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* Excludes 34 applications withdrawn after initial denial.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%.