Managed care companies rely upon corporate medical and procedural policies as tools for defining which services are medically necessary, for handling claims and payments, for controlling utilization, and for other purposes – and physicians and practices are bound to follow them. The payors also frequently exercise their right to change these policies as they see fit and expect you to keep up. NCMS is launching a new tool to help your practice monitor changes to managed care policies that can affect your practice. We’re calling it the Payor Policy Project.
The concept is simple. NCMS will be closely monitoring four managed care companies for policy changes – BCBSNC, United HealthCare, Aetna, and CIGNA. As policy changes are announced, we will compile them in a running list and provide links into each payor’s website in case you‘d like to review more of the details. You can access the list in the Members Section of our website. Check back often!
If you know about a new or revised policy that isn’t listed, or if you have comments or suggestions for improving this new tool, we want to hear from you!
Please contact Lyric Wohlgemuth or Conor Brockett and let us know.
(Excel file - updated as of 7/27/2010)
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