As you probably are already aware, Preferred Health Systems (PHS) was acquired by Coventry Health Care, Inc. (CHC) on February 1, 2010. Due to this acquisition, PHS’ subsidiary companies, Preferred Plus of Kansas, Preferred Health Systems Insurance Company, Preferred Benefits Administrator, Kansas Health Plan, and Preferred Health Care Inc., all became Coventry Companies.
The contract integration of PHS is targeted to be complete by April 1, 2011. Until that time, all PHS contracts, including the fee schedules, will continue. During the months of December and January, CHC Network Contracting staff will be making contact by mail, phone, or a personal visit to complete the contract integration.
There is a possibility our office will receive the correspondence. If we do receive any notice on your behalf, we will work with you to get the PHS contract integration complete. However, if a CHC representative comes to your office, there are a few items you need to be aware of.
- Please do not sign any document(s) while the CHC rep. is in your office. They may tell you it is just like your Coventry agreement, if you have one, or that it is simply switching the PHS agreement to be under your, already in place, Coventry agreement; however, there may be areas of concern you need to address, primarily with the rates’ section. You may be taking a fairly large cut from the current PHS rate(s) to the new CHC rate(s).
- If you do sign any document(s) with CHC while on location without first carefully reading through the language and analyzing the fee schedules/rates, your BlueCross BlueShield (BCBS) agreement could be in jeopardy. Your BCBS of Kansas agreement states you agree not to enter into an agreement where your payment is less than BCBS; and if you do, those lesser amounts will become the maximum allowable under your BCBS agreement. We have those rates for you and will be glad to help you with any necessary analysis.
Our recommendation: If Coventry makes a visit to you personally, please meet with their representative and get any questions you may have answered. If they present a contract or any documents for signature, please explain you will need to review in detail and will need to get back with them at a later date. There is still plenty of time, and a signature on the spot is not required.
Please feel free to contact Stephanie Kurtz, (316) 281-3700, in our office if you have any questions, would like assistance in reviewing any Coventry document(s) presented for signature, or have any questions regarding your obligations under your BCBS agreement.
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Editor: Philip Blann (pblann@anesthesiabilling.com).
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