Docstoc

Virginia-Premier-HMO-Medicaid-Forum-Presentation-April-17

Document Sample
Virginia-Premier-HMO-Medicaid-Forum-Presentation-April-17 Powered By Docstoc
					                                       Medicaid Managed Care
                              Virginia Premier Health Plan
                                                         April 17, 2012




Virginia Commonwealth University Health System Health Plan Division       1
  Today’s Presentation
  1. Introduction to Medicaid Managed Care

  2. Why Virginia Premier?


  3. What does this mean for my patients?
           •       Member Benefits and Eligibility


  4. What does this mean for my practice?
           •    Provider Benefits and Services
           •    Claims
           •    Medical Management
           •    Pharmacy

Virginia Commonwealth University Health System Health Plan Division   2
  Managed Care Organizations

Major changes in the health insurance industry have occurred:
   – Managed Care networks have become more prevalent
   – Government funded programs ensure health care services are
     accessible to the elderly and low-income population


These changes resulted from:
   – Rising health care costs
   – The need to shift the financial risk from the State to Managed Care
     Organizations
   – Competition among health care providers
   – The need for enhanced services to improve access to care, promoting
     disease prevention, ensuring quality care, and reducing Medicaid
     expenditures.

 Virginia Commonwealth University Health System Health Plan Division   3
 What is an MCO?
  DMAS defines an Managed Care Organization (MCO) as an
  arrangement for the delivery of health care in which a health carrier
  undertakes to provide, arrange for, pay for, or reimburse any of the
  costs of health care services for a covered person on a prepaid or
  insured basis, which
           • Includes any credentialing requirements intended to influence the cost or
             level of health care services between the health carrier and the one or
             more providers with the respect to the delivery of health care services;
             and
           • Requires or creates benefit payment differential incentives for covered
             person to use providers that are directly or indirectly managed, owned,
             under contact with or employed by the health carrier.


  Managed Care Organizations offer programs geared toward improving
  health and managing care to improve efficiency, quality and access to
  care for recipients.

Virginia Commonwealth University Health System Health Plan Division                      4
 Benefits of Managed Care
    Services Available to Managed Care
    Participants include:

            –     24-hour nurse line
            –     Enhanced pre-natal programs
            –     Preventative programs
            –     Case management services
            –     Disease management services
            –     Health education
            –     Discharge planning
            –     No referral necessary


Virginia Commonwealth University Health System Health Plan Division   5
  Medallion vs. Medallion II


     • Most Virginia Medicaid enrollees are required to receive
       their medical care through a managed care plan.

     • Virginia has two care plan categories established to
       provide quality health care services to enrollees:
        - Medallion PCCM (straight fee-for-service)
        - Medallion II (administered through an MCO)




Virginia Commonwealth University Health System Health Plan Division   6
 Medallion II Eligibility

• Medallion II eligible persons include non‐institutionalized
  individuals in the following covered groups:
        – Families and Children
        – Aged, Blind or Disabled

• Non-eligible persons for Medallion II include:
        – Dual eligible
        – Individuals on certain waivers
        – Individuals confined to nursing homes, or free-standing mental health
          facilities




Virginia Commonwealth University Health System Health Plan Division          7
  MCO Enrollment Process

       • Enrollment in Managed Care:
               – Determined eligibility for Medicaid
                  • DSS enters into system

               – 15 - 45 days after eligibility the enrollee is entered into system
                  • MCO pre-assignment takes place

               – Enrollee is notified by letter
                  • Given the opportunity to select an MCO of their choice

               – If no call is made
                   • Enrollee is assigned to the pre-assigned MCO




Virginia Commonwealth University Health System Health Plan Division                   8
  MCO Enrollment Process

    • Enrollee has 90 days after effective date to change
      MCO’s for any reason


            – Before the18th of the month:
               • Effective 1st of following month
            – After the 18th of the month:
               • Enrollment delayed another month




Virginia Commonwealth University Health System Health Plan Division   9
                              Why Expand Managed
                             Medicaid Medallion II into
                               the Far Southwest?




Virginia Commonwealth University Health System Health Plan Division   10
 Why Expand into the Far Southwest?


  • Shift the burden and financial risk from the State to
    Managed Care Organizations.

  • Reduce the burden placed on PCPs to effectively
    manage members.
                   • Managed Care Organizations provide outreach staff for member
                     home visits
                   • Care management for effective discharge planning
                   • Care management programs specifically focused on Medicaid
                     population (asthma, diabetes, OB care)


  • Improve access to care, quality and reduce Medicaid
    expenditures for the overall benefit of tax payers.

Virginia Commonwealth University Health System Health Plan Division                 11
                                    Why Virginia Premier?
                                                                      About Us




Virginia Commonwealth University Health System Health Plan Division              12
  VCU Medical Center & Virginia Premier

 VCU Medical Center
         •     Academic medical center in Central Virginia
         •     Referral center for Mid-Atlantic States
         •     32,500 admissions and 500,000 outpatient visits

 MCV Hospitals
         •     Teaching hospital of the VCU Health System
         •     779 licensed beds
         •     20.5% share of the Richmond inpatient market
         •     80,000 patients treated annually in hospital’s emergency
               department-region's only Level I Trauma Center

 Children’s Hospital of Richmond
         •     Pediatric specialty hospital
         •     60 licensed beds

 MCV Physicians
         •     566-physician, faculty group practice

 Virginia Premier Health Plan (VPHP)
         •     Medicaid Health Plan-since 1995


Virginia Commonwealth University Health System Health Plan Division       13
  Our Mission
 • Virginia Premier Health Plan, a managed care
   organization partnered with Virginia Commonwealth
   University Health System, meets the needs of
   underserved and vulnerable populations in Virginia by
   delivering quality driven, culturally sensitive, and
   financially viable healthcare.




Virginia Commonwealth University Health System Health Plan Division   14
    Virginia Premier’s Service Area

                                                                                           Non-Service Area



                                                                               Western       Fredericksburg




                                                                                      Central VA
                                                        Roanoke
                    Far Southwest Area
                                                                      Danville/Lynchburg
                                                                                                     Tidewater




•    VA Premier currently has the largest Medicaid Service Area of all health plans

•    With offices in Abingdon, Richlands, Wise, Roanoke, Harrisonburg, Virginia Beach,
     and Richmond, we believe in hiring locally and supporting the community with
     employment opportunities




Virginia Commonwealth University Health System Health Plan Division                                              15
    Our Accomplishments
1. The Top Ranked Health Plan in Virginia for four consecutive years -
   2008, 2009, 2010, 2011
2. In 2011 VA Premier is ranked 26th Nationally out of over 200 Medicaid Health
   Plans
3. Through Virginia Premier’s nationally recognized Healthy Heartbeats
   Prenatal program, we have decreased the number of preterm and low-birth
   weight babies
4. 2010 Best Practice Award for Anti-Depressant Medication Management -
   DMAS awarded
5. The Center for Health Care Strategies awarded DMAS and VPHP the
   Innovation Award for Improving Health Care Quality for Racially and
   Ethnically Diverse Populations
6. 2008-VPHP was awarded the “Recognizing Innovation in Multicultural Health
   Care Award” by the National Committee of Quality Assurance (NCQA)
7. Virginia Premier is the only Virginia health plan that operates its own
   transportation system, inclusive of vans that will be utilizing alternative
   fuels (Compressed Natural Gas / Propane fueled vehicles)
8. 2007-2013 VPHP Awarded NCQA Accreditation Status – Top Rating
   “Excellent”
9. Only Medicaid MCO serving the Roanoke area for 10 years with over 40,000
   members
Virginia Commonwealth University Health System Health Plan Division               16
                               What does this mean for
                                    my patients?
                                Member Benefits & Eligibility




Virginia Commonwealth University Health System Health Plan Division   17
  Your Patients

  Your patients benefit from:

  • An expanded team of healthcare professionals to assist in
    accessing the right care, at the right time, in the right
    setting
  • Increased involvement in their personal health care.
  • Access to a network of specialists
  • Programs targeted to address
  their individual healthcare needs




Virginia Commonwealth University Health System Health Plan Division   18
  Member Benefits Include
  Benefits                                                            Programs targeted for:
  • Physician visits – well and sick                                  • Pregnancy
  • Hospital services                                                 • Heart condition
  • Emergency care                                                    • High blood pressure
  • Laboratory services                                               • Asthma or other breathing
  • Prescription drugs                                                   problems
  • Family planning services                                          • Mental health
  • X-ray/imaging                                                     • Diabetes
  • Mental health services                                            • Case management
  • Home health services
  • Rides to medical appointments
  • Maternity and high risk pregnancy care
  • Newborn care
  • Immunizations (shots) for children
  • Physical, occupational, and speech
     therapies
  • Routine eye exams & glasses for children
  • Routine eye exams for adults

Virginia Commonwealth University Health System Health Plan Division                                 19
  Ancillary Services

 Labs                               VPHP maintains a list of approved labs that may be performed in the
                                    physician’s office. All other lab test(s) must be performed by LabCorp or
                                    by Solstas Labs. Lab procedures performed in the office must be
                                    performed in accordance with your CLIA certification level. Providers
                                    may bill one draw fee per patient.

 Radiology                          NIA will provide utilization management services for outpatient CT, CTA,
                                    CCTA, MRI, MRA, PET Scan, and Nuclear Cardiology imaging
                                    procedures. You may obtain prior authorization through the NIA Web site
                                    at www.RadMD.com or by calling NIA at 800-642-7578.

 Vision                             Routine eye exams and eyeglasses are covered through Vision Service
                                    Plan (VSP). Members may self-refer for routine vision services to a
                                    participating VSP optometrist without obtaining a referral from their
                                    PCP.

 Dental                             Dental services for children are provided by the DMAS Smiles for
                                    Children program. Adult dental services are limited to medically
                                    necessary oral surgery and associated diagnostic services such as x-
                                    rays and surgical extractions.




Virginia Commonwealth University Health System Health Plan Division                                             20
Member Services Department

 For Members and Providers:
     •      Toll-free number 800-727-7536.
     •      Hours of Operation: 8 am to 5 pm, Monday-Friday
     •      Offer Spanish/Bilingual reps
     •      Assist providers and members with the following types of
            issues:
              •    PCP Selection and Provider Participation
              •    Eligibility Verification
              •    Transportation Scheduling
              •    Member Orientation and Education
              •    Member address changes and ID card Request


Virginia Commonwealth University Health System Health Plan Division    21
  Verifying Member Eligibility

     • Member eligibility must be verified monthly (a list of assigned
            members will be sent to you monthly) and prior to rendering
            services.


     • Virginia Premier provides four convenient methods to verify
            member eligibility:
              1. DMAS Automated Voice Response System - recommended
              2. Interactive Voice Response System
              3. NaviNet – a free web based program that allows providers to view
                    member eligibility, claim status and authorizations www.navinet.net

              4. Call VPHP Member Operations



Virginia Commonwealth University Health System Health Plan Division                       22
  Member ID Cards




               Medallion II/FAMIS Plus                                       FAMIS




                                                                FAMIS Moms
Virginia Commonwealth University Health System Health Plan Division                  23
 Transportation
VPHP provides non-emergency transportation to members who do not
have readily available transportation. VPHP operates a fleet of vans
used to transport members with offices located in Abingdon, Richlands
and Norton.

1. 72 hour prior notification is required to schedule transportation.
2. Must be a VPHP member with valid ID card.
3. Appointments are scheduled based upon availability of service.
4.       Non-emergent transportation is not a covered service for FAMIS
         recipients.
5.       Non- Emergency Ambulance transportation is arranged through
         Virginia Premier’s Member Services, call 1-800-828-7953, Press 2,
         8am - 5pm, M-F.



Virginia Commonwealth University Health System Health Plan Division          24
                               What does this mean for
                                    my practice?
                                Provider Benefits & Services




Virginia Commonwealth University Health System Health Plan Division   25
  Provider Benefits
• An expanded team of healthcare professionals working with you to
  meet your patient’s needs
       –    Outreach
       –    Transportation
       –    Health Educators
       –    Case Managers
       –    Disease Managers


• PCP’s have the potential to see growth
as new members are assigned to their panels.

• Greater access to your patients information across
 the healthcare continuum.




Virginia Commonwealth University Health System Health Plan Division   26
  VPHP Provider Services
  •      Dedicated Provider Services Representatives located in our Abingdon office
         conduct regular site visits to network providers and act as a liaison between
         the provider and Virginia Premier. They assist providers with issues, answer
         questions and conduct educational in-services, as needed.

  •      Conduct quarterly educational meetings between VPHP and Participating
         Providers.

  •      Quarterly Newsletters to Providers.

  •      VPHP’s convenient self service applications such as Navinet and IVR allow
         providers to check claims, eligibility and authorizations when it’s convenient
         for them.

  •      VPHP has three local offices located in Abingdon, Richlands and Norton.
         This allows us to interact with our providers and members and develop
         business relationships within these communities.



Virginia Commonwealth University Health System Health Plan Division                       27
  Provider Service Representatives

• Abingdon:

        Amanda Helton (276) 619-0966
         ahelton@vapremier.com

        Felicia Campbell (276) 619-0963
         fcampbell@vapremier.com




Virginia Commonwealth University Health System Health Plan Division   28
                                What does this mean for
                                     my practice?
                                                                      Claims




Virginia Commonwealth University Health System Health Plan Division            29
  Claims Department
  1. Claims are processed within Virginia
  2. On average, 99% of claims are processed within 30 days of
     receipt (Medicaid standard is 90%) with a total overall accuracy of
     99.8%.
  3. VPHP strongly encourages providers to consider filing claims
     electronically which will assure claims are submitted timely,
     reduces timely filing denials, and reduces claims administrative
     costs. A complete listing of all EDI Clearinghouses that VPHP
     accepts can be found at the VPHP website at
     www.vapremier.com.
  4. Providers may receive payments and remits electronically. In
     order to receive EFT from VPHP visit our website at and click on
     the Claims and select the Forms tab to download the EFT forms.
     To receive ERA’s please contact your clearinghouse directly.




Virginia Commonwealth University Health System Health Plan Division        30
 Claims Policies
        1. Timely Filing: Participating providers are required to submit their
              claims to VPHP within the timeframe established in their provider
              contract.

        2. Claim Appeals: Appeals for denied claims must be submitted to
              VPHP within 60 days of the original date of the denial. Should a
              claims processing error be attributable to Virginia Premier, providers
              have up to 365 days after receipt of payment to appeal.

        3. Claim Forms: Provider, ancillary and out patient services should be
              submitted to VPHP on the CMS-1500. Hospital and facility claims
              should be submitted to VPHP on the UB04 form. Providers must use
              original claim forms.

        4. Pre-Authorization: For services that required an authorization that
              number should be submitted to VPHP in Box 23 if the CMS-1500 form.

        5. Coding: Providers should always refer to the most current versions of
              the CPT and ICD9 coding manuals when billing services.

Virginia Commonwealth University Health System Health Plan Division                    31
 Claims Customer Service

  1. Please contact the claims customer service department if you
     have claims issues, however, if you have issues that are not
     resolved to your satisfaction please then contact your local
     Provider Service Representative. To reach the Claim Customer
     Service Department call:1-800-727-7536, Option 4.
  2. Claims Customer Service can assist with questions related to
     claims:
     a. verify claim status
     b. researching claims issues and denials
  3. Claim status and claim line detail can also be viewed on Navinet,
     www.navinet.net , 24/7 and is free of charge.




Virginia Commonwealth University Health System Health Plan Division      32
                                What does this mean for
                                     my practice?
                                              Medical Management




Virginia Commonwealth University Health System Health Plan Division   33
 ER Services
 1. In the case of sudden onset of an unexpected medical
    condition and time permits, VPHP members are instructed to
    contact their PCP for medical advice. If the member is unable
    to reach their PCP or the situation arises after business hours,
    members are instructed to call the Nurse Advice Line at 1-800-
    256-1982. The PCP or Nurse Advice Line will assess the
    member’s medical condition and instruct the member on
    obtaining appropriate medical care.
 2. If a PCP directs a member to the ER then the office should
    notify VPHP the next business day so the claim can be paid
    without retrospective review.
 3. Emergency Room services that do not meet the Prudent
    Layperson standard will be reimbursed for a medical screening
    or “triage fee” only.
 4. Members may also be directed to participating Urgent Care
    Centers for treatment of non-life threatening emergencies.



Virginia Commonwealth University Health System Health Plan Division    34
 Referrals
    1. VPHP does not require referrals to participating (in-network)
       specialist for its members enrolled with our Medallion II and
       FAMIS plans.
    2. A written report from the specialist to the PCP informing them of
       the evaluation and care rendered should be sent after the
       members visit.
    3. Members are required to visit participating providers for care and
       services. Referrals to non-participating specialists are permitted
       only if the required specialist is not available through the Virginia
       Premier network and the service is pre-authorized by VPHP.
    4. Please utilize one of the following options to obtain an out of
       network authorization/referral.
       – Navinet – www.navinet.net
       – VPHP Medical Management – (888) 251-3063



Virginia Commonwealth University Health System Health Plan Division            35
 Pre-Authorization

 1. VPHP requires providers to obtain pre-authorizations from the
    health plan for certain services, procedures and all hospital
    admissions. Failure to obtain pre- authorization from VPHP for
    services will result in a denial of the services and the provider will
    be held responsible for the services.
 2. In order to pre-authorize services, select one of the following:
    a. Enter the request online through Navinet at www.navinet.net.
    b. Fax an IP/OP Auth Form to VPHP which can be found at
        www.vapremier.com
    c. Call VPHP (888) 251-3063 and select the option for Medical
        Management.
 3. VPHP maintains a list of OP procedures that do NOT require pre-
    authorization. The list can be found at www.vapremier.com
    located under Medical Management and Utilization Management.


Virginia Commonwealth University Health System Health Plan Division          36
 Appeals Medical Necessity
       1. The Medical Necessity Appeals process is a mechanism through
          which a member’s representative, attending physician/provider
          or facility can request a review of a non-certification decision by
          VPHP. Appeals will be considered if received within thirty (30)
          days of the decision.
       2. There are 2 types of Medical Necessity Appeals:
                 - Expedited Appeal: may be requested when a denial is made by VPHP prior
                   to, or during the course of treatment. If the member / or provider feels that
                   VPHP’s decision is not acceptable, a request to appeal should be faxed to
                   VPHP’s Medical Management dept (804) 819-5186. Once the appeal is
                   received, VPHP will select a physician of the same or related specialty to
                   review the case. This physician will be responsible for returning a decision
                   within three (3) calendar days of receiving the information.
                 - Standard Appeal: Standard appeals are generally made after services have
                   been rendered. All documentation and/or medical records should be faxed
                   or mailed to:          Virginia Premier Health Plan, Inc.
                                                          Medical Management/ Quality Appeals
                                                          PO Box 5244
                                                          Richmond, VA 23220-0244

Virginia Commonwealth University Health System Health Plan Division                                37
Case Management Programs
 •     VPHP offers an Integrated Case Management Program for all members that
       are high risk and who require complex medical interventions. The Case
       Management Team works closely with the member's PCP to coordinate
       healthcare services across the continuum of care. Case Managers may also
       intervene when patients t demonstrate non-adherence to their treatment
       plan. Circumstances that warrant referral to the Case Management Team
       include:
         – Presence of progressive, chronic, or life-threatening illness
         – Need for inpatient or outpatient rehabilitation
         – Readmissions or high utilization of the ER
         – High risk pregnancies
         – Acute/traumatic injury, or an acute exacerbation of a chronic illness
         – Complex social factors
         – Children with Special Health Care Needs

  Refer a patient for VPHP's Case Management Services by calling
  Medical Management at 800-727-7536 or through the website:
  www.virginiapremier.com
Virginia Commonwealth University Health System Health Plan Division                38
Integrated Case Management Program

                                         Disease Management                              Disease Management
                                                                                         •Chronic Care
                                                                                         •Assessment &
                                            (Population Health)                          education
                                                                                         •Quarterly contact
                                                                          Level 1
                                                                          •Intake Assessment -no Care Plan (CP)
                                                                      1   •Care Coordination
                                                                          •1-3 contacts


                                                                            Level 2
                                                                      2     •Assessment & updates to CP
                                                                            •Monthly contact


                                                                          Level 3
                                                                          •Intensive CM
                                                                      3   •Assessment & freq. updates to CP
                                                                          •Weekly contact until sustained
                                                                          improvement

Virginia Commonwealth University Health System Health Plan Division                                           39
 Disease Management Programs
       • VPHP is pleased to welcome members to its disease
         management programs. These programs will help members
         better understand their condition and keep them updated on
         new information.
       • Our programs are based on nationally accepted guidelines and
         support the physician-patient relationship at no cost to the
         member. Available programs:
               -    Asthma
               -    Childhood Nutrition
               -    COPD
               -    Diabetes
               -    Healthy Heartbeats (High Risk Pregnancy)
               -    Heart Disease
               -    BiPolar and Schizophrenia
       • To refer a member to Disease Management, please call (866)
         243-0937 or through the website at www.virginiapremier.com

Virginia Commonwealth University Health System Health Plan Division     40
    Healthy Heartbeats is VPHP’s prenatal care program
    that includes pregnant members from conception
    through birth. Awarded “Best Practice”
  Goal:
     To improve health outcomes of mothers and infants
    by:
  • Creating a partnership between the member,
    Obstetrician, and Virginia Premier
  • Decreasing low birth weight and premature infants born
    into the plan
  • Increasing early and consistent prenatal care
  • Improving nutritional status of mothers and infants
  •      Increasing knowledge of the importance of prenatal
         care
Virginia Commonwealth University Health System Health Plan Division   41
 Program Components

  • Prenatal Doctor Visits
          • MD’s receive $25 for submitting OB registration
  •      Prenatal Classes
  •      Special Teen Classes
  •      WIC Enrollment
  •      Home and Outreach Visits
  •      Case Management
  •      Incentive Awards

Virginia Commonwealth University Health System Health Plan Division   42
                                What does this mean for
                                     my practice?
                                             Pharmacy Information




Virginia Commonwealth University Health System Health Plan Division   43
 Pharmacy Benefits
1. Pharmacy benefits are administered by Envision.

2. VPHP’s Preferred Drug List is a combination of open and closed
   therapeutic classes. If the medication being dispensed has a generic
   equivalent version then the generic medication should be dispensed
   unless brand is specifically requested by the physician on the
   members prescription. If you have questions regarding prescription
   drug products that require authorization please contact Envision.

3. Certain medications may have drug quantity limits and /or follow a
   step therapy program.

4. Drug Prior-Authorizations: Medications requiring prior authorization
   and excluded medications desired for the appropriate medical
   management of a patient may be requested by calling Envision at
   800-361-4542.




Virginia Commonwealth University Health System Health Plan Division       44
  Covered OTC Medications*
  •      Generic oral analgesics for pain                             •   Generic anti-ulcer
         relief                                                       •   Generic laxatives
  •      Generic oral antipyretics for fever                          •   Generic prenatal vitamins
         control                                                      •   Generic topical corticosteroids
  •      Generic ferrous sulfate                                      •   Generic vitamins & minerals
  •      Generic antacids                                             •   Generic nicotine replacement
  •      Generic antidiarrheals                                           therapy
  •      Generic antifungals (topical and                             •   Insulin
         vaginal)                                                     •   Insulin syringes
  •      Generic scabicides and                                       •   Blood Glucose Diagnostics
         Pediculicides                                                •   Glucometers
  •      Generic Calcium Supplements                                  •   Urines tests
  •      Generic cough and cold products
  •      Generic antihistamines
  •      Generic
         antihistamine/decongestants
           *OTC benefits are only available to Medallion II/FAMIS Plus members only. OTC
           medications must be written on a physicians RX pad in order to be covered.

Virginia Commonwealth University Health System Health Plan Division                                         45
                                     Contact Information &
                                       Closing Remarks




Virginia Commonwealth University Health System Health Plan Division   46
  Contacts
• Medical Management
        • Pre-Authorization: 888-251-3063 or www.navinet.com
        • Radiology: National Imaging Associates, INC (NIA) 800-642-7578
          www.radMD.com
        • ER/Nurse Line: 800-256-1982
        • Vision: VSP Vision 800-852-7600
        • Lab Services: LabCorp 800-873-7251 or Solstas 800-653-2205
        • Dental Services: Smiles for Children 888-912-3456
        • Pharmacy: Envision 800-361-4542

• Claims
        • Customer Service: 800-727-7536, option 2
        • IVR: 800-727-7536 option 4, option 2

• Member Services
        • Member Services/IVR: 800-727-7536 option 1


Virginia Commonwealth University Health System Health Plan Division        47
 Summary
  • 15 years of experience in Virginia

  • VPHP is owned by a center that treats patients
    like yours, so we understand your challenges
           – It is our goal to make your work easier and become
             your preferred Health Plan


  • We recognize the community-wide benefits of
    promoting healthy living for members

  • We look forward to partnering with you!
Virginia Commonwealth University Health System Health Plan Division   48
        Before Questions: A Word of Thanks
    We recognize you are providing a needed
   service to your community, and we sincerely
              appreciate what you do.




Virginia Commonwealth University Health System Health Plan Division   49
                                                    Questions




Virginia Commonwealth University Health System Health Plan Division   50

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:4
posted:11/26/2012
language:English
pages:50