New Doctor Office Incentives

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Presentation transcript:

New Doctor Office Incentives

Doctors Incentives details Higher Capitation (with minimum 20 patient transfers/new enrollments) $150 Medi/Medi $120 Medicare Only Transfer Bonus (for transfers with effective dates of September 1st - January 1st 2016) $200 For Medi/Medi /Medicare

Doctors Incentives details continued Customer Service 800 number available for members for help with transferring IPAs & Health Insurance / Eligibility/ Medi-cal/ LIS questions Increase patient retention/Satisfaction Reduce doctor office customer service calls Marketing In office poster/blue cards Patient welcome letter/customer service introduction Marketing pieces around community introducing doctor with Picture/CV (Curriculum Vitae)

Office Managers Are Rewarded too Office Managers Are Rewarded too!!! Contest dates September 1st-January 1st Win a Kindle Fire with 20 new patient transfers/enrollments Win a 28 Inch Flat Screen TV with 30 new patient transfers/enrollments Win an Ipad Mini with 50 new patient transfers/enrollments

Medicare Utilization *The Average Medicare Member sees a Primary Care 6.85 sees a Specialist 3.15 10.0 times a year    The Average Medicare Payment = $65 per visit 65 x 6.85 = $445.25 445.25 /12 (months) = ** $37.09 pm/pm * Utilization per / 1000 ** Without a copay

Competitive Compensation Payment for all covered services for which Primary Care Physician is the responsible party, under each participating Health Plan, shall be made at a fixed capitation rate according to the following schedule: Medicare Advantage Enrollees $120.00 pm/pm Medi-Medi Enrollees - When Enrollee is assigned to the same PCP & IPA for both product lines $150.00 pm/pm -When Enrollee is NOT assigned to the same PCP & IPA for both product lines Will revert to appropriate Medicare Advantage or Medi-Cal Only Compensation * PCP must transfer 20 new Medicare or Medi/Medi patients to Doctors Choice Medical group in order to qualify for new higher capitation rate

PRO FORMA SHEET Based on Medicare & Medi-Medi Conversion Enrollment IPA Conversion Medicare  50 x $120 pm pm = $6,000.00 x 12 (months) = $72,000.00  Medi-Medi 50 x $150 pm pm = $7,500.00 x 12 (months) = $90,000.00 + 200 per member transfer/New Enrollee bonus= $10,000 bonus with 50 new members! Fee for Service (Medicare) 50 x $ 37.09pmpm = $ 1,854.50 x 12 (months) = $22,254.00

Medicare/Medi-Cal: They can select a new plan every month. Enrollment Periods Medicare: Open Enrollment October 15th to December the 7th; every year. Medicare/Medi-Cal: They can select a new plan every month.

Time to Get started… Here are some ideas of ways we can help you reach your goals and improve revenue - How Many Medicare Aged Patients does your practice currently have? -Do you have any clients that are aging into Medicare ? We can help them enroll in Medicare and assign them to Doctors Choice… each enrollment=1 transfer… -Do you have any clients with other IPAs that we can move over to Doctors Choice? Doctors Choice Customer Service can take care of everything for you. - Do you want your patients to sign up for Doctors Choice here in your office? We can send an agent out on a specific day each week to help them enroll in Medicare or simply to transfer IPAs here in your office. We would need a common area that is not a waiting room or treatment room such as an office or break room to get started. -Would you like Doctors Choice to help market in the area? Let’s get started… Who would you like to target? Medi/Medi, Medicare, Turning 65s? What radius around your office? Do you have a 2nd location? -Addendum/Agreement and time for action !