Payer Relations and Contracting

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The Payer Relations and Contracting Department provides a central contracting function for the Lifespan system for contracts with non-governmental payers. The unified contracting function supports the mission of the New England Physician Alliance (NEPA) and the system affiliates which includes Miriam, Rhode Island, Newport, Emma Pendleton Bradley Hospitals and Lifespan Home Medical, a durable medical equipment provider.

The Department supports services and activities promoting partnerships internally and externally serving as a liaison between Lifespan and payers. We work with operational entities to maximize contract compliance and performance. We promote and maintain collaborative relationships and are a Managed Care resource for the Lifespan system and the members of NEPA, supporting activities to achieve success in a managed care environment.

Important Announcements

United Behavioral Health July 2010 Clinical Network Forum 06-16-10

NHPRI Partnering with MedSolutions 02-25-10

UnitedHealth Group-UnitedHealthcare acquisition of Health Net 03-01-10

Tufts Health Plan Coverage Updates for Commercial Products 02-012-09

Tufts Health Plan Radiation Awareness Initiative 02-012-09

Tufts Health Plan Nurse Practioner Contracting 02-012-09

Tufts Health Plan Physician, Outpatient Hospital Fee Scheduled Updated April 02-012-09

Tufts Health Plan Enhancements to Inpatient Mental Health Preregistration 01-02-09

Tufts Health Plan Update – New Commercial Coding Edit – Diagnostic and Radiology Services 12-24-08

Rhode Island Hospital now Blue Distinction Center for Bariatric Surgery 11/19/08