Select Health Network Provider Meeting December 11, 2018

Agenda Introductions Sagamore Health Network & Cigna – Cindy Railer New Plans for 2019 Anthem Medicaid Meridian ACOs St. Joseph County Government School City of Mishawaka Trinity Health Colleague Plan through Aetna

Select Medicaid Changes MDwise Select HHW/HIP termination Effective December 31, 2018 Anthem HIP and Hoosier Care Connect Effective January 1, 2019 Anthem HHW Effective February 1, 2019 Amendments to add Anthem Medicaid to your Select Agreements coming soon!

Anthem HIP and HCC Providers must first have an Anthem Medicaid contract to participate through Select No change in claims payment or claims address Upside Shared Savings Quality Measures Reduce Spend Bonus Potential

Anthem HHW Providers must first have an Anthem Medicaid contract to participate through Select Claims will be sent to and processed by CMCS Enhanced Fee Schedule Risk Contract Quality Measures Care Management Reduce Spend Bonus Potential

Meridian Medicare Advantage Plan Medicare Fee Schedule Sample ID Card

St. Joseph County Government Shared Risk ACO plan effective January 1, 2019 Dual Choice Network Claims Payor – Auxiant Claims Repricer – CMCS Fee Schedule – PPO-R w/ withhold Primary Care Provider Assignment Health Risk Assessment Select Care Management

St. Joseph County Government Prior Authorization List – Coming soon! Select Utilization Management Phone: 574-283-5911 or 800-634-9585 Fax: 574-283-5940 Email: UMDept@selecthn.com Online authorizations www.cmcs-indy.com

Online Authorizations

Online Authorizations

School City of Mishawaka Shared Risk ACO plan Claims Payor – SIHO Fee Schedule – PPO-R w/ withhold Primary Care Provider Assignment No change in prior authorization list for 2019 Health Risk Assessment

SCM – Sample ID Cards

Trinity Health Colleague Plan Claims Payor – Aetna 2019 Changes Shared Risk Fee Schedule Select Care Management

Questions?