TAILIEUCHUNG - Sách: EMBLEMHEALTH PROVIDER MANUAL

This manual applies to all EmblemHealth, GHI, HIP, and Vytra plans and it replaces all provider manuals published before November 2009. It includes detailed information about your administrative responsibilities, contractual and regulatory obligations and best practices for interacting with our plans and for helping our members navigate our delivery systems. You will also find information on our wellness programs that foster disease prevention and healthier living. These services support our mission of providing a choice of products and services so that our members have access to the medical care they need when they need it at prices they can. | EmblemHealth EMBLEMHEALTH PROVIDER MANUAL TABLE OF CONTENTS Click on the titles below to jump to the chapters. EmblemHealth Provider Manual YOUR PLAN ACCESS TO CARE AND DELIVERY MEDICAL RECORD CARE CLINICAL PRACTICE QUALITY HEALTH PROMOTION AND DISEASE INTEGRATIVE PHARMACY DURABLE MEDICAL RADIOLOGY CARDIOLOGY RADIOLOGY CARDIOLOGY IMAGING RADIATION THERAPY BEHAVIORAL HEALTH CHIROPRACTIC PHYSICAL AND OCCUPATIONAL THERAPY DISPUTE RESOLUTION- COMMERCIAL CHILD HEALTH DISPUTE RESOLUTION- MEDICAID FAMILY HEALTH DISPUTE RESOLUTION- REGULATORY MANDATORY FRAUD AND MEDICAL TRANSPORTATION REQUIRED PROVISIONS TO NETWORK PROVIDER Group Health Incorporated GHI GHI HMO Select Inc. GHI HMO HIP Health Plan of New York HIP HIP Insurance Company of New York Vytra Health Plans Management Systems VHMS and EmblemHealth Services Company LLC are EmblemHealth companies. EmblemHealth Services Company LLC provides administrative services to the EmblemHealth companies. ii OVERVIEW This manual applies to all EmblemHealth GHI HIP and Vytra plans and it replaces all provider manuals published before November 2009. It includes detailed information about your administrative responsibilities contractual and regulatory obligations and best practices for interacting with our plans and for helping our members navigate our delivery systems. You will also find information on our wellness programs that foster disease prevention and healthier living. These services support our mission of providing a choice of products and services so that our members have access to the medical care they need when they need it at prices .

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