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 |
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