Blue Shield exchange/off-exchange plans leading to confusion among physicians The California Medical Association (CMA) has seen a large increase in calls from physicians confused about the plans/products offered by Blue Shield both on and off the exchange. As you may know, federal law requires that every plan offered in the exchange also be offered off the exchange, using the same network. This has resulted in a number of practices unknowingly seeing patients out-of-network for products that use the insurer's narrower exchange network. It has also created an additional level of confusion for physician practices when checking patients' coverage ... February 12, 2014 Managed Care Covered California, Health Benefit Exchange, Health Insurance Exchange, Insurance/Reimbursement, Managed Care, Blue Shield 0 0 Comment Read More »
CMA develops simple tool to identify physician participation status in exchange plans On January 1, 2014, Covered California began providing health coverage to more 500,000 patients statewide. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff have a clear understanding of their exchange plan participation status so they can communicate this information to patients before scheduling. It’s equally as important that practices understand the reimbursement rates and other terms associated with the plans with which they are contracted. Even if you did not intentionally contract with any exchange ... January 27, 2014 General Covered California, Health Benefit Exchange, Insurance/Reimbursement, Health Care Reform 0 0 Comment Read More »
Surviving the first month of Covered California On January 1, 2014, California's health benefit exchange, Covered California, began providing health coverage to more 400,000 patients statewide. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff know what to expect. To that end, the California Medical Association (CMA) offers these tips to survive the first month of Covered California. This document is available to members only. Please join CMA or Login to access the document. January 9, 2014 Managed Care Health Insurance Exchange, Covered California, Health Benefit Exchange, Health Care Reform 0 0 Comment Read More »
NEPO launches regional Covered California health care provider outreach and education meetings The CMA Foundation's Network of Ethnic Physician Organizations (NEPO) is hosting its first Covered California provider outreach and education meeting December 7, 2013, at 9:30 a.m. at the Kaplan Medical offices in Pasadena. Physicians and other health care providers and their staff are invited to attend this 2.5 hour educational session. Participants will learn more about Covered California and how they can help patients get health insurance coverage. Registration is free, but space is limited, so secure your spot today. For more information or to register, visit http://www.eventbrite.com/event/9019901769. This is first ... November 6, 2013 General Covered California, Health Benefit Exchange, Network of Ethnic Physician Organizations, Health Care Reform, Health Insurance Exchange, NEPO 0 0 Comment Read More »
Provider search function operational on Covered California website In what has been one of the most fluid deadlines put forth by the state’s health benefit exchange, Covered California launched the online provider search function on Monday, October 7. The search will allow patients to determine if a particular physician is contracted with any of the participating health plans. Though aimed at patients, physicians can also use the search to determine which plans list them on their exchange provider directories. The California Medical Association (CMA) recommends physicians review their status with plans offered in their area to determine whether ... October 8, 2013 General Covered California, Health Benefit Exchange, Health Insurance Exchange, Health Care Reform 0 0 Comment Read More »
CMA optimistic as Covered California opens Sacramento – As Covered California, the state’s Health Benefit Exchange, opened today, California Medical Association (CMA) physicians remain optimistic. Throughout the health care reform debate, CMA strongly advocated for affordable access to care for California’s uninsured and for an expansion of health insurance coverage. “CMA has long supported access to health care for all patients,” said Paul R. Phinney, M.D., CMA president. “Today marks a positive inflection point in our nation's commitment to access to health care for all Americans Five categories of plans will be available through Covered California, consisting ... October 1, 2013 General Covered California, Health Benefit Exchange, Health Care Reform 0 0 Comment Read More »
Health Benefit Exchange Toolkit Now Available In 2010, Congress passed historic sweeping health care legislation, the Patient Protection and Affordable Care Act (ACA), which reformed the for-profit health insurance industry and beginning in 2014 will provide health insurance to most of the nation’s uninsured. Under the ACA, two thirds of California’s uninsured will be covered by private insurance through a health insurance exchange purchasing pool. The exchange’s goal is to start pre-enrollment in October 2013. CMA has developed a new toolkit titled, CMA’s Got You Covered: A physician’s guide to Covered California, the state’s health benefit ... March 6, 2013 CMA Affordable Care Act (ACA), Covered CA, health benefit exchange 0 0 Comment Read More »
