medical provider network update leah hole-marshall, acting health services analysis program manager...
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Medical Provider Network Update
Leah Hole-Marshall, Acting Health Services Analysis Program ManagerJanuary 2014
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Application Processing Status
Network Enrollment (as of Jan 1, 2014):
Status Number of providersApproved 19,255
Provisional 293Nonprovisional: (In Process App) 700
TOTAL APPROVED OR PENDING DECISION 20,248
All Approved and Provisional providers can currently bill and be paid for ongoing care for injured workers. In process applications that are not provisional can provide initial visit only.
99% of open claims have an approved or provisionally approved attending provider.
Latest MPN Statistics- Providers as of 1-8-14
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550; 3% 150; 1% 300; 1%
19300; 95%
Application in processOtherProvisional StatusApproved
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Status of denied applications – through January 1, 2014
Providers
Providers Initially Denied* 133
Providers Approved on Reconsideration 28TOTAL PROVIDERS WITH FINAL OR PENDING DENIAL 71
Denial Final & Implemented 54
Denial Pending or in Reconsideration 17
TOTAL PROVIDERS WITH FINAL OR PENDING DENIALS 73
* Excludes 34 applications withdrawn after initial denial.
NOTE: Proportionate additional denials are expected as more applications are reviewed. The overall denial rate is currently 0.3%.