Kaiser Single Case Agreement

MANAGED HEALTH NETWORK (MHN) includes Health Net / CenteneBLUE SHIELD OF CALIFORNIACALIFORNIA HEALTH AND WELLNESS-MEDI-CAL (also called CENPATICO) ANTHEM BLUE CROSS-MEDI-CALWESTERN HEALTH ADVANTAGEMAGELLAN (serves most imperial patients, at which time Kaiser does not allow children to be seen by private therapists like me). EAP PROGRAM MEMBERS AND SUTTER EAP (non-SUTTER Select) ANTHEM BLUE CROSS EAP FAMILY MEMBERS (including Unicare, Wellpoint) MISCELLANEOUS: If you don`t see your health plan above, I recommend calling the Behavioral Health number on the back of your insurance card. Ask them if I am a network provider. If they don`t report me as a supplier, you can ask them to enter into a single contract with me (called a “Single Case Agreement”) or you can inquire about their “Out of Network” (OON). In the case of OON, the member usually pays first for the therapy and then is reimbursed by the insurance company for some or, in some cases, for all of the costs. If the patient has recently changed insurance providers, the insurance company may arrange a limited number of meetings (approximately 10) and a period (.B e.g. 60 days since the change of insurance) to allow the patient to continue treatment with the current provider outside the network, while switching to a network provider. If there is evidence that the person might pose a danger to themselves or others, or if it affected the patient psychologically/mentally (e.g.B returns during treatment) if this is necessary to switch to a network provider, a case could be made for increased continuation of care with the current provider. Examples: a patient has an uncertain bond and it is very difficult to trust others.

The already existing therapeutic relationship with the current provider can be considered as a factor in the allocation of sca. What needs to be considered when approving agreements on a case-by-case basis Approving an agreement on a case-by-case basis can be a tedious and tedious task. Our task is to help you in this task. However, if the FCC has been approved, our task is not complete. Here we need your help to take into account the following aspects: Sometimes an insurance company may have a “payment at the highest network rate” policy, in which case you cannot negotiate the rate. You always have the option to refuse the SCA if the rate and conditions are not acceptable to you. One thing to keep in mind is that insurance companies are legally required to properly treat patients by properly trained professionals. Therefore, if the insurance plan does not cover out-of-network services and there are no networked providers with the indicated specialization, you can, as a trained provider, negotiate your usual full meeting fees for new patients. This is because the patient does not simply choose to see you, but is forced to do so with network providers insufficiently. . .

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