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Network Operations

Directory Updates

CMS routinely audits Medicare Advantage (MA) online provider directories. CMS issues compliance notices to health plans if it determines the plan’s provider directory is inaccurate.

A person who enrolls in a health insurance plan relies on these online directories to access care. When the information is incorrect, it can create a barrier to members getting the healthcare they need.

Premier Health Plan’s provider directories must be updated every 30 calendar days, or the Health Plan can be sanctioned by CMS. Practices must provide accurate office location, phone number(s) and hours of operation data to PHG. It’s important to notify us when this information changes. Please communicate all provider changes (i.e. new providers, terminations, office changes, accepting new patients/not accepting new patients, etc.) to the PHG team using the Provider/Change of Address/Deletion Form. This form is now a fillable PDF file, which means you can type the needed information directly into the form on our website. Please email the completed form to PHG@PremierHealth.com or fax to (937) 641-7377.

Medical Pay Policies

Throughout the year, we update our Medicare and Commercial Policies and Procedures. Click on the links below to view the most recent policies and procedures:

Earn a $250 Quality Reward and CME Credits

As part of the Quality Reward Program, you will receive a yearly quality reward of $250 if you complete the PHG sponsored coding and risk adjustment training. In addition, you will receive CME credits. The training will focus on defining Risk Adjustment and the importance of accurate documentation and coding.

The first training is scheduled for the below time. Please note there are two times to accommodate schedules. You will need to register for this training. Registration details will be announced in the April provider brief.

April 26, 2018
Premier Health Center
2nd Floor, Conference Room 2
7:00-9:00 am OR 6:00 pm - 8:00 pm

Who should attend the training? Physicians, Nurse Practitioners, or Physician Assistants.

Back to the March 2018 Issue