As a provider, if your request to join a payer network in the following markets has been denied, you might have some recourse for appeals.

As a provider, if your request to join a payer network in the following markets has been denied, you might have some recourse for appeals.
Maryland Physicians Care (MPC) Provider Relations Representatives Maryland Physicians Care
Advanced financial and statistical support relating to Capitation Rates, Risk Adjustment Models, and Payment Methodologies.
This dataset contains the total number of Medi-Cal Managed Care enrollees based on the reported month, plan type, county, and health plan.
Various reports from the State of California regarding the quality of care provided by Medi-Cal managed care health plans. Plan-specific evaluation reports are also prepared for each individual health plan reviewed.
Eligibility: Contract Language (Payer v Provider) and Sample to Use.
The Managed Care Legal Database is a resource identifying how state and federal statutes and regulations address many issues that may occur between private payers and physicians, such as prior authorization, credentialing, network adequacy, out-of-network payment, and contract termination. The Database also contains relevant AMA policy, issue briefs, advocacy resources, model legislation, and a State Laws Map.
Effective Jan. 1, 2022, Health Plan commercial members will be protected from balance billing after receiving emergency care and nonemergency care from certain out-of-network providers at in-network facilities. The No Surprises Act, which is included within the Consolidated Appropriations Act of 2021 (the CAA), provides the following:
Carenodes Health Enterprise
Office of the Executive
Dear Health Plan Representative,
Please see attached Notice regarding the implementation of Senate Bill 855, Mental Health and Substance Use Disorder Coverage.