December 12, 2018
Area(s) of Interest: Commercial Payors Payor Contracting Payor Issues and Reimbursement
On January 1, 2019, Blue Shield of California will complete the integration of Care1st Health Plan into its operations, and Care1st’s name will change to Blue Shield of California Promise Health Plan. The newly renamed health plan will remain a separate company and a wholly owned subsidiary of Blue Shield of California.
Care1st physicians serving Medicare Advantage HMO, Medi-Cal or Cal MediConnect members will not need to contract with Blue Shield of California to continue providing services, and participating physicians will receive a mailed contract amendment later this year that reflects the name change. The contract amendment only refers to the name change and will not impact reimbursement rates or other material changes.
In addition, the migration of member and provider data to improve information-technology infrastructure will result in several changes requiring some action on the part of current Care1st network providers, including new provider ID numbers, member ID numbers and member ID cards, as well as changes to submission processes for encounter data.
Greg Buchert, M.D., MPH, president and CEO of Care1st, and a California Medical Association (CMA) member for 27 years, has provided a Q&A for CMA members to learn more about the transition – learn more by downloading here.