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News & Press: Insurance/Provider

FIRST SecureCare Monthly Report Card issued May 16, 2019

Thursday, May 23, 2019   (0 Comments)
Posted by: Sheri Ryan
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The first report cards issued by SecureCare were sent to all Aetna of Alaska providers on May 16, 2019 via email.  Each individual doctor should have received their report card at the email address used at sign-up.  The current report is not available via your online portal.  Report cards will continue to be emailed for the next couple of months until the new online SecureCare portal is ready.  

 

If you are a participating provider in-network with Aetna and have not received your report card email, please check your spam/junk folder for an email dated 05/16/2019 from Provider Services with the subject SecureCare Monthly Report Card.  

 

 

Sample report card:  

 

Dear Dr. First Name Last Name, 

 

Each month, SecureCare participating providers receive monthly report cards as part of our utilization management (UM) process. Our UM objective is to ensure that all in-network providers are practicing within the established network benchmark and utilizing the appropriate level of care for patients from a clinical necessity standpoint.

 

The report card data shows how your averages compare with the total Aetna Alaska network based on a specific clinical benchmark- allowed dollars per patient. To retain in-network status, providers must remain in compliance with the allowed dollars per patient benchmark at the January and July reporting periods each year. Your first report card is below.

 

Aetna Alaska Provider Report Card

April 2018 – March 2019

 

Metrics

First Name Last Name, DC

Clinical Benchmark

Services per visit

1.93

 

Visits per patient

1.67

 

Allowed dollars per visit

$159.24

 

Allowed dollars per patient

$265.40

$1,250 per patient average

Number of patients

9

 

 

 

Providers who remain in compliance during the designated reporting period will be allowed to practice with minimal oversight. If you are out of compliance when the July report card is released, you will be identified as an outlier and be required to submit medical records for review to determine if the care being provided is necessary. It is our commitment to work with each outlier provider and assist them back into compliance so that they can remain in-network.

 

If you have questions regarding your report card or the UM process, please contact Provider Relations at providerservices@securecarecorp.com.

 

Best regards, 

 

 

Mark A. Knoll, DC

Medical Director

SecureCare, Inc.  

 

--

 First Name, Last Name, DC


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