PHO Provider Payer Summary

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PHO Provider Payer Summary
PHO Provider Payer Summary
Generated:
May 10, 2016
Provider:
PHO Effective Date:
~ Eastern Iowa Sleep Center, N/A
09/18/2007
Payer Name
Coventry Healthcare of Iowa
Coventry Healthcare of Iowa
Coventry Healthcare of Iowa
Coventry Healthcare of Iowa
Health Alliance Plan
Health Alliance Plan
Humana
Humana
Interplan Health Group
Medicaid
Medicaid
Medicaid
Midlands Choice
MMC Tiered Network
O'Hara
UnitedHealthcare
UnitedHealthcare
Wellmark
Wellmark
Wellmark
Wellmark
Product Name
Aetna/Coventry HMO & PPO
Coventry Carelink
Coventry Medicare Advantra
CoventryOne
Health Alliance Medicare Advantage
Health Alliance Plan PPO
Humana ChoiceCare PPO & HMO Commercial
Humana ChoiceCare PPO & HMO Medicare Advantage
Interplan Health Group PPO
Medicaid Amerigroup Iowa, Inc.
Medicaid AmeriHealth Caritas Iowa, Inc.
Medicaid UnitedHealthcare Community Plan
Midlands Choice PPO
MMC Tiered Network
O'Hara Workers Compensation
Options PPO & Non-Options & RV Heritage
SecureHorizons Medicare Advantage
Unity Point/St. Luke's Employee Plan
Wellmark Blue Rewards UnityPoint HyVee
Wellmark HMO
Wellmark PPO
Status
Par
Par
Par
Par
Par
Par
Par
Par
Par
Par
Par
Par
Par
Par
Effective Date
09/18/2007
01/01/2014
09/18/2007
01/01/2014
01/01/2015
09/18/2007
08/01/2015
09/18/2007
09/18/2007
04/01/2016
04/01/2016
04/01/2016
09/18/2007
07/25/2013
09/18/2007
09/18/2007
07/01/2009
Par
Par
01/01/2015
09/18/2007
09/18/2007
Par
Comments
Narrow Network - Out of Network
Payer loads as department of hospital
Tier 2
Payer loads as department of hospital
EISC Directly Contracted w/ UnityPoint
Narrow Netwrok Tier 2

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