Working With Health Plans

News and Updates

• Efforts by ACC, ASE Result in Reversal of Problematic Coding Changes by McKesson  (6/12) 
• Payer Advocacy in Action -- Mobile Imaging Lab Requirements Strengthened; More  (5/11)
• ACC Letter to NIA on Exclusion of Medicare Approved Accreditation Organizations (9/10)
• Payers Expanding Imaging Prior Notification Requirements (6/10)

Tools and Resources

• ACC Payer Hassle Forms: Imaging Hassle Form
• Learn More About ACC's Cardiovascular Imaging Strategies Product for Health Plans
• Health Information Privacy Resources (U.S. Department of Health and Human Services)
• HIPAA Version 5010 Resources  
• Model Managed Care Contract (American Medical Association): This fourth edition of the AMA's Model Managed Care Contract offers a reasonable alternative to the one-sided take-it-or-leave-it contracts physicians typically receive from health plans.
• American Medical Association’s Claim Management Documents: The following resources are designed to help practices better understand the claims management process: 

  * Prepare that Claim
  * Follow that Claim
  * Appeal that Claim
  * How to Appeal Inappropriate Health Plan Claim Denials
  * Claims Workflow Assistant