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▷ ▶ SPLIT GROUPS - MEDICARE ADVANTAGE SelectSmart.com free Business flowcharts and decision trees.
A SelectSmart.com Flowchart by LM1234. See LM1234's 4me blog page.
Viewed 164 times. Created August 2015.
This SelectSmart.com Business flowchart, a free online decision tool is a creation of LM1234 and for amusement purposes only. The implicit and explicit opinions expressed here are the author's. SelectSmart.com does not necessarily agree.
BusinessSPLIT GROUPS - MEDICARE ADVANTAGE
By LM1234
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Split Groups

                 
 
 
Identify split groups
 
 









 
 
Contact each group and request they complete Hospital Verification Form for their physicians or attest which physicians do and don't admit to an MA hospital
 
 









 
 
Do all applicable provider specialties admit to MA hospital
 
 




YES


NO



 
Complete maintenance as needed for CPIMS, eVIPS, workbooks.
 
Send letter to provider group to serve as notice that affected provider(s) have 90 days to obtain hospital privileges in order to be MA.
 









 
 
 
Complete maintenance to load affected provider as MAN (non-MA).
 









 
 
Confirmation received that hospital privileges have been obtained
 
 





YES




 
 
Complete maintenance to load affected provider as MAP (contracted with MA). Send maintenance to update Vistar/eVIPS to show updated hospital privileges