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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, it 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 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.
Questions? Call PREFERRED's Provider Relations Department at
800.664.5240.
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