SUMMER MEDICAL RESOURCES OF IDAHO unicare by benbenzhou

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SUMMER MEDICAL RESOURCES OF IDAHO unicare

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									                       MEDICAL RESOURCES OF I                                                        DAHO
                                               NEWSLETTER
                                                         SPRING 2006
                                                                  MRI BOARD MEMBERS
   PLANCARE PPO                                                         William Schubert, M.D. – President
                                                                      Benjamin F. Call, M.D. – Vice President
                                                                        Drew McRoberts, M.D. – Secretary
MRI has signed a letter of intent to provide a                              Cliff Field, M.D. – Treasurer
network for PlanCare PPO. This is the group that                         Sherwin D’Souza, M.D. – Member
provides network service for Union Pacific                                 Lloyd Jensen, M.D. – Member
Railroad Employees and Retirees. The contract                             Ken Newhouse, M.D. – Member
will take effect on 08-01-06. So beginning in                     D. Richelle Heldwein, MPH - Executive Director
August the railroad claims will be paid according
to the MRI fee schedule. The claims will still be
paid by United Healthcare, but will be using
PlanCare PPO and MRI as their network.
                                                                 INTERWEST
                                                             SIPHO and MRI have entered into a new
PlanCare provides networks for many other
                                                             contract with InterWest Health. This is an active
groups as well, but the MRI contract is only for the
                                                             contracting body in our surrounding states and
railroad employee benefits program.
                                                             they have recently expanded to our region.
                                                             InterWest is contracted with many of the payors
   BLUE CROSS OF IDAHO                                       that have small groups in our market, such as
         True Blue HMO-Secure BluePPO                        Starmark, Trustmark, and PHCO. They do all
The financials for the Medicare Advantage product            of their own claims repricing, so we will have
were profitable for 2005 year-end. Those providers that      better control of the claims payment issues.
M            R                     I
    claims for ESOURCES patients, each NC.
hadEDICAL BCI Medicare OF DAHO, received an
                 bonus check for
additional 5% P.O. BOX 4182 the services they
                                              I              InterWest will be paying claims based on the
                                                             MRI Fee Schedule and the discount will show up
provided to Blue Cross Medicare patients.
            POCATELLO, ID 83205                              on the EOB as “InterWest”. We look forward to
            HMO Managed Care Plan
    (208) 238-1401 (208) 637-2806 Fax                        a long, successful relationship with this multi-
    www.medicalresourcesofidaho.com
The Blue Cross of Idaho HMO market is shrinking.             state regional network.
This is a national trend for all Blue’s programs. We
               richelle@dcdi.net
still have some covered lives in our market, but the
numbers are significantly lower the last half of 2005.
We will continue to contract for HMO business with
                                                              NEW CONTRACT LISTING
Blue Cross, but with less emphasis on that market.           The back of this newsletter has an updated list of
                    Chamber Blue                             payors that currently contract with Medical
Blue Cross has a product that has been introduced in         Resources of Idaho. We have worked hard to
other Idaho markets that they are interested in bringing     make sure that these contracts have good sound
to Pocatello. It is called Chamber Blue and it is a PPO      language and that they pay at or above the MRI
plan designed to be marketed to small employers who          fee schedule. If you have questions about any of
are members of the Chamber of Commerce who have              those contracts, please do not hesitate to contact
not offered insurance coverage to their employee in the
                                                             Richelle at 238-1401
previous two years. It is targeted to get uninsured lives
into an insurance product. The providers are asked to
give an additional 5% discount on E & M codes and
15% on procedure codes. BCI is decreasing their                             EMR UPDATE
administration rates by 22% and brokers have to agree        It is not lost nor forgotten… MRI is still working
to a reduced commission. MRI has not made a decision         toward a community wide electronic medical record.
on participation in this product, but would like your        We are in the process of partnering with PMC, and
feedback. Please call Richelle - 238-1401                    others to seek grant funding for assistance to offset the
                                                             cost to providers for purchase of an integrated EMR.
                                            MEDICAL RESOURCES OF IDAHO
                                            P.O. BOX 4182
                                            POCATELLO, ID 83205
MRI/SIPHO Contracts                         (208) 238-1401 (208) 637-2806 Fax E-mail- richelle@dcdi.net
CONTRACT                                                      TPA                                PHONE                      Fee Sch
Altius Health Care                                            Altius                             (801) 933-3500             RBSI
Bannock County                                                CBSA                               1-800-925-2272             RBSI
Beech Street                                                  Listed Below                       1-800-877-1444             RBSI
    ACORDIA NATIONAL INC                       FLEETWOOD ENTERPRISES INC                         NYHART COMPANY INC
    ALLIED BENEFIT SYSTEMS                     FLORIDA TROWEL TRADES HEALTH                      OMNI NETWORKS INCORPORATED
    AMERIBEN SOLUTIONS                         GILSBAR INCORPORATED                              OXFORD LIFE INS CO
    AMERICAN FIDELITY ASSURANCE CO             GLOBAL EXCHANGE                                   PAYLESS SHOE SOURCE
    AMERIHEALTH ADMINISTRATORS                 GM SOUTHWEST                                      PERSONAL INSURANCE ADMINISTRAT
    ASSOCIATED PLAN ADMINISTRATO               GROUP & PENSION ADMIN                             PLUMBERS & PIPEFITTERS OUT NV
    BEECH STREET REVIEW (RP)                   HARRINGTON BENEFIT SERVICES                       POMCO
    BENEFIT MANAGEMENT COMPANY                 HEALTH NET                                        PREFERRED ONE ADMINISTRATORS
    BENEFIT PLANNERS INC                       HEALTH SMART (CAP)                                PROFESSIONAL BENEFITS ADMN IL
    BEST LIFE                                  HEALTH SMART (FFS)                                RETAIL STORE EMP HLTH & WLFR T
    CARPENTERS HEALTH & WELFAR N               HEALTH SMART PREFERRED CARE                       REYNOLDS & REYNOLDS
    CBA ADMINISTRATIVE SERVICES                HEALTHCOMP THIRD PARTY ADMIN                      RIVERSIDE RESORT & CASINO
    CHOICE NET                                 HTH WORLDWIDE INSURANCE SERVIC                    SBC COMMUNICATIONS INC
    CLAIRES STORES                             INDECS CORPORATION                                SBC PACIFIC TELESIS GRP
    COALITION AMERICA                          KEY PARTNERS KEY BENEFIT ADM                      SELECTCARE RISK MANAGEMENT
    COASTAL ADMINISTRATIVE SERVICE             LAS VEGAS MET POLICE OUT NV                       SINCLAIR OIL HEALTH SERVICES
    COMBINED KLAIS                             LOOMIS COMPANY                                    SISCO COTTINGHAM & BUTLER
    CONSTRUCTION IND & LBRS H & W              MARSH ADVANTAGE AMER OF OK                        SOUTHWEST ADMINISTRATORS
    CORPORATE BENEFIT SERVICES OF              MARSH ADVANTAGE AMER SPOKAN                       STAR HEALTHCARE NETWORK INC
    CORRECTIONAL MEDICAL SERVICES              MEDICAL BENEFIT ADMIN OHIO                        STATE OF GEORGIA
    COX HEALTH SYSTEM INSURANCE CO             MEGA PFL MIDWEST NATIONAL LIFE                    STATE OF NEVADA
    CR ENGLAND                                 MILLENNIUM INTERNATIONAL PPO                      STRATEGIC RESOURCE COMPANY
    DARDEN RESTAURANTS                         MOHAWK INDUSTRIES                                 STUDENT INSURANCE KLAIS
    DEFINITY HEALTH                            MOUNTAIN STATES ADMINISTRATION                    TLC ADVANTAGE
    DEFINITY HEALTH NAP                        MS ADMINISTRATIVE SERVICES                        UNICARE LIFE & HEALTH
    DIVERSIFIED GROUP ADMIN                    NATIONAL HEALTH CARE ALLIANCE                     UNIGRAPHIC SOLUTIONS
    DIVERSIFIED STUDENT UNDERWRTRS             NEW AMERICAN EMPLOYEE LSG CO                      UNION LABOR LIFE INSURANCE CO
    E B C DIVISION OF JOHN PEARL               NEW WEST HEALTH SERVICES                          UNITED MEDICAL RESOURCES INC
    EASTERN BENEFIT SYSTEMS INC                NORTH AMERICAN ADMINISTRATORS                     WASATCH CREST MUTUAL INS
    ECOM BENEFITS                              NORTH AMERICAN BENEFITS NETWOR                    WASHINGTON TEAMSTERS WELFARE
    ELI LILLY & COMPANY                        NORTH AMERICAN PREFERRED WRAP                     WESTERN MUTUAL INSURANCE
    EPOCH GROUP KS                             NORTHSTAR ADMINISTRATORS                          WESTERN TEAMSTERS TRUST
                                                                                                 WILLIAM C BEELER & COMPAN
Blue Cross of Idaho PPO & Traditional                         Blue Cross                         1-800-627-6655             BCI PPO & Trad
Blue Cross of Idaho HMO Products                              Blue Cross                         1-800-627-6655             BCI HMO
Blue Cross of Idaho Medicare Advantage                        Blue Cross                         1-800-627-6655             BCI HMO
City of Chubbuck                                              Tall Tree Admin                    1-801-938-1125             RBSI
Deseret Mutual Benefit Administrators                         DMBA                               1-800-777-3662             New
Gem Plan (Idaho Counties)                                     CBSA                               1-800-925-2272             RBSI
Idaho Integrated IPA                                          Variable                           1-208-385-7407             BCI PPO & Trad
Idaho Cooperative Health Network                              Variable                           1-208-385-7407
Idaho State University                                        Academic Health Risk               1-817-427-3800             ISU
InterWest HealthCare                                          See listed below                                              RBSI
       Allegiance Benefit Plan Management      800-877-1122   Montana University System          877-778-8600
       American Counsel of Engineering         888-813-7099   Mountain States Administration     800-828-8012
       Benefit Administrative Systems          708-799-7400   National Health Insurance Co       800-237-1900
       Benefit Planners                        866-868-8748   National Preferred Provider Ntwk   See ID card
       Boulder Administrative Service          877-406-3699   New West Health Services           800-290-3657
       Boys & Girls Club Ins. Trust            800-245-8813   Northwestern Energy                866-284-5970
       Coalition America                       800-878-7896   Nova Net                           See ID card
       Ecom PPO.com                            214-561-6300   OutsourceOne Benefits              877-655-8467
       First Administrators, Inc.              800-658-3073   Performax                          See ID card
       Fortis Benefits                                        PHCO                               888-298-1574
       Great West Healthcare                   800-663-8081   Seabury & Smith                    800-582-2498
       Health Network America                  877-280-2341   Starmark                           800-822-1246
       IAC                                     877-663-8963   Superien Health Network            888-315-6045
       John Alden Life Insurance               800-328-4316   Timber Products Mfg Trust          800-877-1122
       MACo Health Care Trust                  888-883-3233   Time Insurance Company             800-743-8463
       Marsh Advantage America                 800-562-4023   True Choice USA                    See ID card
       Medical Claims Management Corp.         800-334-0609   Trustmark Insurance CO.            800-444-6254
       Meritain Health                         800-397-2122   World Insurance                    800-786-7557
       Montana Unified School Trust            800-877-1122   Watkins Shepard Trucking           888-554-7629
J.U.B. Engineers                                              P5 EHS                             1-800-551-4049             New
NonPareil                                                     P5 EHS                             1-800-551-4049             RBSI
ODS - (Les Schwab Rupert and others)                          ODS                                1-877-337-0650             RBSI
Old Castle                                                    P5 EHS                             1-800-551-4049             RBSI
Peak Medical                                                  P5 EHS                             1-888-620-3147             New
Portneuf Medical Center                                       EBMS                               1-800-777-3575             New
PlanCare PPO (Railroad Employees)                             United Healthcare                                             RBSI *
Power County                                                  MS Administrators                  1-208-343-2964             RBSI
REGENCE BLUE SHIELD - REGIONAL CARE ONLY                      RBSI                               1-208-234-0020             RBSI

								
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