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Post Tagged with: "Provider Contracts"
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UHC Extends Premium Designation Program Deadlines; Physicians Should Check Designations
UnitedHealthcare (UHC) has informed the NCMS that its Premium Designation Program Public Designation Display will become available on June 1, 2011 and not March 30, as previously reported.
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State Health Plan to Seek Reimbursements from Ineligible Members, Not Physicians
Due to successful advocacy efforts by the NCMS, the State Health Plan will not pursue reimbursement from physicians who treated SHP patients that were later determined ineligible.
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UHC Notifying MDs about Physician Profiling/Tiering Program; Doctors Have Limited Time to Seek Reconsideration of Misinformation
UnitedHealthcare (UHC) is mailing letters this week to in-network physicians about the managed care company’s physician profiling system, known as the Premium Designation Program. The letter will include a quality […]
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Palmetto GBA Releases First Details about Medicare Part B Transition
Palmetto has designated May 28, 2011 as its Operational Date, the date on which outgoing contractor, CIGNA Government Services, will transfer all pending and in-process Part B operations to Palmetto, including claims, appeals, and enrollment applications.
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BCBSNC Launches Tiered Providers Network for Food Lion
Blue Cross Blue Shield of North Carolina (BCBSNC) has created and launched a tiered provider network for self-insured employer group Delhaize America, the parent company of Food Lion.
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Managed Care Settlement Successes Result in Billions for Physicians
The Physician Advocacy Institute (PAI) this week released updated documents showing the successes that have been achieved in helping physicians in settlement agreements with managed care companies.
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Humana Announces Physician Rewards Program
Humana has announced the Physician Quality STAR Rewards Program, providing an opportunity for physician practices to receive additional reimbursement above their contracted fee schedule. The rewards program was developed by […]
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BCBSNC Names New VP of Network Management
Blue Cross and Blue Shield of North Carolina this week announced the appointment of Lisa Cade as vice president of Network Management, effective October 18, 2010. For the past four […]
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Focus on Health Care Reform: NAIC “Blanks Form” for Reporting Medical Loss Ratio
The Affordable Care Act (ACA) requires insurers to report annually to the Department of Health and Human Services (DHHS) the percentage of health care premium dollars spent to reimburse providers for health care services and on quality improvement measures, known as the Medical Loss Ratio.
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PAI Proposes Partnership in Development of Multi-Payor Claims Database
The Physicians Advocacy Institute, Inc.(PAI) has asked Donald Berwick, MD, Administrator for the Centers for Medicare and Medicaid Services (CMS), for a meeting to discuss the recent CMS contract award to Ingenix Public Sector Solutions, Inc., to build and operate a multi-payor claims database (MCPD).
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