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Value Options?

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PMRNC:
To clarify, many NY providers are saying they are NON par with "OBAMACARE" when in all actuality they have an all payors clause in the contracts they signed with the insurance companies offering up exchange plans in NY. They are seeing this very problem in other states too.   

Christy:
thanks ladies!!

Linda, so you are saying that even though the claims go through VO, the pay rate is dependent on the actual carrier?

Since I am relatively new to mental health, I am wondering with VO- who does the actual payment come from, VO or the carrier?

PMRNC:
Value Options is one of the largest MH TPA's in the country, they are a Third Party Admin with clients such as GHI, many unions, and really big companies. They actually have a page that outlines ALL of their networks. http://www.valueoptions.com/providers/Network.htm

An example is that Value Options took over administration of the Empire Plan (NY) we were PAR with the Value Options Network but we still had to complete another enrollment in addition to webinar that providers had to take for credentialing in this plan. The ones who didn't could still maintain VO status but authorizations and in some areas fee-schedules were reduced. Confusing but like I said if you take the time to review ALL of the provider contracts your client has you will be the better for it.

Christy:
thanks, Linda. You are always a big help! :)

Christy:
I have another Value Options question?

I see that VO assigns their own id # to each patient, which is different than the patient's actual id# with their individual carrier. Can we submit claims with the carrier id# or only the VO id#?

How do you obtain the VO id#?

I have never seen this with any other TPA?

help!

thanks!

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