Healthcare risk management in France: tools exemples
|
|
|
- Blake Bishop
- 6 years ago
- Views:
Transcription
1 Healthcare risk management in France: tools exemples Dr Thierry Demerens Medical advisor CNAMTS Barcelone Octobre 2016
2 Risk management: different steps Know the risk Prevent and anticipate the risk Minimize the cost of the risk
3 Main levers Targets Healthcare providers employeers customers Modern tools Using/combining different tools Information systems New jobs (DAM, ) Modernize traditional tools NICT Information Detailing Sensitization Financial incentives PAR Healthcare organizaton
4 Health Insurance data set
5 The General health insurance scheme Covers 57 million people (86% of French population) including civil servants and students 2 levels of Information : at regional level (101 local health insurance funds): Personal data on health professional and insurees (family name, first name, address etc) linked to reimbursements at national level : same information but anonymous Information on : ambulatory care (drugs, medical visits and procedures, biological tests, dental care, ), in-patient care, payment for sick leave, etc.
6 General architecture of the health insurance information system Reimbursement for ambulatory care Guidelines (patients, medical data, health care supply...) Regional health insurance data COUNT Other schemes PMSI Controls and anonymisation SNIIR-AM National health insurance data (SNIIR-AM) Linkage with hospital data possible (PMSI)
7 Health insurance data set (SNIIR-AM) 1/2 Patients data: Age Month and year of birth Gender Full reimbursement data for low income beneficiaries CMUc = "couverture médicale universelle complémentaire", a free complementary insurance for annual income less than ~ 7600 euros Medical diagnoses (ICD-10 code) for severe and costly chronic diseases, for which patients may be exempted for any payment: ALD = "affection de longue durée", if requested by the patient and agreed by a health insurance physician (~ 9 million people) Department and region of residence Date of death
8 Health insurance data set (SNIIRAM) 2/2 Ambulatory care data : All detailed reimbursements with dates of prescription and dispensing, with corresponding codes: Primary care and specialists consultations Medicines Medical procedures Biological tests Medical devices Health care from other health care professionals
9 Hospital data base (PMSI) Hospitalisation data : French public and private hospitals Discharge diagnosis (ICD-10 codes): principal, related, associated diagnosis Medical procedures performed during hospital stay (specific coding) Date of discharge and length of stay Diagnosis-related groups ( Groupe Homogène de Malades ), to classify patients in subgroups according to medical procedures and discharge diagnoses Ambulatory visits in hospital medicines and medical devices included in a specific list of costly and most necessary products
10 SNIIRAM & PMSI limitations 1/2 No information on: - Over-the-counter drugs - Results of clinical exams, blood pressure, BMI - Results of laboratory tests, histology, - Risk factors : smoking, alcohol use, exercise, diet, family history, - Drugs taken during hospital stay except for most costly and necessary drugs (specific list) - Long term hospitalisations (hospitals with specific status), especially for elderly - Causes of death
11 SNIIRAM & PMSI limitations 2/2 Few information on socioeconomic status, limited to full reimbursement for low income earners (CMUc) Access to SNIIRAM data is limited to the 3 last years + the current year (i.e. today from 2009 to 2012), but a specific request is possible - if justified - for a longer period
12 SNIIRAM & PMSI : Despite the limitations Large sample size: whole French population Large, comprehensive and detailed information No loss to follow-up, except if long stay abroad Unlike primary care electronic medical record databases, no medical indication for prescribed drugs, but information available on 100%-reimbursed chronic diseases Possibility of supplementary information in regional studies (before anonymization) with collection of more data, e.g. from specific questionnaires or medical charts
13 Academic detailing
14 Academic detailing Improve the system efficiency Conducted by medical advisors or Health insurance representatives Target: Prescribers Pharmacists Patients Individual Profile, visual aid, memo, costs memo Results: Drugs and medical devices: Yearly savings: 400 M
15 Main topics Hospital: Viral Hepatitis C Rheumatoid arthritis EPO Severe asthma Retail Lipid lowering drugs Gliptins Antibiotics Generics Off labelling prescription Elderly patient prescription
16 Academic detailing and Health Insurance information system Identify the topic Targeting Profiling Evaluating
17 Prior Authorization Request
18 Rational Crestor in the Top 10 reimbursed products: 340 M, +9,7% Atypical consumption structure vs european countries remains Despite previous academic detailing campaigns Health Insurance database analysis shown no clinical (morbidity, mortality) differences between Crestor and simvastatin
19 PAR Perimeter Rosuvastatin, ezetimib, ezetimib + simvastatin Treatment initiation Ambulatory patients Retail prescription
20 PAR: General process Prescriber Pharmacist Patient Prescription Check the previous prescription If rosuvastatin 1st prescription, fulfills and transmits on line to the Health Insurance the PAR Prescription form given to the patient In case of denial, the prescriber has to specify «Non reimbursed» on the prescription form Rosuvastatin PAR Automatic process Approval or Denial Immediate or Real-time Medical service Decision tree Controls PAR Notification to the patient by mail PAR Database Prescriber Patient Decision Administrative service Denial Special process MSAP médicaments
21 Exemple: Rosuvastatin PAR decision tree Secondary prevention or not high risk patient Denial Less than 2 g/l Cardiovascular risk level? High risk patient (except secondary prevention) Contra indications? Atorvastatin and Simvastatin Denial Approval Familial hypercholestero lemia? Yes No Approval LDL c Blood level? Between 2 and 2,2 g/l Cardiovascular Risk level? More than 2 risk factors Less than 3 RF or secondary prevention Contra indication? Denial Atorvastatin and Simvastatin Denial Approval High risk patient (except secondary prevention) Contra Indications? Atorvastatin and Simvastatin Denial Approval 3 RF or more Contra Indications? Atorvastatin Denial Approval More than 2,2 g/l Cardiovascular Risk level? Less than 3 RF or secondary prevention Denial HR Patient (except secondary prevention) Contra Indications? Atorvastatin Denial Approval
22 Main results Lipid lowering drugs initiation market share 50% 45% + 11% atorvastatin* 40% 35% + 3% Other statins* 30% 25% 20% 15% - 10% rosuvastatin* 10% 5% - 2% ézétimib* 0% set-14 oct-14 nov-14 des-14 gen-15 feb-15 març-15 abr-15 maig-15 juny-15 jul-15 rosuvastatine ezetimibe ezetimibe + simvastatine atorvastatine autres statines Données RG y compris SLM, France entière 22
23 Lipid lowering drugs market 40,0% 35,0% 30,0% Number of treatments (monthly market share) + 1% other statins* + 3% atorvastatin* 25,0% 20,0% - 3% rosuvastatin* 15,0% 10,0% 5,0% - 0,5% ezetimib* 0,0% set-14 oct-14 nov-14 des-14 gen-15 feb-15 març-15 abr-15 maig-15 juny-15 jul-15 rosuvastatine ezetimibe ezetimibe + simvastatine atorvastatine autres statines
24 Thank you for your attention
Enrollment Form. Fax all completed forms to Enroll Your Patient Today. Simple Steps To Enroll Your Patient. Comprehensive Support
For help enrolling your patients, call us at 1-844-PRALUENT (1-844-772-5836), option 1. Enroll Your Patient Today With MyPRALUENT for PRALUENT (alirocumab), support is available to your patient as soon
Pharmacy Coverage Guidelines are subject to change as new information becomes available.
(atorvastatin, fluvastatin, fluvastatin er, lovastatin, pravastatin, and simvastatin) Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in
Innovative Prescription Drug Management from Great-West Life
Issue 1 June 2011 Innovative Prescription Drug Management from Great-West Life Is your plan keeping pace? Prescription drug benefits play a significant role in the overall health and well-being of your
The drug market regulation in the context of the economic crisis in France
The drug market regulation in the context of the economic crisis in France «La Prestación Farmacéutica frente a la Crisis Económica en Europa» Universidad Carlos III October 15 2010 - Madrid Francis Fagnani
Innovative Prescription Drug Management from Great-West Life
Issue 1 Innovative Prescription Drug Management from Great-West Life Is your plan keeping pace? Prescription drug benefits play a significant role in the overall health and well-being of your employees,
Pharmaceutical Management Medicaid 2018
Pharmaceutical Management Medicaid 2018 Toll-free Contact Number: Pharmacy Administration: (810) 244-1660 MHP42721056 Rev. 2/13/18 Introduction Pharmaceutical Management promotes the use of the most clinically
Rocky Mountain Health Plans PPO
Quality Overview Rocky Health Plans PPO Accreditation Exchange Product Accrediting Organization: NCQA PPO (Exchange) Accreditation Status: Accredited Note: Accredited is the highest rating an exchange
Continuum Application Statement of Health Form for Health Care and Dental Care Insurance
Continuum Application Statement of Health Form for Health Care and Dental Care Insurance Please PRINT clearly. In this application form, you and your refer to the person applying for insurance. We, us,
Guide to Prescribed Minimum Benefits 2018
Guide to Prescribed Minimum Benefits 2018 Who we are Remedi Medical Aid Scheme (referred to as 'the Scheme"), registration number 1430, is a non-profit organisation, registered with the Council for Medical
Has a family member been a patient in our office? Yes No
Patient Information *Please complete all pages First Name M.I. Last Address Sex M / F Age City State Zip Code Date of Birth Social Security Marital Status S M W D Primary Phone Alternate Phone E-mail Physician
Who to call for an emergency: Name: Address: Home Phone: ( ) - Work Phone: ( ) - Cell Phone: ( ) - Relationship:
Patient Information: Patient Name: Social Security Number: / / Date of Birth: / / Sex: M / F (Circle one) Married/Single/Divorced/Widow Address: Zip Code: Home Phone: ( ) - E-mail Address: Cell Phone:
Prior Authorization, Pharmacy and Health Case Management Information. Prior Authorization. Pharmacy Information. Health Case Management
Prior Authorization, Pharmacy and Health Case Management Information The purpose of this information sheet is to provide you with details on how Great-West Life will be assessing and managing your claim
2018 RETIREE ANNUAL ENROLLMENT PERIOD 11/15/17 11/29/17
RETIREE WELL BEING FAIR PRESENTATION November 15, 2017 2018 RETIREE ANNUAL ENROLLMENT PERIOD 11/15/17 11/29/17 PLAN DESIGN CHANGES FOR FY19 PLAN YEAR (Effective 03/01/18) TOTAL MEDICAL PLAN COST What was
ProviderNews. Discussing health issues with your patients. New mandatory generic policy for Medical record documentation standards FALL
ProviderNews FALL 2015 Discussing health issues with your patients Security Health Plan members may be asked to complete surveys regarding conversations they have had with their provider that are mandated
The Life Protector Plan
The Life Protector Plan Application for Assurance Life Protector (an Annually Renewable Life assurance) pays a lump sum in the event of death by natural or accidental cause. Policy carries a five year
Note: Accredited is the highest rating an exchange product can have for 2015.
Quality Overview Permanente Accreditation Exchange Product Accrediting Organization: NCQA HMO (Exchange) Accreditation Status: Accredited Note: Accredited is the highest rating an exchange product can
The HPfHR 3-Tier System
The HPfHR 3-Tier System The basic level (Tier 1) of the new healthcare system would cover the entire population- from cradle to grave and would include, based on evidenced based data, all medical, surgical
Utilisation of medical services
07 March 2016 Research and Monitoring Unit 1 Table of Contents Table of Contents... 2 List of tables... 3 List of figures... 3 1. Background... 4 2. Introduction... 4 3. Summary of Data used in the analysis...
2012 Physician Quality Reporting Measures Groups Specifications Manual Release Notes 11/10/2011
2012 Physician Quality Reporting Measures Groups Specifications Manual Release Notes 11/10/2011 CPT only copyright 2011 American Medical Association. All rights reserved. CPT is a registered trademark
Prior Authorization, Pharmacy and Health Case Management Information. Prior Authorization. Pharmacy Information. Health Case Management
Prior Authorization, Pharmacy and Health Case Management Information The purpose of this information sheet is to provide you with details on how Great-West Life will be assessing and managing your claim
Subject: Pharmacy Services & Formulary Management (Page 1 of 5)
Subject: Pharmacy Services & Formulary Management (Page 1 of 5) Objective: I. To ensure the clinically appropriate prescription and use of pharmaceuticals by Tuality Health Alliance (THA) providers and
Quick Patient Registration Form Patient Information:
Quick Patient Registration Form Patient Information: Legal First Name: MI: Legal Last Name: Sex: M F Date of Birth: Primary Language: Marital Status: Married Single Partner Divorced Widowed Race: Ethnicity:
PATIENT INFORMATION NAME SOCIAL SECURITY BIRTH DATE ADDRESS CITY STATE ZIP CODE
Whom may we thank for referring you to our office? PATIENT INFORMATION PATIENT INFORMATION NAME SOCIAL SECURITY BIRTH ADDRESS CITY STATE ZIP CODE HOME PHONE WORK PHONE CELL PHONE E-MAIL ADDRESS COLLEGE
Please be aware that this office does not do pain management and will not prescribe narcotics to new patients, nor on an ongoing basis.
Patient Information Sheet Last Name: First Name: Middle Initial: Patient Is: Policy Holder Responsible Party RESPONSIBLE PARTY Last Name: First Name: Middle Initial: Address: City, State, Zip: Home Phone:
FLEXIBLE SPENDING PLAN
Madison-Oneida BOCES FLEXIBLE SPENDING PLAN Summary Plan Description Effective: 10/1/2017 TABLE OF CONTENTS INTRODUCTION... 1 POINTS TO REMEMBER... 2 ELIGIBILITY... 3 HEALTH INSURANCE PREMIUM ACCOUNT...
The benefits of the PBS to the Australian Community and the impact of increased copayments
The benefits of the PBS to the Australian Community and the impact of increased copayments Health Issues No 71 June 2002 Executive Summary The purpose of this paper is to argue that the Pharmaceutical
PHARMACY COVERAGE GUIDELINES ORIGINAL EFFECTIVE DATE: 1/18/18 SECTION: DRUGS LAST REVIEW DATE: 8/13/18 LAST CRITERIA REVISION DATE: ARCHIVE DATE:
STEP THERAPY Coverage for services, procedures, medical devices and drugs are dependent upon benefit eligibility as outlined in the member's specific benefit plan. This Pharmacy Coverage Guideline must
2014 Physician Quality Reporting System (PQRS) Measures Groups Specifications Manual Release Notes 12/13/2013
2014 Physician Quality Reporting System (PQRS) Measures Groups Specifications Manual Release Notes 12/13/2013 CPT only copyright 2013 American Medical Association. All rights reserved. CPT is a registered
Pension Employees currently participating in a defined benefit ( DB ) pension plan
THE FOLLOWING APPLIES TO ALL ACTIVE NON-UNION FULL-TIME EMPLOYEES Pension Employees currently participating in a defined benefit ( DB ) pension plan We will be ceasing pension accruals for employees under
Medical Expense Reimb. Plan, PORAC Retiree Med. Trust: Coverage Period: Begins on or after 7/1/13
Medical Expense Reimb. Plan, PORAC Retiree Med. Trust: Coverage Period: Begins on or after 7/1/13 (sponsored by the Peace Officers Research Association of California ( PORAC )) Plan Type: Retiree Medical
This document contains both information and form fields. To read information, use the Down Arrow from a form field.
This document contains both information and form fields. To read information, use the Down Arrow from a form field. Prior Authorization, Pharmacy and Health Case Management Information The purpose of this
Attached is the material you have requested about MetLife s Accelerated Benefits Option ( ABO ) for your Group Insurance plan.
American Airlines Metropolitan Life Insurance Group Life Claims Telephone Number: 1-800-638-6420 Dear Claimant: Attached is the material you have requested about MetLife s Accelerated Benefits Option (
Health Information Technology and Management
Health Information Technology and Management CHAPTER 9 Healthcare Coding and Reimbursement Pretest (True/False) CPT-4 codes are used to bill for disease and illness. Medicare Part B provides medical insurance
Short Option. Coverage for Short-Term Health Care Needs. anthem.com PDF (01/07)
Short Option Coverage for Short-Term Health Care Needs 916127-PDF (01/07) anthem.com Short Option Health Coverage We realize that many Virginians, for one reason or another, are in need of health care
Get the most from your prescription benefit
Get the most from your prescription benefit TE Connectivity HealthFund HRA Plan Welcome to Express Scripts What s Inside Your benefit at a glance...2 Your plan s preferred medicines...2 Prior authorization...2
ACCESS TO THE HIGHEST QUALITY PRIMARY HEALTHCARE AT AFFORDABLE PRICES
ACCESS TO THE HIGHEST QUALITY PRIMARY HEALTHCARE AT AFFORDABLE PRICES WELCOME TO ELIXI MEDICAL INSURANCE PURPLE PLAN - PRIMARY AND HOSPITAL CARE Elixi Medical Insurance aims to make private healthcare
See Important Reminder at the end of this policy for important regulatory and legal information.
Policy: Rosuvastain (Crestor) Reference Number: TCHP.PHAR.18005 Effective : 01.01.19 Last Review : 11.15.18 Line of Business: Oregon Health Plan Revision Log See Important Reminder at the end of this policy
Glossary. Adults: Individuals ages 19 through 64. Allowed amounts: See prices paid. Allowed costs: See prices paid.
Glossary Acute inpatient: A subservice category of the inpatient facility clams that have excluded skilled nursing facilities (SNF), hospice, and ungroupable claims. This subcategory was previously known
Aetna Select Medical Plan PLAN FEATURES NETWORK OUT-OF-NETWORK. Plan Maximum Out of Pocket Limit excludes precertification penalties.
Schedule of Benefits Employer: Yale University ASA: 877076 Issue Date: July 25, 2016 Effective Date: January 1, 2016 Schedule: 12D Booklet Base: 12 For: Aetna Select - Security Staff (Outside CT) Electing
Translating Health Data into Community Change
Translating Health Data into Community Change Ricky C. Brathwaite, PhD Director, Health Economics 11th Caribbean Conference on Health Financing Bonaire, 2016 Topics The Need for Claims Analysis Select
City of Monroe: City of Monroe Medical Care Plan Coverage Period: July 1, 2016 June 30, 2017
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.tuckeradministrators.com or by calling 704 525-9666.
Chapter 7 General Billing Rules
7 General Billing Rules Reviewed/Revised: 10/10/2017, 07/13/2017, 02/01/2017, 02/15/2016, 09/16/2015, 09/18/2014 General Information This chapter contains general information related to Health Choice Arizona
You don t need to meet any deductibles in this Plan. This is a medical expense reimbursement plan. There is no network.
This is only a summary. The SBC shows you how you and the plan would share the cost for covered healthcare services. If you want more detail about your coverage and costs, you can get the complete terms
Pharmaceutical Management Medicaid 2017
Pharmaceutical Management Medicaid 2017 Customer Service: (888) 327-0671 TTY: 711 Pharmacy Administration: (810) 244-1660 Visit our website at: McLarenHealthPlan.org MHP42721056 5/2017 Introduction Pharmaceutical
Share a Clear View. Marquette University CPHP (Co-Pay Health Plan) Printed on:
Share a Clear View Marquette University CPHP (Co-Pay Health Plan) Printed on: Share a Clear View NAVITUS CUSTOMER CARE HOURS: 24 Hours a Day 7 Days a Week 866-333-2757 (toll-free) TTY (toll-free) 711 MAILING
Tri-County Schools Insurance Group: Basic Plan Coverage Period: 01/01/ /31/2014
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.tcsig.com or by calling Delta Health Systems at 1-800-464-7627.
Lindsey Imada, PharmD Candidate 2016 Midwestern University, Chicago College of Pharmacy
Lindsey Imada, PharmD Candidate 2016 Midwestern University, Chicago College of Pharmacy Under the Preceptorship of Dr. Craig Stern Pro Pharma Pharmaceutical Consultants, Inc. September 11, 2015 S OBJECTIVES
Prescription Drug Benefits
Stryker s healthcare plan provides benefits for covered prescription drugs, including contraceptives, insulin and diabetic supplies. Benefits are paid for covered drugs that are medically necessary for
The Accelerated Benefits Option ( ABO )
The Accelerated Benefits Option ( ABO ) Metropolitan Life Insurance Company Group Life Claims Telephone Number: 1-800-638-6420 Please read the following important information before completing the attached
TECHNICAL APPENDIX 1 THE FUTURE ELDERLY MODEL
TECHNICAL APPENDIX 1 THE FUTURE ELDERLY MODEL To estimate the potential health benefits of PCSK9 inhibitors, we use the Future Elderly Model (FEM), a dynamic microsimulation model developed by Goldman
Important Questions Answers Why this Matters: For PPO Providers: $1,500 Member/$3,000 Family For Non-PPO Providers:
Anthem Blue Cross Life and Health Insurance Company ACWA / JPIA: Account Based Health Plan (EV85) Coverage Period: 01/01/2015-12/31/2015 Summary of Benefits and Coverage: What this Plan Covers & What it
Chapter 17: Pharmacy and Drug Formulary
Chapter 17: Pharmacy and Drug Formulary Introduction Health Choice Insurance Co. (Health Choice) is pleased to provide the Health Choice Formulary, which is available on line at www.healthchoiceessential.com/members/rxdrugs.
Cummins Central Power, LLC Coverage Period: 05/01/ /30/2015
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: HDHP What is the overall deductible? This is only a summary. If you want more detail about
2014 Physician Quality Reporting System (PQRS) Measures Groups Specifications Manual Release Notes 01/23/2014
2014 Physician Quality Reporting System (PQRS) Measures Groups Specifications Manual Release Notes 01/23/2014 CPT only copyright 2013 American Medical Association. All rights reserved. CPT is a registered
Cummins Central Power, LLC Coverage Period: 05/01/ /30/2016
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual/Family Plan Type: HDHP What is the overall deductible? This is only a summary. If you want more detail about
TRICARE Operations Manual M, April 1, 2015 Claims Processing Procedures. Chapter 8 Section 6
Claims Processing Procedures Chapter 8 Section 6 Revision: 1.0 GENERAL 1.1 Pursuant to National Defense Authorization Act for Fiscal Year 2007 (NDAA FY 2007), Section 731(b)(2) where services are covered
Strategies for Assessing Health Plan Performance on Chronic Diseases: Selecting Performance Indicators and Applying Health-Based Risk Adjustment
Strategies for Assessing Health Plan Performance on Chronic Diseases: Selecting Performance Indicators and Applying Health-Based Risk Adjustment Appendix I Performance Results Overview In this section,
PRIVILEGES AND CONDITIONS
PRIVILEGES AND CONDITIONS 1. Benefits We shall pay the benefits as specified in the schedule if a member incurs medical expenses due to illness or injury for primary care, specialist care or hospital care
MediRaksha. Claim Form. Part A (To be filled in by the Insured)
MediRaksha Claim Form Tata AIG General Insurance Company Limited: A-501, 5th Floor, Building.4, Infinity Park, Gen. A.K. Vaidya Marg, Dindoshi, Malad (East), Mumbai 400 097 IMPORTANT: The Issue of this
Benefits as a Newton Public Schools Retiree
Benefits as a Newton Public Schools Retiree For updated health and dental information and forms, please check periodically the Newton Public Schools website at: www.newton.k12.ma.us. Click on the Human
Princeton University Prescription Drug Plan Summary Plan Description
Princeton University Prescription Drug Plan Summary Plan Description Princeton University Prescription Drug Plan Summary Plan Description January 2018 Introduction... 1 How the Plan Works... 2 Formulary...
ACTIVELY MANAGED DRUG SOLUTIONS SPECIALTY DRUGS. Supporting employees and building sustainable drug plans...together
ACTIVELY MANAGED DRUG SOLUTIONS SPECIALTY DRUGS Supporting employees and building sustainable drug plans...together Not available in the province of Quebec INTRODUCING THE SPECIALTY DRUG PROGRAM If you
Prescription Drug Benefits
Stryker s healthcare plan provides benefits for covered prescription drugs, including contraceptives, insulin and diabetic supplies. Benefits are paid for covered drugs that are medically necessary for
What is the overall deductible?
Molina Healthcare of California: Molina Silver 70 HMO Coverage Period: 01/01/2014 12/31/2014 Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family Plan
Thomas Rousseau NIHDI - COOPAMI 2. Ulla Cahay NIHDI - COOPAMI
11-05-2017 Thomas Rousseau NIHDI - COOPAMI 2 Ulla Cahay NIHDI - COOPAMI Agenda Characteristics of the Belgian health care system Standard procedure : reimbursement NIHDI? Questions? Characteristics of
Medicaid Prescribed Drug Program Spending Control Initiatives. For the Quarter April 1, 2014 through June 30, 2014
Medicaid Prescribed Drug Program Spending Control Initiatives For the Quarter April 1, 2014 through June 30, 2014 Report to the Florida Legislature January 2015 Table of Contents Purpose of Report... 1
Your Pharmacy Benefits Handbook
Your Pharmacy Benefits Handbook Summary of FCPS Prescription Benefits Available Through CVS Caremark Pharmacy Benefit Manager for Aetna/Innovation Health and CareFirst BlueChoice Advantage Plans Plan Year
Agenda A year by year look at Health care reform
Understanding National Health Care Reform Presented by Linda Huber President Benefits Solutions Group Agenda A year by year look at Health care reform What has happened in 2010 What changed in 2011 2012
FLOYD CARDIOLOGY Demographic Information
FLOYD CARDIOLOGY Demographic Information Patient Information Last: First: MI: SS #: Sex: DOB: Street Address: City: State: Zip: Home Phone: Work Phone: Email Address: Employer: Occupation: Responsible
RULES OF TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION DIVISION OF TENNCARE CHAPTER COVERKIDS TABLE OF CONTENTS
RULES OF TENNESSEE DEPARTMENT OF FINANCE AND ADMINISTRATION DIVISION OF TENNCARE CHAPTER 1200-13-21 COVERKIDS TABLE OF CONTENTS 1200-13-21-.01 Scope and Authority 1200-13-21-.02 Definitions 1200-13-21-.03
Co-pay Accumulator Adjustment Programs
THE PHYSICIAN S PERSPECTIVE JUNE 2018 Co-pay Accumulator Adjustment Programs Madelaine A. Feldman, MD, FACR Not everyone can afford the medication they need. To make drugs more accessible, manufacturers
Conway Regional After Hours Clinic
Conway Regional After Hours Clinic Patient Information Patient Name: Date of Birth Sex (M) (F) SS# Marital Status M S W D Home Phone ( ) - Cell Phone ( ) - Work Phone ( ) - Mailing Address: Street City
Inside this Benefits Summary: Medical
BENEFITS SUMMARY Aetna Affordable Health Choices insurance plan Plan design and benefits provided by Aetna Life Insurance Company (Aetna) and administered by Strategic Resource Company (SRC). Unless otherwise
For households exceeding 4 members, add $21,600 for each additional member to the $125,500 referenced above.
Do I qualify for PASS? Patient Assistance Program Enrollment Form Need help paying for your medicine? In many cases, we can help. PASS has a financial solution for eligible patients, regardless of your
SCHWARTZ EYE ASSOCIATES
SCHWARTZ EYE ASSOCIATES 1378 SE 17 th Street, Fort Lauderdale, FL 33316 Tel: (954)467-6227 Fax: (954) 467-1488 Schwartzeyedoc@gmail.com Date: Gender: male female Name: Date of Birth: Age: Home address:
❶ PATIENT INFORMATION: ❷ WHO MAY WE THANK FOR REFERRING YOU TO OUR PRACTICE? ❸ RESPONSIBLE PARTY INFORMATION: PATIENT SIGNATURE DATE
❶ PATIENT INFORMATION: DATE WORK PHONE PATIENT S NAME ADDRESS HOME PHONE EMAIL BIRTH DATE AGE CELL PHONE GENDER: MALE FEMALE ❷ WHO MAY WE THANK FOR REFERRING YOU TO OUR PRACTICE? FAMILY / FRIEND NAME OFFICE
Preauthorization Form Request For Cashless Hospitalisation For Medical Insurance Policy
Aditya Birla Health Insurance Co. Limited Preauthorization Form Request For Cashless Hospitalisation For Medical Insurance Policy DETAILS OF THE THIRD PARTY ADMINISTRATOR (To be filled in block letters)
Anthem Blue Cross University of the Pacific Student Health Plan PPO with Student Health Center (100/80/60) Coverage Period: 08/01/ /31/2016
Anthem Blue Cross University of the Pacific Student Health Plan PPO with Student Health Center (100/80/60) Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: 08/01/2015-07/31/2016
IMPLICATIONS OF THE AFFORDABLE CARE ACT FOR COUNTY EMPLOYERS
IMPLICATIONS OF THE AFFORDABLE CARE ACT FOR COUNTY EMPLOYERS Mississippi Association of Supervisors Annual Convention Biloxi, Mississippi June 20, 2013 Presented by Leslie Scott MAS General Counsel Group
3/16/2018. Healthcare Cost : Why are they so high? Why should I understand? Health Care Spending per Capita 2016 OECD data (US Dollars) DC Gohn
Healthcare Cost : Why are they so high? Why should I understand? DC Gohn % of GDP 20 18 Health Care Spending as Percentage of GDP 16 14 12 10 8 6 4 Australia Canada Germany Japan Norway Spain Sweden Switzerland
Benefits and Premiums are effective January 01, 2019 through December 31, 2019 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY
The maximum out-of-pocket limit applies to all covered Medicare Part A and B benefits including deductible. Combined Annual Maximum Out-of-Pocket Amount (Plan Level / includes deductible) Annual Maximum
Kansas Legislator Briefing Book 2017
K a n s a s L e g i s l a t i v e R e s e a r c h D e p a r t m e n t Kansas Legislator Briefing Book 2017 E-1 Kansas Health Insurance Mandates E-2 Payday Loan Regulation Financial Institutions and Insurance
Prior Authorization, Pharmacy and Health Case Management Information. Prior Authorization. Pharmacy Information. Health Case Management
Prior Authorization, Pharmacy and Health Case Management Information The purpose of this information sheet is to provide you with details on how Great-West Life will be assessing and managing your claim
Welcome to our office
Welcome to our office I, the undersigned, realize that I am financially responsible for all services rendered to me by the Haben Practice for Voice & Laryngeal Laser Surgery, PLLC. For those insurances
Important Questions Answers Why this Matters:
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.anthem.com/ca or by calling 1-855-333-5730. Important
Important Questions Answers Why this Matters:
Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage for: Individual + Family Plan Type: PPO This is only a summary. If you want more detail about your coverage and costs, you
Standard Life And Accident Insurance Company: PremiumSaver
This is only a summary. This plan is supplemental to your group s major medical plan. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document
Prior Authorization, Pharmacy and Health Case Management Information. Prior Authorization. Pharmacy Information. Health Case Management
This document contains both information and form fields. To read information, use the Down Arrow from a form field. Prior Authorization, Pharmacy and Health Case Management Information The purpose of this
Student Health Insurance Plan Insurance Company Coverage Period: 08/15/ /14/2015
This is only a summary. If you want more detail about your coverage and costs, you can get the complete terms in the policy or plan document at www.studentplanscenter.com or by calling 1-800-756-3702.
Patient Registration. Patient Information. Guarantor Information (skip if same as patient) Emergency Contact Information. Insurance Information
Patient Registration Patient Information Patient name (Last, First) Patient date of birth Patient gender (M / F) Patient marital status Mailing address (address number & street) Patient Social Security
CLAIM FORM. CLAIM FORM PART A TO BE FILLED IN BY THE INSURED The issue of this Form is not to be taken as an admission of liability
CLAIM FORM CLAIM FORM PART A TO BE FILLED IN BY THE INSURED The issue of this Form is not to be taken as an admission of liability SECTION A DETAILS OF PRIMARY INSURED a) Policy No b) Sl. No/ Certificate
CHFP. Certified Healthcare Financial Professional (CHFP) Exam.
HFMA CHFP Certified Healthcare Financial Professional (CHFP) Exam TYPE: DEMO http://www.examskey.com/chfp.html Examskey HFMA CHFP exam demo product is here for you to test the quality of the product. This
Drug Reimbursement - Croatia. Roganovic Jelena
Drug Reimbursement - Croatia Roganovic Jelena Population: 4,292,095 (July 2017) Area: 56,594 km 2 Density: 75.8/km 2 21 counties http://www.lokalniizbori.com/wp-content/uploads/2013/04/hrvatska-%c5%beupanije.jpg;
Green Hills Plastic Surgery Stephen M. Davis, MD, FACS
Green Hills Plastic Surgery Stephen M. Davis, MD, FACS General Information Date: Patient Name: Date of Birth: Age: M.I. How would you like to be addressed by our office staff? Sex: Marital Status: Spouse
Cigna. Confirmed complaints: 5. Quality Overview. How Often Do Members Complain About This Company? Accreditation Exchange Product
Quality Overview Accreditation Exchange Product Accrediting Organization: NCQA Health Plan Accreditation (Exchange) Accreditation Status: Pending (214) Accreditation Commercial Product Accreditation Organization:
RULES OF TENNESSEE DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT DIVISION OF WORKERS COMPENSATION
RULES OF TENNESSEE DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT DIVISION OF WORKERS COMPENSATION CHAPTER 0800-02-06 GENERAL RULES OF THE WORKERS COMPENSATION PROGRAM TABLE OF CONTENTS 0800-02-06-.01 Definitions
Health Care Insurance in France : Its impact on income distribution between age and social groups
Health Care Insurance in France : Its impact on income distribution between age and social groups N Fourcade J Duval, R Lardellier, R Legal Drees, Ministry of Health and Social Affairs 1 Context : Two
Deep Dive Medicare Advantage Advance Notices Part I and II
Deep Dive Medicare Advantage Advance Notices Part I and II Noah Champagne, FSA, MAAA Noah Champagne is a consulting actuary in Milliman s New York office. Noah has a breadth of Medicare experience working
Calendar Year 2018 Benefits Program. Johns Hopkins Health System
Calendar Year 2018 Benefits Program Johns Hopkins Health System 1 Benefits Strategy Philosophy Benefits positioned to be competitive Benefit menu designed to provide choice, affordability and access Comparative
Secondary Insurance Co. Name & Address: Subscriber s Name: Subscriber Soc. Sec. No. Group number:
M a u r i c i o R o n d e r o s, D D S, M S, M P H I. PATIENT INFORMATION: Last Name: First Name: MI: Mr. Mrs. Ms. Male Female Birth date (M/D/Y): Marital status: Dr. Other: Address: City, State: Zip: