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Mountain State has established a Provider Advisory Committee (PAC) to afford providers a mechanism to offer recommendations and comments to the Plan on provider billing, coding, and administrative issues.
The PAC may also serve as a forum to discuss regional or national issues regarding interactions among providers, their patients and health plans. This may include exploring ways to improve health care delivery, clinical quality, cost-effectiveness of services, communication and cooperation. Mountain State may also seek input from the PAC on proposed new initiatives or changes to existing programs that may affect providers.
The PAC will not address individual provider billing disputes or Mountain State medical policies, reimbursement levels, eligibility, or coverage rules.
At least a majority of PAC members will be participating
providers in Mountain State's networks. At least three members
will be selected from nominations submitted by the West Virginia
State Medical Association. Members will represent different
specialties and geographic areas, and include provider representatives
who deal directly will billing, coding, and plan administrative
issues.
Interested providers may attend PAC meetings either in person or via conference call. However, if it becomes necessary for the Committee to discuss personally identifiable health information or proprietary information, all non-PAC members except Mountain State employees will be excused from the meeting prior to the discussion of such information, in order to comply with federal and state privacy requirements or to protect proprietary information of the Plan.
A provider may submit an issue for consideration by the PAC by sending written comments, either by letter or email, to:
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