decisionhealth Newsletters, Part B News - 2002 Issue 10 (October)
CMD can be a great asset to practices, but communication is key
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Article Overview
This article explains the role of carrier medical directors in physician-payer communication and why practices may benefit from building relationships with them. It covers general approaches for raising Medicare concerns, using medical societies and advisory committees as communication channels, and improving coordination around claims denials, payment delays, and local medical review policy discussions. The piece is aimed at physicians, practice managers, compliance staff, and medical society leaders interested in Medicare administration and carrier relations.
Why This Topic Matters
Understanding how to communicate effectively with a carrier medical director can help practices navigate recurring claim issues, raise concerns through the right channels, and stay informed about regional Medicare policy discussions. The article is relevant to practices seeking better payer relationships and clearer communication pathways.
Article Sections
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Practitioner relationship with the carrier medical director
Introduces the role of the carrier medical director and describes why practices may seek out that relationship. It frames the discussion around general Medicare communication and claims concerns.
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Tips for using medical director communication channels
Outlines broad suggestions for when and how practices should contact the medical director versus other available resources. It also discusses the role of medical societies and carrier advisory groups in raising concerns.
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Regional communication, responsiveness, and practice advocacy
Describes differing views on responsiveness, geographic reach, and communication practices across a region. It also addresses how information may be shared among practices and specialty groups.
What You Will Learn
- How carrier medical directors fit into Medicare-related practice communication
- Which general concerns are appropriate to raise through medical director channels
- How medical societies and advisory committees can support communication with payers
- Why responsiveness and geography can affect practice-payer coordination
- How practices may use communication to address claim and policy concerns
Who Should Read This
- Physicians
- Medical practice managers
- Compliance staff
- Billing and coding professionals
- Medical society leaders
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