> Health Plan Search Tool: Provider Manuals, Policies, Physician Credentialing
Health Plan Search: Provider Manuals and Policies
AAPC has compiled data from over 500 local and national health plan's websites, provider manuals, provider policies, physician credentialing and medicare/medicaid eligibility. This new search tool will be available to all for a limited time, after which it will only be available to AAPC members.
Note: Some health plans require a provider ID and in those cases you will be directed to the page where you can enter your ID and continue using this tool.
- Step 3: Find your payer and select row for search capabilities for that payer or plan (if not already visible)
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In order to be effective in your search, we've collected some tips on how to perform an effective search:
- Narrow your search If the amount of results are too broad, there are two (2) ways to narrow them down. First, if you are searching the entire website, try just searching the provider manuals by checking the appropriate button below the search box. If the payer you are searching does not have policies made available publicly, this option will not be available. Second, try perform and exact phrase search by clicking the button just below the search box. Then try experimenting with your search terms by adding more specific phrases for your search.
- Broaden your search If the amount of results are not sufficient, there are two (2) ways to broaden them up. First, if you are searching just the provider manuals, try just searching the entire website by checking the appropriate button below the search box. Second, if you are searching using the "exact phrase" button selected, try performing a search with "any keyword" by clicking the button just below the search box. Then try experimenting with your search terms by using more generic phrases for your search; don't rely on the suggested terms provided as that is only a suggestion of common searches and does not contain the entire range of possible search terms.
Here are just a few reviews we've gotten from members. We would love to get your feedback as well.
"We are a billing service in Florida with many physicians of all different specialties and we are constantly looking for all the tools for credentialing, contracting, fee schedules, and payment policies. I have seriously been looking for a company that would provide this type of information all in one place for quite a while. Leave it to the AAPC to put this together… You guys are awesome!!"
—Lisa Clifford, CPC–Naples, Florida
"Love this!!! It's like a central hub to so many of the websites I use every day. And I am discovering new sites I didn't know about. Thanks!"
"What a wonderful application! Everything I clicked on worked great. The searchs, the links all opened to the right information. Keep up the good work."
"I work as in billing for a private practice and I find this new tool very useful. It will be easier to come to one website to search for policies for multiple insurance companies."
"I wish I would have had this [...] when I was credentialing our new physician."
"Awesome idea! When deciding whether or not to provide a new service we often search payment policies for multiple payers. This tool will definitely save some time searching on the payer's website for the policy links."
"I work for a PHO that does medical management. This is a great tool to have at our fingertips. It saves so much time looking for the correct websites, as well as scouring the websites once you get there. When writing policies we use many of the major payers' policies as a resource and this is extremely helpful in getting to not only the payer policies, but the clinical ones as well. It is unfortunate that soon the availability will be restricted to only the AAPC members. Seems like the major payers could or should be able to get together and chip in money for the site's upkeep, so all providers could have free access. Thanks for taking the initiative to build this for all of us."
"this just came in handy. Very often it takes more time to find the direct phone number than asking for the denial reason."
"This tool is absolutely wonderful."
"I am a Credentialing Specialist for a multi-specialty group of @80 providers. This site was very easy to use and was especially nice to have payer websites so easy to access."
"This website and search engine will be invaluable. It is so difficult to locate provider information on third party payer sites, so this is a great resource from AAPC. Thank you!"
"I use the Payer websites frequently in the course of my daily work. This is a great tool. I found easy access to the two payers that I checked out for Connecticut. Realy great idea! I am passing the info on to other Coders who may not be aware that the tool is available."
"ALL I CAN SAY IS "WOW"!!! THANK YOU SO MUCH, AND I AM SURE THAT IT WILL ONLY GET BETTER! I am not suprised that the AAPC are the ones to be on the cutting edge of technology and provide tools to it's members that they can REALLY use!"
The icons used refer to the following:
||= The insurer's home page
||= The insurer's provider section
||= The insurer's policy & procedure page
||= The insurer's credentialing page
||= Opens the search area for this insurer
|NOTE: If there is a lighter equivalant icon, it means that resource is not available for that particular payer