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What's New for March 2004
CIGNA Behavioral Health:
As we discussed at the Management Meeting yesterday, we are pleased to announce the new direct contract with Cigna Behavioral Health, for our Psych Physicians, effective February 12, 2004 (their credentialing date). Dr. Davis is still pending credentialing but should be credentialed today.
This contract is for all outpatient CVMC Psych services for all the Cigna Behavioral Health products--including PPO, POS and HMO.
REMINDERS:
1--CVMC is contracted with Cigna Behavioral health for all Behavioral Health products (PPO, POS and HMO) (effective December 2003).
2--This contract is NOT for the medical/surgical Cigna business. To-date, CVMC only participates in the Cigna PPO med/surg product. We are in negotiations now for inclusion in all their product portfolio---including the POS and HMO--and will let you know when our status changes.
It is easy to confuse the Cigna med/surg with the Cigna behavioral health since the hospital does not participate in all products for both companies. Please be very careful in your communication of our participation as not to confuse members/pts. about CVMC's Cigna participation. Please refer to the current Payor listing (attached and also available on the intranet) as a reference.
3--Currently the CVMC outpatient Rehab is NOT contracted with Cigna for any product line. We are still working on this issue and hope to have resolved soon.
BCBS CVMC Hospital Based Physicians:
Just a reminder of our notice from last month:
CVMG, PT/Rehab, Emergency Dept., and Psych department MDs are participating in the BCBS PPO, POS and HMO products effective
2-1-04. Up until this time, these practices have only participated in the BCBS PPO product due to exclusivity issues.
As you will recall CVMC executed a contract with BCBS 10-1-03 for participation in their POS and HMO products and since then, we have been working with BCBSto finalize the hospital based MD agreements.
A few EXCEPTIONS:
1--Fairgrove Clinic has not completed the BCBS credentialing process. They were not originally contracted with BCBS and therefore until the credentialing process is complete, this group is not participating in ANY of the products.
2-The Psych MDs are participating in the BCBS PPO product only through this direct agreement. BCBS subcontracts Behavioral Health Services to Magellan for their POS and HMO products. CVMC and the Psych department participate with Magellan and will therefore continue to see the BCBS POS and HMO members through the Magellan agreement.
DOC (Department of Corrections)
As we discussed yesterday, we are on schedule to begin accepting DOC patients within the next 30-60 days. Greg Billings and Amy Barnes are spearheading this unit and will be sending additional information to the team as we get closer to the implementation date. Rachel Cozort will be our UR DOC liaison and may be contacting your departments in the near future regarding in-service/policy education.
