CHA News Article

CMSP Announces New Third-Party Administrator
New provider participation agreements to be established in early 2015

The County Medical Services Program (CMSP) has announced that Advanced Medical Management, Inc. (AMM) will serve as the new CMSP third-party administrator for dates of service beginning April 1, 2015. Anthem Blue Cross will continue to provide CMSP with administrative services through the end of March 2015. AMM’s new administrative responsibility will affect the authorization of CMSP medical and dental services and the processing and payment of CMSP claims beginning with April 1, 2015, dates of service.

In early 2015, AMM will reach out to establish new CMSP provider participation agreements with hospitals, community health centers, physicians and other providers that have contracted under Anthem to serve CMSP members. CMSP indicates the terms of the new provider agreements will be substantially similar to the provider agreements now in place with Anthem. It is important to note that current CMSP provider rates will be continued. In addition, CMSP will continue its relationship with MedImpact as its pharmacy benefits manager.

Following provider contracting, AMM will help providers establish and follow the new processes for CMSP benefit authorization and payment. In early spring of 2015, the CMSP Governing Board will provide webinar trainings for county social services departments about the change to AMM, including information about the member notification process and new member ID cards.

As part of terminating its CMSP administrative responsibilities, Anthem has begun notifying providers about the upcoming change and the need to terminate the provider’s CMSP agreement with Anthem Blue Cross. The provider notice is available on the CMSP website.

Providers should visit CMSP’s website at www.cmspcounties.org/providers/providers.htm for additional updates about the change.

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