PROVIDER RELATIONS

Provider Network Management

Each physician in the IPA operates as an independent office and AMM is available to these physician offices for problem solving, guidance and answering questions. In addition, initial new physician and office staff education can be provided, especially for those physicians who have had little involvement in managed care. In order for the IPA to be successful, physician offices must be trained in customer service, benefits, reimbursement, contract terms, utilization management, policies and procedures, managed care philosophy and other relevant information. AMM can also develop a Provider Education Manual that contains information pertaining to contracts, eligibility, benefits, referral policies and procedures, authorization procedures, claims payment guidelines, utilization management policies, and guidelines for managing physician offices.