Split Groups
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Identify split groups
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Contact each group and request they complete Hospital Verification Form for their physicians or attest which physicians do and don't admit to an MA hospital
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Do all applicable provider specialties admit to MA hospital
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YES
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NO
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Complete maintenance as needed for CPIMS, eVIPS, workbooks.
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Send letter to provider group to serve as notice that affected provider(s) have 90 days to obtain hospital privileges in order to be MA.
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Complete maintenance to load affected provider as MAN (non-MA).
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Confirmation received that hospital privileges have been obtained
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YES
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Complete maintenance to load affected provider as MAP (contracted with MA). Send maintenance to update Vistar/eVIPS to show updated hospital privileges
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SPLIT GROUPS - MEDICARE ADVANTAGE
