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31 11/2005
9. Completion of Recredentialing Requirements
It is important to note that provider involvement in many of the above mentioned
activities is a requirement for continued network participation. To this end, we
encourage providers to be receptive and respond in a timely manner whenever written
informational requests related to monitoring of these activities are received by your
facility. If you have any questions or desire additional information regarding
standards of participation, please contact your senior network specialist. In addition,
review of your contract for participation may provide additional clarification regarding
requirements for participation in QI activities.
Health Improvement Programs
BCBSHP has worked with panels of medical providers and experts to develop Health
Improvement Programs (proactive programs) aimed at specific disease states.
Presently we have programs for diabetes, congestive heart failure, asthma (children
and adults ages 2-56)) and prenatal care [Baby Connection]. These programs are
available to all fully insured HMO/POS /PPO members.
These programs are intended as an extension of your plan of treatment and are
geared toward the provision of educational information and facilitation of services. As
we identify potential program candidates, you or a member of your office will be
contacted to ensure that it is appropriate for the member to participate. Program
participation is voluntary.
If you have any questions, comments or would like more information regarding our
programs, please contact the Department of Health Improvement Resources at (800)
638-4754 from 8:00 AM through 6:00 PM or email us at
caremanagement@bcbsga.com.