Whether it’s identifying and fighting unfair payment practices, improving the efficiency of your practice, or negotiating payor contracts, we have tools and resources to help.
Tool Kits
- Taking Charge: Steps to Evaluating Relationships and Preparing for Negotiations - A Focus on Payor Contracting
- Best Practices: A Guide for Improving the Efficiency and Quality of Your Practice
- CMA Balance Billing Advocacy Tool Kit
- Medicare Enrollment Guide for Individual Physicians
Publications
Know Your Rights
- Know Your Rights: Timely Payment
- Know Your Rights: Timeframes to Appeal
- Know Your Rights: Quick Guide for Appeals
- Know Your Rights: Identify and Report Unfair Payment Practices
- Know Your Rights: Filing a formal complaint with the regulator
Payor Contracting
- Blue Shield Contract Analysis
- Taking Charge: Steps to Evaluating Relationships and Preparing for Negotiations - A Focus on Payor Contracting
- Contract Amendments: An Action Guide for Physicians
- CMA Analysis of Major Health Plan Contracts
- Anthem Blue Cross Prudent Buyer Contract Analysis
- Blue Cross Survival Tool Kit, July 2007
- United Healthcare Contract Analysis, January 2007
- PacifiCare/United Healthcare Survival Kit, August 2007
- Health Net Contract Analysis
Billing/Coding
- CMA Medicare Consultation Code Billing Guide
- CMA Managed Care Consultation Code Quick Reference Guide, Updated October 2011
Sample Letters, Checklists and Worksheets
- Financial Impact Worksheet
- Payor Solvency Checklist
- Sample Tracking Sheet: Health Plan Acknowledgement of Receipt of Claim
- Sample Termination Letter - Patient
- Sample Termination Letter - Material Modification to Contract
- Sample Letter - Request for Complete Fee Schedule and Detailed Payment Rules
- Sample Letter - Request for Copy of Signed and Executed Contract, Complete Fee Schedule and Detailed Payment Rules
Other Resources
- Special Investigations Unit Audit Guide
- CMA Timely Access Guide
- Anthem Blue Cross Important Changes: What They Mean to Your Practice
- Comparison of Anthem Blue Cross Access Standards
- LaSalle Medical Associates: Important Changes
- Medicare Electronic Prescribing (eRx) Overview
- Medicare Part B 2012 Important Changes: What They Mean to Your Practice
- 5010 Quick Reference Guide
- Patient Handout: FAQ About Accountable Care Organizations (ACOs)
- Heritage California Accountable Care Organization (ACO) Physician Frequently Asked Questions