthcare Plans Frequently Asked Questions What medical plans pa will be made available aaabeo to professional staff under the District s contract proposal? Personal Choice 1 (PPO) Personal Choice 10/20/70
Administrators & Consultants Advantica (Vision Only) Advantical Eye Care (WellCare Medicare Advantage) Commercial
Eye Care Exam Insurance Plans & Benefits at Baltimore Washington Eye Center Baltimore Washington Eye Center and our ophthalmologists and optometrists accept many eye care exam insurance plans and benefits.
STAKEHOLDER CONSULTATION SUMMARY 2011 Connecticut Insurance Exchange Planning and Development
STAKEHOLDER CONSULTATION SUMMARY 2011 Connecticut Insurance Exchange Planning and Development Consultation with stakeholders is an important component of Exchange planning and development for Connecticut.
Managed Care in New York
Managed Care in New York This profile reflects state managed care program information as of August 2014, and only includes information on active federal operating authorities, and as such, the program
Aetna. Anthenn. Anthem-Federal Employees. Assurant Health. *These are just some of the insurance companies. we work with. CNIC.
MONTROSE COUNTY FAMILY PLANNING INSURANCE COMPANIES Aetna Anthenn Anthem-Federal Employees Assurant Health Champ-VA Cigna *These are just some of the insurance companies we work with. CNIC Cofinity Colorado
The BlueCard Program Provider Manual
The BlueCard Program Provider Manual October 2014 Anthem Blue Cross and Blue Shield in Ohio, Kentucky, Indiana, Missouri and Wisconsin are pleased to provide the following information to you. This packet
Radiology Prior Authorization Program Frequently Asked Questions for the UnitedHealthcare Community Plan
Radiology Prior Authorization Program Frequently Asked Questions for the UnitedHealthcare Community Plan 1. What is the UnitedHealthcare Radiology Prior Authorization Program? Acting on behalf of our Medicaid
Presented by: Tony Haberman
Presented by: Tony Haberman AGENDA What are your options for 2014? NYS SHOP / Individual Health Exchange Health Care Reform Compliance Forms Small Group (1 50) options Access coverage Off of the Exchange
2015 Aetna MD Bronze, Silver and Gold OAMC
Insurance Company Insurance Product Whole Health - SCCIPA Whole Health - Connecticut Preferred Health Network Whole Health - Hartford HealthCare and Value Care Alliance Whole Health - Maine Whole Health
BCBSIL Medical Management 800-572-3089
BCBSIL Medical Management 800-572-3089 IVR Hours of Availability: Monday-Friday 6:00 a.m. 11:30 p.m. (CT), Saturday 6:00 a.m. 3:30 p.m. (CT), Sunday Closed The table below provides the Blue Cross and Blue
Plan Names, ID Card and Provider Directory Reference Guide
Anthem Blue Cross of California Provider Directory: https://www.anthem.com/health-insurance/providerdirectory/searchcriteria?qs=%2aj7vxisnfeux2dsg3u70q4g==&brand=abc Plan name on CoveredCA.com Plan name
Health Insurance for PLTS Students. KAREN MARRINER, MBA Licensed Insurance Agent KM Consulting
Health Insurance for PLTS Students KAREN MARRINER, MBA Licensed Insurance Agent KM Consulting True or False? Individuals can be charged more for their health insurance for having medical conditions. All
New York Consumer Guide to Health Insurance Companies. New York State Andrew M. Cuomo, Governor
New York Consumer Guide to Health Insurance Companies 2013 New York State Andrew M. Cuomo, Governor Table of Contents ABOUT THIS GUIDE... 2 COMPLAINTS... 3 PROMPT PAY COMPLAINTS... 8 INTERNAL APPEALS...
Member ID card update for 2015 ACA-compliant health plans
Member ID card update for 2015 ACA-compliant health plans Members purchasing or continuing an ACA-compliant individual or small group health plan for the 2015 plan year will receive new Blue Cross and
Anthem Centers of Medical Excellence (CME) Transplant Network. CONTRACT OPERATIONS MANUAL for Transplant Program
Anthem Centers of Medical Excellence (CME) Transplant Network CONTRACT OPERATIONS MANUAL for Transplant Program A supplemental document to the Anthem Blue Cross Facility Operations Manual TABLE OF CONTENTS
Healthcare Monitor Services Analyzing the Digital Experience of Health Insurance Members and Prospects
www.corporateinsight.com Corporate Insight User Experience Research & Competitive Intelligence Healthcare Monitor Services Analyzing the Digital Experience of Health Insurance Members and Prospects 2015
Issuers Owing Refunds for 2013
Issuers Owing Refunds for 2013 Based on MLR reports filed through June 30, 2014 State AK Premera Blue Cross $2,626,786 $0 $0 The MEGA Life and Health Insurance Company $39,115 $0 $0 Time Insurance Company
Insurance Terms 101. Patient Access Specialists I
Access Management Insurance Terms 101 University of Mississippi Medical Center Patient Access Specialists I As a Patient Access Specialist Your job is to collect ACCURATE patient information during registration.
Child Advocacy. Medical Staff: Administrative Staff: Children s Access Center. Outpatient Referral. Child Advocacy Office Numbers
Child Advocacy Children s Access Center 24/7 access for referring physicians (866) 353-KIDS (5437) Outpatient Referral Referral forms online at: www.childrenscentralcal.org/services/medicaloffice/refer
New York State Department of Health Division of Managed Care and Program Evaluation Managed Care Plan Directory
Friday, August 07, 2015 Page 1 of 28 Aetna Health Inc. HMO (Health Maintenance Organization) 2/3/1986 For-profit 1160286 100 Park Avenue, 12th Floor New York, NY 10017 (212) 457-0700 Mr. Steven Logan,
NYU Program for Surgical Weight Loss Fees and Policy Outline
WHAT DO I NEED TO SCHEDULE MY SURGERY? While the following documents are not required to meet with your surgeon, they will be required in order to schedule your surgery. Nutritional Assessment* and History
BlueCard Tutorial BlueCard Program Basics
BlueCard Tutorial Welcome to BlueCard After completing the tutorial, you will be able to: Understand basic facts and processes Know the benefits of submitting your BlueCard claims to Blue Shield of California
Caregiver Outreach Series, December 2014 Medicaid Changes in 2015
Evelyn Frank Legal Resources Program EFLRP@nylag.org 212.613.7310 Caregiver Outreach Series, December 2014 Medicaid Changes in 2015 Your loved one may soon get mail about a new type of health insurance
2015 Annual Election Period (AEP) Results. Gorman Health Group Sales Marketing and Strategy Division
2015 Annual Election Period (AEP) Results Gorman Health Group Sales Marketing and Strategy Division Issued: March 2015 TABLE OF CONTENTS 2015 ANNUAL ELECTION PERIOD RESULTS... 3 NATIONAL ENROLLMENT TREND...
Welcome to the BlueChoice Network
Welcome to the BlueChoice BlueChoice Objective The BlueChoice network is composed of hospitals, physicians, health care professionals, and ancillary providers that have contracted with Blue Cross and Blue
2015 Health Plan Comparison in New York State
New York State Department of Health 2015 Health Comparison in New York State A Report Comparing Quality and Satisfaction Performance Results for Health s QARR Report Series Issue 2 of 5 health.ny.gov Table
New York Consumer Guide to Health Insurance Companies. New York State Andrew M. Cuomo, Governor
New York Consumer Guide to Health Insurance Companies 2015 New York State Andrew M. Cuomo, Governor Table of Contents ABOUT THIS GUIDE... 2 COMPLAINTS... 4 PROMPT PAY COMPLAINTS... 9 INTERNAL APPEALS...
Using the Availity Web Portal to build a healthier business
Using the Availity Web Portal to build a healthier business About Availity Agenda Availity and your practice Troubleshooting Enhancements Next Steps About Availity About Availity Availity delivers revenue
Blue Medicare PPO. Physician & Other Professional Provider Orientation
1 Blue Medicare PPO Physician & Other Professional Provider Orientation as of May 2009 A product of HCSC Insurance Services Company, an Independent Licensee of the Blue Cross and Blue Shield Association
KAISER PERMANENTE PLAN (Non-Medicare Eligible)
CEMENT MASONS HEALTH AND WELFARE TRUST FUND FOR NORTHERN CALIFORNIA RETIRED CEMENT MASONS AND THEIR ELIGIBLE DEPENDENTS EFFECTIVE JANUARY 1, 2015 GENERAL When You Can Change Plans Type of Plan, Service
Release Notes December 08, 2011
Release Notes December 08, 2011 UnitedHealthcareOnline.com Website Design Changes The look of UnitedHealthcareOnline.com has been updated to reflect UnitedHealthcare s new single brand. In many places
The Big Data Dividend
The Big Data Dividend Enhancing Revenue in an Era of Change May 7, 2015 Agenda Big Data Sample Healthcare Big Data Sets Healthcare Applications of Big Data Revenue Enhancement Opportunities Rate Benchmarking/Rate
New York Consumer Guide to Health Insurance Companies. New York State Andrew M. Cuomo, Governor
New York Consumer Guide to Health Insurance Companies 2014 New York State Andrew M. Cuomo, Governor Table of Contents ABOUT THIS GUIDE...2 COMPLAINTS...3 PROMPT PAY COMPLAINTS... 8 INTERNAL APPEALS...
RADIATION THERAPY MANAGEMENT PROGRAM CARECORE NATIONAL FREQUENTLY ASKED QUESTIONS FOR MVP PROVIDERS
RADIATION THERAPY MANAGEMENT PROGRAM CARECORE NATIONAL FREQUENTLY ASKED QUESTIONS FOR MVP PROVIDERS Evidence-Based Healthcare Solutions CARECORE NATIONAL. 400 BUCKWALTER PLACE BOULEVARD, BLUFFTON, SC 29910
Medicare Advantage Outreach and Education Bulletin
Medicare Advantage Outreach and Education Bulletin 2012 California Medicare Advantage Update Dear Healthcare Provider, Annual benefits changes for Medicare Advantage plan members will be effective January
Key Strategies for Successful Out of Network Billing. What does it mean to be Out of Network? How do you find the Employers that offer PPO Benefits
Key Strategies for Successful Out of etwork Billing ASC BLLG SPECALST, LLC Suzanne Webb - COO What does it mean to be Out of etwork? n simple terms it means you as the provider do not have a contract with
Medicare Advantage Outreach and Education Bulletin
Medicare Advantage Outreach and Education Bulletin Blue Cross and Blue Shield of Georgia 2016 Georgia Medicare Advantage Plan Changes Dear Healthcare Provider, Annual benefits changes for Medicare Advantage
2013 Health Plan Comparison in New York State
QARR Report Series, Issue No. 2 of 5 2013 Health Comparison in New York State 2013 A r e p o r t c o m p a r i n g Q u a l i t y a n d S a t i s f a c t i o n P e r f o r m a n c e r e s u l t s f o r
Avoiding Overuse: NCQA s private health insurance rankings
A good health care plan should provide high overall quality and help members avoid unnecessary medical care. That can help cut health care costs and reduce the risks that come with all medical tests and
Blue Choice PPO SM Physician and Professional Provider Roles and Responsibilities
SM Roles and Responsibilities In this Section, cont d The following topics are covered in this section: Topic Page Blue Choice PPO ID Card B 4 Using the ID Card B 4 Other Information B 5 Department of
INSURANCE AUTHORIZATION REQUIREMENTS
PHOENIX BARIATRIC CENTER, PLC 3805 E Bell Rd, Suite 5300 Phoenix, AZ 85032 Ph 602 422 9690 Fax 602 422 9680 Kurt W. Sprunger, MD, FACS INSURANCE AUTHORIZATION REQUIREMENTS ALL PATIENTS Age 18 or older
MAKING THE MOST OF YOUR 2014 HIP AND GHI HEALTH BENEFITS
MAKING THE MOST OF YOUR 2014 HIP AND GHI HEALTH BENEFITS City of New York Employees, Non-Medicare Eligible Retirees and Medicare Eligible Retirees At EmblemHealth we understand and respect that people
Ready Reference Guide UPDATE 01-01-16 Anthem Blue Cross and Blue Shield in Ohio
Ready Reference Guide UPDATE 01-01-16 in Ohio Products (Contact f the address f returning checks) Local Products Blue Access Blue Preferred Blue Traditional Blue Access Options PPO f ERC Health 7/1/15
University of Maryland, College Park Graduate Assistant Benefits Orientation
University of Maryland, College Park Graduate Assistant Benefits Orientation Topics to Be Covered Eligibility Enrollment Procedures State Sponsored Benefits Please Feel Free to Ask Questions at Anytime
Health Homes CMART. Users Manual
New York State Department of Health Health Homes CMART Care Management Annual Reporting Tool Users Manual Installation For those entities using the Health Homes Care Management Annual Reporting Tool (HH
MEMORANDUM. Connecticut Health Insurance Exchange Advisory Committees
MEMORANDUM To: From: Re: Connecticut Health Insurance Exchange Advisory Committees Connecticut Health Insurance Exchange Staff Essential Health Benefits and Benchmark Plan Options Date: June 4, 2012 In
HEFFERNAN BENEFIT ADVISORY SERVICES 2014 HEALTH CARE TREND REPORT
HEFFERNAN BENEFIT ADVISORY SERVICES 2014 HEALTH CARE TREND REPORT HEFFERNAN BENEFIT ADVISORY SERVICES TABLE OF CONTENTS What is Trend 1 Medical Trend Projections 2 Historic National Medical Trend 2 Dental
Florida Health Insurance Advisory Board
Florida Health Insurance Advisory Board Affordable Care Act Outcomes in Florida August 26, 2014 Florida ACA Overview Individual Market 2014 vs. 2015 2014 2015 Federal Information: Rate Filing Approval
CU Health Plan. Provider Education Meetings June 2013
CU Health Plan Provider Education Meetings June 2013 Introductions Anthem Representatives Kelly Henry, Network Director Jackie Ferguson, Provider Communication and Education Exclusive Network Representatives
Servicing Out-of- Area Blue Members
Servicing Out-of- Area Blue Members BlueCross BlueShield of Tennessee BlueCard 201 Servicing Out-of-Area Members: Overview Contiguous Area Claim Filing Overlapping Service Area Claim Filing Ancillary Providers
Can Patient Sign a EXAM. Aetna Must check each plan for details No CT's and MRI's 1 week Medsolutions 888.693.3211 cpt specific
INSURANCE COMPANY Can Patient Sign a WAIVER? EXAM Schedule Out AARP/MEDICARE Complete No CT's and MRI's 2 weeks UHC West cpt specific Aetna Must check each plan for details No CT's and MRI's 1 week Medsolutions
PAYER TYPE LIST PAYER TYPE CODE PAYER TYPE DEFINITION
PAYER TYPE LIST PAYER TYPE CODE PAYER TYPE DEINITION PAYER TYPE ABBREVIATION 1 Self Pay SP 2 Worker's Compensation WC 3 Medicare MCR Medicare Managed Care 4 Medicaid 4 B Medicaid Managed Care 5 Other Government
INSURANCE GUIDE FOR ENDOSCOPY PROCEDURES
INSURANCE GUIDE FOR ENDOSCOPY PROCEDURES Insurance companies vary with regard to coverage for endoscopy procedures. We strongly encourage you to check your coverage by calling your insurance company directly
AUTHORIZATION STATUS USER GUIDE
AUTHORIZATION STATUS USER GUIDE BlueCross BlueShield of South Carolina and BlueChoice HealthPlan are independent licensees of the Blue Cross and Blue Shield Association AUTHORIZATION STATUS USER GUIDE
ANTHEM BLUE CROSS BLUE SHIELD OF TEXAS PDF
ANTHEM BLUE CROSS BLUE SHIELD OF TEXAS PDF ==> Download: ANTHEM BLUE CROSS BLUE SHIELD OF TEXAS PDF ANTHEM BLUE CROSS BLUE SHIELD OF TEXAS PDF - Are you searching for Anthem Blue Cross Blue Shield Of Texas
Accepted Health Plan List
Anthem Blue Cross Advantage PPO Blue Cross PPO (Prudent Buyer)-Large Group Blue Cross PPO (Prudent Buyer)-Small Group Bronze 60 D EPO (Pathway-Tiered EPO/ Bronze 60 D Health Savings Account EPO (Pathway
HealthCare. HealthCare. HealthCare News. Title font is: Wiesbaden Swing LT Std. Table of Contents. Coding and Billing
#352 March 2013 THORConnect.org Table of Contents Coding and Billing Psychiatric and Substance Abuse Services Institutional... 1 Psychiatric Services... 1 Inpatient... 2 Residential Treatment Centers (RTC)...
CHAPTER 7: UTILIZATION MANAGEMENT
OVERVIEW The Plan s Utilization Management (UM) program is collaboration with providers to promote and document the appropriate use of health care resources. The program reflects the most current utilization