HNE_contract_nov2010

3/20/2013

implementation of electronic systems for claims processing, eligibility verification or referral. Prospective …

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BMC_HealthNet_analysis_2012

3/20/2013

Insurance Connector Authority (“Connector”) to operate as a managed care plan for persons eligible … the provider can satisfy the required coverages. 10. Section II.N requires prior eligibility verification …

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UnitedHealthcare_analysis_2012

3/20/2013

the claims against it. Eligible physicians were required to file claims against the settlement by October 5 … certain services as provided for in United’s Administrative Guide, in order to be eligible … but not limited to determining an enrollee’s eligibility, verifying benefits, and submitting a claim …

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NetworkHealthAnalysis2007

3/20/2013

that physicians must meet in order to be eligible to be designated as a Provider under this contract. Section (d …, and will remain, eligible. Further, physicians who have already been credentialed by the Plan and are signing … requires verification of eligibility prior to the provision of service. Physicians may wish to review …

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Aetna_analysis_2012

3/20/2013

prohibits the provider from billing Dual Eligible Medicare/Medicaid members for Cost-Sharing Amounts (i.e …

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CIGNA_analysis_2012

3/20/2013

. Laboratory Test Procedures. Providers who own a laboratory test procedure will be eligible …

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Electronic Prescribing

3/8/2013

eligible providers incentive payments for using an electronic prescribing (ePrescribing) system … is the last year to incur an eRx payment adjustment 2014 eRx Payment Adjustment Individual eligible …, individual eligible professionals would have had to have been a successful electronic prescriber in 2012 …

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Prescription Monitoring Program: Proposed Regulations (pdf)

2/15/2013

monitoring program on behalf of the primary account holder. An individual eligible to be a primary account …

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Longworth Presentation (pdf)

1/29/2013

• Certain populations are at very high risk such as the dual eligiblessuch as the dual eligibles …

/Continuing-Education-and-Events/Conference-Proceeding-Archive/Longworth-Presentation-(pdf)/

lindseypres2012 (PDF)

11/30/2012

  (Medical Claims,Pharmacy,Member Eligibility) Clarity Console(ETL) PATIENT EXPERIENCE CMS Pioneer …

/Continuing-Education-and-Events/Conference-Proceeding-Archive/lindseypres2012-(PDF)/