WPPA ProviDRs Care is excited to announce that effective February 1st, 2012, HCA has completed the acquisition of Galichia Heart Hospital. As an integrated component of Wesley Medical Center, the 82-bed facility at 2610 N. Woodlawn will now be an in-network hospital for WPPA ProviDRs Care Network.This is a great complement to our existing contracting facilities in Wichita. In addition to the main hospital at Central and Hillside, Wesley also has a standalone emergency department on the west side at 13th and Tyler.What does this mean to our members?• A third ER in Wichita• Another hospital that provides inpatient and outpatient state of the art medical technology• All services provided by Galichia Heart Hospital will now be preferredFor more information, contact (316) 683-4111 or (800) 801-9772.
Galichia Heart Hospital is now preferred with ProviDRs Care Network
Online Claim Status Now Available
ProviDRs Care customers can now check claim repricing status online. With the recent launch of our new software, online claim repricing status can be accessed at http://services.providrscare.net/BizServ/MedClaimSearch.aspx. This new feature was created to inform medical providers of the repricing status of claims. Due to regulations and issues of privacy (including HIPAA), there is a limit to the information that is provided on this site. ProviDRs Care is a Preferred Provider Organization; not a claims payer. If payment information is needed regarding a claim repriced by ProviDRs Care , please contact the payer. For additional information regarding the repricing of a claim or for assistance using this new feature, please contact our ProviDRs Care Claims Department at 800-801-9772.
Providers can submit EDI claims using Emdeon
ProviDRs Care is pleased to announce that our providers can now submit EDI claims through Emdeon. Providers using Emdeon should submit to Payer ID 48100. We encourage providers to submit their claims electronically to eliminate paper and postage and to expedite the delivery of the claim to the payers for processing. If assistance is needed, please contact ProviDRs Care Claims Department at 800-801-9772 or your Emdeon Account Representative.
ClaimEDIx software suite launched to manage network operations
ProviDRs Care, a leading preferred provider organization (PPO) network serving Kansas and western Missouri, went “live” May 2 with new operational software from ClaimEDIx, Inc. of Kansas City, MO. ProviDRs Care is owned by the Medical Society of Sedgwick County and headquartered in Wichita
The ClaimsEDIx system — MCO Pro software suite — supports inbound and outbound electronic data interchange (EDI), claims repricing, provider maintenance, fee schedule and schedule modeling, billing and remittance and sales support as well as customer service. The new system centralizes all the PPO’s data and supports all departments.
“The MCO Pro system will enable us to provide greater efficiencies and service to all of our partners, including physicians, insurance companies, third party administrators, employers and brokers” said Karen Cox, chief operating officer, ProviDRs Care. “We now have access to more and better data that is essential as we continue enhancing our high performing network.”
“We are delighted to have the opportunity to work with ProviDRs Care and are confident that we can assist them in streamlining their PPO operations, increasing productivity, lowering costs while still delivering the level of customer service and savings they are well known for,” said Mark Winner, co-founder, ClaimEDIx Inc.
About ProviDRs Care
ProviDRs Care, formerly known as WPPA and operational since 1985, is the only physician owned PPO network in Kansas. ProviDRs Care is accessed by insurance companies and self-funded employers for discounted health care services and utilization review. It has contracts with 2,039 primary care, 3,122 specialists, 144 acute care hospitals throughout Kansas and adjoining states. Visit http://www.providrscare.net/ to learn more.
About ClaimEDIx, Inc.
Founded in 2004 in Kansas City, MO, ClaimEDIx specializes in EDI claims repricing and transmission, database design, web applications, and administration software for the managed care community. Since its release in June 2010, the MCO Pro software suite has become the company’s flagship product and is currently utilized by PPO networks operating in nine states. MCO Pro affords PPOs a single application built upon a single database interfaced by all departments. With “auto-repricing” benchmarks over 80% and a single claims processor handling over 1m000 claims daily, the highest cost center for a PPO can be alleviated. The MCO Pro system is 4010 and 5010 compliant. Visit www.claimEDIx.com for more information.
ProviDRs Care announces new product
ProviDRs Care, the only physician-owned preferred provider organization (PPO) in Kansas, has created a new network option, effective January 1. Called ProviDRs Care Plus, the new network offers Kansas Heart Hospital as an additional hospital choice. Work is underway to include more specialty facilities to the new Plus network.
Self-funded employer plans and insurance companies can select either ProviDRs Care Plus or its current PPO option, ProviDRs Care Network.
“By developing ProviDRs Care Plus, we’re responding to the needs of many employers and insurance companies who want to offer more facility options in their employee benefit packages,” said Karen Cox, chief operating officer.
“The Kansas Heart Hospital is proud to partner with ProviDRs Care. Over the past 12 years we have delivered outstanding cardiovascular care to patients from Wichita and the state of Kansas. Now ProviDRs Care can offer this service to their enrollees as well,” said Dr. Greg Duick, President and Chairman of the Kansas Heart Hospital.”
Affiliated with the Medical Society of Sedgwick County, ProviDRs Care includes over 4,200 physicians, 143 hospitals, 1,400 ancillary providers and 580 outpatient facilities serving covered individuals in four states and 103 Kansas counties. For more information, contact Karen Cox at 316-683-0665.
Via Christi announced acquisition of Wichita Clinic
Via Christi announced today (December 9, 2010) that it has finalized the acquisition of the Wichita Clinic. Over a “yet-to-be-determined period of time”, the Clinic’s 13 locations in the Wichita metropolitan area will change their names to Via Christi Clinic. This change will not effect the participation of the Wichita Clinic in ProviDRs Care Network nor will it affect where our members seek services. For more answers to frequently asked questions, please see the list of questions and answers below:
1. Do I need to change doctors if my health insurer doesn’t currently contract with Via Christi? No. Patient preferences and insurance requirements will continue to be honored by Wichita Clinic.
2. Do I still have a choice of hospitals? Yes. Patient preferences and insurance requirements will continue to be honored by Wichita Clinic.
3. Does my Wichita Clinic physician have to refer me to a Via Christi specialist? No. Patient preferences and insurance requirements will continue to be honored by Wichita Clinic.
4. Do I have to change doctors if my health insurance company requires me to use a hospital other than Via Christi? No. Patient preferences and insurance requirements will continue to be honored by Wichita Clinic.
5. Via Christi is not an in-network provider in my medical plan. Does that mean Wichita Clinic is no longer an in-network provider for my plan? No. You will still be able to use Wichita Clinic services.
6. What should patients do if they have questions about whether specific services will continue to be available from their Wichita Clinic doctor? Each patient should discuss their individual medical and service needs with their own physician.
Rehabilitation hospital earns 2nd certification
BY KAREN SHIDELER
The Wichita Eagle
Wesley Rehabilitation Hospital has earned a Gold Seal of Approval for its stroke rehabilitation program. The disease-specific certification comes from the Joint Commission, the organization that accredits and certifies health care facilities and their programs. The certification is for two years and was effective April 7, 2010, according to the Joint Commission. Click here to read more…
Formation of the ProviDRs Care Physicians for Change Task Force
As you may know, ProviDRs Care is the physician-managed PPO under the Medical Society of Sedgwick County. The new ProviDRs Care Physicians for Change Task Force is composed of experienced, respected physicians who are committed to exploring how the role of the physician can contribute to the numerous efforts currently underway to improve health care access, cost and quality in Wichita.
Click here for more information about the Task Force.
Wichita Business Coalition on Health Care Publishes Comparison of Area Hospitals
Hospital care represents the most expensive single component of health care costs, consuming nearly one-third of the health care dollars spent in America. One of the keys to reducing the cost of hospital care is to improve the quality of care and assessing hospital quality is important. This Data Brief is the first in a series of publications planned by the Wichita Business Coalition on Health Care to provide information about our region’s health, health care and quality performance. This issue will provide an overview of publicly available information about hospital performance.
Click here for Data Brief.
ProviDRs Care Network announces new agreement with Wesley Medical Center effective October 15, 2009
Wesley Medical Center and ProviDRs Care Network have reached a new agreement effective October 15, 2009. This agreement provides even deeper discounts and exceptional value in a changing provider environment. With health care trends nationally approaching 10% and changes in the Wichita provider and insurer landscape, ProviDRs Care Network is committed to keeping health care costs competitive.
Wesley Medical Center has been ProviDRs Care Network’s preferred hospital in Wichita since January 1988. The 21 year partnership between Wesley Medical Center and ProviDRs Care Network has been one with a common goal. The goal is to deliver the most cost-effective health care to our employer groups. As our continue partner, Wesley Medical Center has supported our efforts to improve savings to all of our customers.
Our valued partnership with Wesley is evident with our new agreement. The employer groups and their employees that access Wesley through our network will see a significant savings as well as enhanced services and technology. The latest enhancements are the new Cath and EP labs and DaVinci robotic surgery technology.
Wesley Medical Center has a long list of services and accreditations. These services include: Level 1 Trauma Center; Level 3 Neonatal Nursery; Wichita’s only Pediatric ER; Certified Stroke Center and Accredited Chest Pain Center; a new surgical weight loss program; the area’s only Gamma Knife and advanced radiation oncology treatment with the new Trilogy system.
For questions or information, contact Karen Cox (KarenCox@ProviDRsCare.Net) or Cheryl Tibbetts (CherylTibbetts@ProviDRsCare.Net) or call (800) 801-9772.
