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Insurance Update - 1.27.2016
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We are still very optimistic about the two relationships we are focused on right now; CareSource and Medical Mutual. You will see all of the activity happening below.

 

Aetna – The OSCA has been receiving complaints about Aetna’s denials for medical necessity.  We are currently working on putting together a sit down with Aetna’s review department and a few of our members.  We are hoping to better understand Aetna’s policy on medical necessity so we can more adequately train our members. We are hoping to have this meeting in February.

 

Ohio Health Choice – We are working to set up another face to face meeting with them to figure out how to move this along.  We have had great feedback from them on working together but things have seemed to stall.  Hoping a face to face will speed things up.  Looking to have this meeting in February.

                                                                                                    

Custom Design Benefits – This connection has been put on hold until we can finalize the relationship with HealthSpan. CDB is connected to them already and felt that having a direct relationship outside of HealthSpan would create issues later.  Our team agreed and we will be working with HealthSpan to make this happen. – No New Update

 

HealthSpan – The meeting schedule for January 13th has been rescheduled for February 12th.  We hope to continue moving the relationship along. – No New Update

 

Care Source – The face to face meeting has been schedule for January 27th.  We will have the CEO and Medical Director from SecureCare in attendance at this meeting.   We are optimistic that we will have true timeline after this meeting.  No New Update

 

Paramount / ProMedica- The meeting scheduled for January 19th has been rescheduled for February 16. – No New Update

 

Molina – Still trying to rekindle these talks.  Still not sure what causes them to stop communicating.  No New Update

 

MMO – We are in an email conversation with MMO right now.  Things are looking very good as we continue to drill down the specifics of the possible relationship. We are working on scheduling a face to face meeting in February.   


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