To provide high quality medical care in a cost effective manner by utilizing services at the right time, in the right setting.

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Please note that this manual may change at any time. For current manuals, please visit Anthem:

Please retain a copy of this assessment with each patient record, and update the assessment yearly. Staying Healthy

CCS Application.pdf

SNMA Master Contract List

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Master Contract List

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August 2013

January 2014

Pay for Performance

Pay for Performance Overview

CPT Category II Codes Tip Sheet

2011 Manual

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Utilization Management

Sierra Nevada Medical Associates’ Authorization/Utilization Management department is comprised of health care professionals who are trained in the policies and procedures developed by the health plans and regulatory agencies that will be used when a prior authorization for a service your physician ordered are needed. The final decision is based on reveiw and evaluation of information submitted from the requesting physician and/or obtained from review of your medical records. Specific care and treatment may vary depending on individual need and benefits covered under the individual’s plan. The criteria are available on request for specific treatment. The Authorization/Utilization department can be reached Monday-Friday during standard business hours at the following phone number (530) 271-3200.

Sierra Nevada Medical Associates’ contracts specifically prohibits the use of incentives for its utilization management programs or coverage determinations. Bonuses or incentive pay is not used in any way to influence a practitioner’s decision to withhold, delay or deny necessary medical services. Any financial incentives used for Utilization Management is not linked or used to encourage decisions that result in under utilization.