Who Pays For What? Today: the 96110

I have had a number of off-line and on-line requests for details about who, exactly, is paying for the deveopmental testing (96110 and 96111) and non-face-to-face codes (or the “telephone codes”), so Igor was kind enough to look it up for me.

As an aside, PCC allows our customers a great deal of flexibility when it comes to configuring their systems.  Thus, our clients use all kinds of names/spellings/etc. for recording work done with individual payers.  This is in contrast to the way that, say, Athenahealth does it, which is to hand you a list of payers and say, “Choose one.”  Though our method is friendlier, theirs is better for the amalgamation of data, so please forgive me if I somehow mis-categorize one or more of these plans.  I have no fewer than 66 versions of “Aetna,” for example, so it’s easy to miss one.  I also have only a partial listing of the Medicaids and BCBSs, as I didn’t track down all the states yet.  If your state info is missing, ask me.

Enough whining from me.  Below, please find a list of payers whose patients have recorded payments on the 96110 in 2009 for our clients.  Note: this does not mean that the payer covers the charge, but that it also may allow the patient to be billed for it.  I thought that this was an important addition.

I’ll look into updating this again in a few months.  Tomorrow, a shorter list of the telephone codes.

 

1st MN/MR/GA 1st
Aetna
Affinity MA
Affordable
AHCCCS
Alliance
AL Medicaid
Alta Bates
Americaid
AmeriChoice
AmeriGroup
AmeriHealth
Anthem
ASR
Atlantic Health System
BCBS Alabama
BCBS CO
BCBS Federal Employees
BCBS Georgia
BCBS MA
BCBS NJ
BCBS NY
BCBS RI
BCBS TX
BCBS UT
Beech Street
Berkshire Health Plan
Best Choice Plus
Best Health
Blue Card
BlueCare
Bluechip
Blue Choice
Blue Shield CO
Blue Shield NH
Blue Shield PA
Boston Medical Center HealthNet Plan
Buckeye Community Health
Capital Blue Cross
Carefirst 345
Caresource
CBA
CCHMO St. Francis
CCHMO St. John (ValuMed)
CCN
Champus
Children’s Mercy
CHIPS
ChoiceCare
ChoiceCare
CHPW Healthy Options
Cigna
CMSP
Cofinity
Community Blue
Community Care
Community Care Network
Community Health Network
Comy
Connecticare
Consultec
Coventry
CT Care
Definity Health
Devon Health Services
Diamond State Partner
Direct Access
EBMS
Educators Mutual
EHP
Empire
Employee Health Plans
Evergreen
Fallon
Famis
Federal Select
First Carolina Care
First Health Network
First Priority Life
Geisinger Health Plans
GHI
GIC
Great West
Greatwest PPO
Guardian
Harvard Pilgrim
Harvard Pilgrim
HCVM
Health America
Health Assurance
Health First Child Hlth+
Health First MA
Healthmate
HealthNet
Health Net
Health New England
Health Plan of Michigan
Healthsmart
Highmark Blue Shield
Hip
Hip MA
Horizon
Humana
Interplan
Kaiser Permanente
Keystone
Magnacare
Mailhandlers
Mail Handlers
Mass Health
Medallion
Medcost
Medicaid MA
Medicaid MT
Medicaid OR
Medicaid WY
Medical Mutual
Medical Network
MediChoice
Mercy
Metlife Network
Metrahealth
Molina
Multiplan
Multiplan
NCAS Capital Blue Cross
NC Healthchoice
Neighborhood Health Plan
Nethealth
Network Health
New Mexico POS
North American Preferred
NovaNet
OH DPA
OHIO HEALTH CHOICE
OK Soonercare
One Health Plan
Optima
OSMA/PLICO
Oxford
PABS BLUECARD
Pacificare
Peachstate
PHC
PHCS
PHS
Physician’s Care
Physicians Health Services
PPOM
Preferred Community Choice
Premera (Non-Regence Blues)
Primary Care Plus
Principal Life
Priority
Priority Health
Private Healthcare Systems
QualCare
Rocky Mountain Health Plan
Select Health
SouthCare
Summa
Teamsters
TennCare
TPA
TriCare
Tufts
TX True Choice
Unicare
Unison
UnitedHealthCare
UOVDPW
UOVHP
UPMC
UPMC Tristate
US Healthcare
Valley Preferred
Vermont Managed Care
WellCare
Well Choice
WV DPW
0 replies

Leave a Reply

Want to join the discussion?
Feel free to contribute!

Leave a Reply