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IPA CONTRACTED HEALTH PLANS & PRODUCTS MANAGED BY CMO EFFECTIVE 1/1/14:
HIP Products:
HIP Access I
HIP Classic HMO
HIP Prime HMO
HIP VIP Medicare (HMO, Essential HMO, High Option HMO) HIP VIP Dual Eligible SNP
HIP Medicaid
HIP VIP Medicaid Advantage SNP
HIP Child Health plus
HIP Family Health plus
Select Care - Healthy NY HMO
Select Care - HMO 40/60
Select Care - HMO 35/55
Select Care - HMO HD6300
Note: CMO logo and claims address will appear on member ID card.
*Oxford/United Products:
AARP MedicareComplete Plan 2 HMO (United)
AARP MedicareComplete Plan 1 HMO (Oxford)
AARP MedicareComplete Essential HMO (Oxford)
AARP MedicareComplete Mosaic HMO (Oxford)
* Effective January 1, 2012, the changes to the risk arrangement is as follows:
• All United/Oxford claims for dates of service after 12/31/11 must be sent directly to United/Oxford for processing. Please note, if office submits claim in error, it will not be directly routed to Oxford but instead deny as “Bill Health Plan”.
• Claims reimbursement methodology will follow United/Oxford guidelines. Payments will be based on your individual or group United/Oxford agreement.
• CMO will continue to manage pre-certification requests but will be following Oxford’s authorization guidelines.
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