Health Insurers

Medicare

• Medicare Toolkit for Your Practice 

Organizations

• Centers for Medicare and Medicaid Services (CMS)
  • Physician Resource Center
  • Practice Administration Resource Center
  • Physician Quality Reporting Initiative Tip Sheet [PDF]
• Noridian—Medicare Part B Carrier for Washington
• SHIBA HelpLine

Billing, Coding, Coverage, and Payment Resources

• Advance Beneficiary Notice [PDF]
• Billing and Coverage Policy
• Covered Medical and other Health Services
• Physician/Practitioner Billing
  
• Compliance Guidance for Small Practices
• Compliance Guidance for Third Party Medical Billing Companies [PDF]
• Conversion Factors
• Consultations vs. Referrals (Noridian Medicare Policy) [PDF]
• E&M Documentation Guidelines (1995 and 1997 Versions)
• E&M Services Guide [PDF]
• Medicare at a Glance Fact Sheet
• Opt Out: Objective Guidance for Physician Practice [PDF]
• Physician Guide: A Resource for Residents, Practicing Physicians, and Other Health Care Professionals [PDF]
• Preventive Services for Physicians, Provider, Suppliers, and Other Health Care Professionals
• Provider Identifiers
• UPIN Look-up - Be aware that UPINs are no longer issued and will be replaced by National Provider Identifiers on May 23, 2008.
• NPI Registry - Allows you to search for individual or organizational provider NPIs
  

Programs

Part B

• Medicare Private Fee-for-Service Plans

Part C – Medicare Advantage (Managed Care)

• Advantage (Managed Care) Fact Sheet
• Medicare Advantage and Cost Prescription Drug Plans - Washington [PDF]

Part D – Prescription Drugs

• Medicare Part D Stand Alone Prescription Drug Plans [PDF]
• Resources on the Medicare Prescription Drug Benefit
• Part D Resource Sheet [PDF]
• Part D Formularies via Epocrates
• Part D Formularies via Medicare.gov
• Prescription Drug Coverage - General Information

Medicaid

• Conversion Factors
• Health and Recover Services Administration
  • Tamper-resistant Prescription Pad [PDF]
  • Provider Publications (Numbered Memos)
  • Washington State Agency Medical Directors' Group
    
• Medicaid Healthy Options (Managed care)
  • Community Health Plan of Washington (CHPW)
  • Molina Healthcare of Washington
• Opt Out: Objective Guidance for Physician Practice [PDF]

Washington Department of Labor and Industries:

Industrial Insurance (Workers Compensation)

• Conversion Factors
• Washington Department of Labor and Industries (L&I) Medical Provider Topics
• Fee Schedule Information
  

Washington State Health Care Authority

• Conversion Factors
• Basic Health
• Health Information Infrastructure Advisory Board (HIIAB)
• Health Technology Assessment Program (HTA)
  
• Uniform Medical Plan
• Washington State Agencies Technical Advisory Group (TAG)

Commercial Insurance

• Medical Directors of Washington Health Insurers [PDF]
• Aetna
• CIGNA
• First Choice Health Network
• Group Health
• KPS Health Plans
• PacifiCare
• Premera Blue Cross
• Regence BlueShield
• United Healthcare

• WSMA Coding and Billing Assistance/Advocacy
• Practice Management Seminars/CEUs
• Health Insurers
  • Medicare Practice Toolkit
• Practice Management Operations
• Products and Services