Dec 17, 2012 | Medical billing basics
Physician Use of Health Care Extenders (ARNP’s and PA’s): Physicians must, in accordance with federal and state regulations and accepted professionalstandards, use physician extenders appropriately. Advanced Registered Nurse Practitioners(ARNPs) and Physician...
Dec 10, 2012 | Medical billing basics
PCP’s Request to Disenroll a Member from their Panel A Plan physician or provider may not seek or request to terminate a member on his/her panel or transfer a member to another health care provider based on the member’s medical condition, the amount or type of care...
Jun 12, 2011 | Medical billing basics
Primary Care Physician (PCP) Responsibilities The following is a summary of responsibilities that are required of PCP’s providing services to Simply Healthcare Plans members: * Ensure 24/7/365 availability as outlined in the Access to Care section noted above *...
Nov 17, 2010 | Medical billing basics
Member Transfers PCPs may request to have a member transferred from their panel due to the inability to establish a good physician/patient relationship, including consistent non-compliance with physician instructions/recommendations or verbally or physically abusive...
Nov 17, 2010 | Medical billing basics
The PCP is responsible for providing or coordinating medical services, which includes: Inpatient admissions Case management for non-surgical admissions Nursing home visits Physician hospital care Office visits Education on preventive health Injections and...
