Check the Comprehensive Client List for Auto Insurance Clients active in your state!

First Health services offered to auto insurance payers:

• The First Health® Network Providers

• Bill Review Services

• First Health Clinical Management

Eligible auto insurance patients include:

• Auto insurees with medical payments coverage (check with the auto carrier on benefit amount)

• Patients who settled a third party claim with their agreement to seek medical care ONLY from The First Health® Network providers.

Patients are actively directed to First Health providers:

• Letters and brochures from the auto insurers promoting the use of First Health providers

• Look for The First Health® Network logo on auto insurance ID cards (unless prohibited by state law)

• Network provider information is available to both auto patients and their agents via a toll free telephonic directory

• Benefit incentives provided based on auto coverage purchased

Provider payment for care rendered to auto insurance patients accessing The First Health® Network is:

• Based on your group health rates (subject to usual and customary adjustments) unless your state has mandated an auto insurance medical fee schedule

• Hawaii, New York, New Jersey, and Pennsylvania have mandated auto insurance medical fee schedules - payment to network providers in those states is based on the discount contained in your provider agreement

Provider identification for claims pricing:

• To ensure claims are priced correctly and patient benefits are appropriately applied, First Health considers three demographic variables when identifying network versus non-network providers.  Because provider address and Federal Tax Identification Numbers (FTIN) change and many names are similar, the process of identifying network providers becomes very complex.  Therefore, First Health has developed a series of reviews which match the submitting provider's FTIN, name and/or address against our participating provider database.  The matching process is a "step-wise" procedure which seeks to match on as many variables as possible.  Ultimately, however, the key variable in the matching process is FTIN.

• As this description of the First Health provider matching process implies, billing under an FTIN other than that in your First Health record can create significant issues for you and your First Health patients.  If your FTIN does change, please be sure to notify our Provider Relations staff at (800) 937-6824.

Locate the names of First Health Auto Insurance Payers (denoted as having Plan Type "D") and other key administrative information on the Comprehensive Client List.

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