Managed Care Contracting
The LRPHO offers the following managed care contracting opportunities for its members. This includes delegated credentialing on behalf of these healthplans, therefore members do not have to complete a separate credentialing application.
Click on any of the links below to request enrollment information for each particular payor:
Plan Vista Solutions
PPO UHC (GEHA)
Private Healthcare Systems (American Lifecare)
As a reminder, upon receipt of a new contract offering, each member may:
- Enroll in the contract by completing and returning the “enrollment form” to the LRPHO.
- Decline the contract offering
- Ask the LRPHO to messenger a “counter offer” on specific codes to the payor.
- The request must be submitted to the LRPHO, in writing, on the member’s office letterhead.
- The request must clearly identify the payor(s) to whom the member would like the “counter offer” to be messengered.
- The request must include a list of the individual CPT codes and the requested revised rate(s).
The LRPHO will messenger the counter offer to the specific payor. The payor may then choose to:
- Accept the messengered counter offer.
- Submit a counter offer through the LRPHO for the member’s consideration
- Decline the messengered counter offer.
As always, providers/groups remain free to contract directly with any payor.