Blue Shield makes positive changes to reimbursement policy for physicians treating out-of-network exchange PPO patients Effective with September 14, 2014 dates of services, Blue Shield will implement changes to the out-of-network claims payment process and will now reimburse providers directly when PPO exchange/mirror product patients are seen out of network. October 20, 2014 General Blue Shield, Blue Shield of California, Claims, Covered California, EPO, Exchange, IFP, Mirror products, out of network claims, PPO, Reimbursement 0 0 Comment Read More »
Physician Advocate Tip of the Month: Be aware of the off-exchange products that utilize Covered CA plan networks Every plan offered in Covered CA must also be offered outside of Covered CA, using the same network. If you see these product names on the ID card, it indicates the patient only has access to the Covered CA network. April 14, 2014 Physician Advocate Tip of the Month Covered California, Exchange, Physician Advocate, Physician Advocate Tip of the Month, Practice Management, Tip of the Month 0 0 Comment Read More »
Physician Advocate Tip of the Month - Surviving the first month of Covered California On January 1, 2014, California's health benefit exchange, Covered California, began providing health coverage to more than 400,000 patients statewide. It is critical that physicians and their staff know what to expect. January 14, 2014 Physician Advocate Tip of the Month CES, Center for Economic Services, Covered CA, Exchange, Exchange Resources, Mitzi Young, Physician Advocate, Practice Resources 0 0 Comment Read More »
ALERT: You May have Automatically been Contracted into an Exchange Plan Open enrollment began October 1st for Covered California (California's Health Benefits Exchange). The OCMA has received many calls from members confused as to whether they are contracted to see these patients. October 15, 2013 Alert Benefits Exchange, California Health Benefits Exchange, Contracting, Covered California, Exchange, Mitzi Young, Open Enrollment, Physician Advocate 0 0 Comment Read More »