THAT DARN PAPERWORK… WAIT, WHAT DID I JUST SIGN?

It's that time of year again - your "in-box" becomes cluttered with requests from various health plans and PPOs, asking you for updated information on your credentials. While everyone wants to remain in the good graces of health plans,is absolutely CRITICAL that you read any paperwork carefully before you respond. The reason? By signing seemingly innocuous credentialing paperwork, you may also be inadvertently agreeing to a different reimbursement!

The good news: More often than not, these requests for recredentialing or other paperwork are not malicious attempts to trick you into deeper discounts. PPOs will send out a "blanket solicitation", outlining general terms and reimbursement which is standard for the common masses, but in many cases the terms may be less desirable than what PREFERRED has been able to secure on your behalf. This is why it is important for you to know your contracts and avoid the pitfalls which sometimes accompany filling out these types of direct requests.

Protect yourself:If you receive recredentialing or other paperwork directly from a health plan or PPO:

• Check to see if you are already contracted, either directly or through PREFERRED. Your payor grid from PREFERRED outlines your participation status with each of our network contracts.
• If you are not sure about your status or whether you need to respond to the solicitation, call us.
• Even if it is not a PREFERRED agreement, we are more than happy to help you review the paperwork if you feel you need a "second set of eyes."

Recent mass mailings: Integrated Health Plan, Three Rivers Provider Network and Multiplan are among those who have recently sent out blanket requests for updated paperwork. If you are participating through PREFERRED, you may disregard their requests.