2013 Practitioner and Provider Manual - Presbyterian Healthcare ...
2013 Practitioner and Provider Manual - Presbyterian Healthcare ...
2013 Practitioner and Provider Manual - Presbyterian Healthcare ...
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IntroductionUsing Your 2014 <strong>Provider</strong> <strong>Manual</strong>This 2014 <strong>Practitioner</strong> <strong>and</strong> <strong>Provider</strong> <strong>Manual</strong> is both a resource for essential information about<strong>Presbyterian</strong> policies <strong>and</strong> procedures <strong>and</strong> an extension of your service agreement.For your reference, this manual <strong>and</strong> many other communications from <strong>Presbyterian</strong> Health Plan,Inc., <strong>and</strong> <strong>Presbyterian</strong> Insurance Company, Inc., will refer to both entities as “<strong>Presbyterian</strong>” onsecond reference.<strong>Presbyterian</strong> mails updated manuals to all contracted practitioners <strong>and</strong> providers on an annualbasis. The digital version of the manual is updated quarterly or as needed <strong>and</strong> is posted athttps://www.phs.org/providers/clinicians-resources. <strong>Provider</strong>s can also request a paper copy ofthe manual be mailed to them at no charge. The 2014 Centennial Care <strong>Practitioner</strong> <strong>and</strong><strong>Provider</strong> <strong>Manual</strong> located at https://www.phs.org/providers/centennial-care can also bereferenced for detailed information on <strong>Presbyterian</strong>’s Centennial Care program.<strong>Presbyterian</strong> updates <strong>and</strong> news will also be communicated periodically through the “NetworkConnection” newsletter <strong>and</strong> on the provider communications page located athttps://www.phs.org/providers/news-communications.You can also receive newsletters <strong>and</strong> updates from <strong>Presbyterian</strong> by signing up to receive emailsfrom <strong>Provider</strong> Network Management at https://www.phs.org/providers/newscommunications/Pages/enews-registration.aspx.How the Term “<strong>Provider</strong>” Is Used in this <strong>Manual</strong>We acknowledge that the National Committee for Quality Assurance (NCQA) distinguishesbetween a practitioner (person) <strong>and</strong> a provider (facility). We make this distinction on thismanual’s cover, but to simplify the text within the manual we have chosen to use the term“provider” as an umbrella term that includes facilities as well as physicians, practitioners, <strong>and</strong>any other staff who are directly or indirectly contracted to provide service to <strong>Presbyterian</strong>members.We Want To Hear From YouWe encourage you to provide us with feedback on this manual. Please forward any corrections,questions, <strong>and</strong> comments to us at providercomm@phs.org.iii2014 <strong>Practitioner</strong> <strong>and</strong> <strong>Provider</strong> <strong>Manual</strong> - Ver. 3
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