BusinessSPLIT GROUPS - MEDICARE ADVANTAGE
A SelectSmart.com Flowchart 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