2024 PrimeTime Health Plan Classic (HMO-POS)

• 6.1.2024 ST Criteria for Website PTHP

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• 7.1.2023 ST Criteria for Website

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• couple 8763070 1280

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• Provider Appeals

  Payment Appeal – A challenge or an ‘appeal’ related to benefit/payment denials by the Medicare health plan that results in zero payment being made to the non-contracted Medicare health plan provider. Examples include: Benefit Determinations Medical necessity issues Coverage issues related to nation and/or local coverage determination policies Claims Payment Dispute – Any decision…

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• PrimeTime Code of Business Conduct and Ethics

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• H3664 CovDeterm3 C

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• 2024 PTHP Basic MA Only Annual Notice of Change

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• Medical Determinations Grievances or Appeals Information

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• Hedis HMO 21 p 800

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• 5.17.2023 Akorn Products

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