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Completing the Network Activities Section of the Physician Renewal

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Completing the Network Activities Section of the Physician Renewal

By Underwriting

Duration: 6:59

pdf    pdf 
Network Renewal FAQs           
Network Renewal Transcript

Transcript

Welcome to the CRICO Underwriting Training Series.

Slide 1: Introduction

Thank you for your assistance in completing this year’s CRICO renewal. Each year, CRICO Underwriting conducts an annual renewal to accurately bill its insured institutions, to comply with reinsurance reporting requirements and to understand any operational or emerging risks.

This video will go through the Network Activities Section of the Renewal and highlight how to complete this section.

Slide 2: Overview

The Network Activities Section of this renewal is intended to collect all affiliations, formal written contracts, or verbal agreements that each institution provides to other organizations. This will include all contracts for all departments and owned and controlled organizations of your institution. Arrangements for clinical services, consulting, education, research, medical director services or branding.

For example, if your organization’s cardiology department has a contract in place for employed cardiologists of your organization to work at another institution one day a week, this should be reported to CRICO through this renewal.

In addition, this will include affiliations your institution has with other hospitals or entities within the CRICO network or within its “parent” organization. For example, if there is a clinical services agreement between your institution and another institution for telemedicine services where both institutions share the same healthcare organization, this should also be reported as it is a separate entity from your own.

You do not, however, need to report services provided within your own institution. For example, if your radiology department provides services for several other service lines, it is not intended to report these relationships.

We will now walk through this section.

Slide 3: Completed By Section

The first area for completion in this section is the Completed By area. The appropriate individual to complete this section will be reporting on any arrangements your organization has with any other organizations for medical/clinical services in which your organizations provides the services. Please list your name, title and contact information should we have questions regarding the completion of this section.

If multiple parties from your institution assist in the collection of this information, please include all individuals’ contact information.

Slide 4: Current vs. Existing Contracts

Based on the renewal completed and finalized during the last renewal cycle, CRICO will pre-populate the data submitted reflecting any current or known contracts in place.

We recommend you first review the rows that are pre-populated with last year’s active relationships.

You will know it is a previously reported contract because while “Status” will be blank, CRICO Contract Number will have a number assigned.

By reviewing current or existing contracts, this will allow you to quickly assess whether an affiliation is still active, whether it’s active but needs some updating based on the data on file, or whether it is no longer active.

Review each current relationship for accuracy. Once complete, please update the “Status” column to reflect one of the following answers:

  • Keep – Contract Still Active/No Changes to Data Listed
  • Keep – Contract Still Active; See Changes to Data Listed
  • Remove – Contract No Longer Active

If the contract is still active but changes have been made (e.g., the physician headcount has revised from 5 to 10), please update the corresponding cell accordingly for this contract and highlight the cell.

Please note that CRICO Contract Number is for internal purposes only. Please do not adjust.

Slide 5: New Contracts

In addition to validating whether prior contracts are still in place and whether changes have occurred, all new or newly reported contracts should also be reported through this section of the renewal. To report a new contract, we will now walk through the required information.

To begin, select the status option of “New Contract.”

Please leave the CRICO Contract Number column blank as this will be assigned by CRICO once your renewal is returned.

Slide 6: New Contracts - CRICO Entity Engaged in Contract, Contracted Entity Name, Entity Type, Service Type

This slide reviews corresponding cells to complete for a new contract — including CRICO Entity Engaged in the Contract, Contracted Entity Name, Entity Type and Service Type.

  • CRICO Entity Engaged in Contract: This is an entity that is owned/controlled by the institution and will vary across affiliations in which your institution is engaged. This could be your institution (i.e., XZY Hospital), the name of a Physician’s Organization of your institution, or another owned organization of your group. In the event of a written agreement in place, this will be the entity that is a party to the contract.
  • For example, if your hospital’s Physician Organization has an agreement with a 3rd party to provide consulting purposes, the CRICO Entity in that case would be the physician organization. Please list that information in this column.
  • Contracted Entity Name and Entity Type: The name of the 3rd party your organization is contracting with as well as the type of organization this entity is. Please be as specific as possible and only use “Other” if necessary.
  • Service Type: Service Type will indicate the type of relationship in which the CRICO Entity Engaged in the Contract and the Contracted Entity Name have. Again, please be as specific as possible and only use “Other” if necessary.

Slide 7: New Contracts - Headcounts and FTE Volumes 

Next, we ask for details of how many clinicians are engaged in the relationship reported.

Please include the headcount and full time equivalent (FTE) for the 4 types of clinicians, which include:

  1. Physicians
  2. CNP
  3. PA
  4. Other HealthCare Providers (e.g., RN)

Slide 8: New Contracts - Nature of Service, Application Service Response, Volume, State, Written Contract

The final columns further confirm the information regarding each contract.

This includes:

  • Nature of Service: This will be the corresponding service line/department engaged in the contract for your institution.
  • Application Service Response: This is your optional response to give any added detail regarding this contract to supplement the Nature of Service field.
  • Volume of Procedures/Visits/Surgeries: This is a measure of the overall volume of this contract. Please use the metric that is most applicable to this contract.
  • State or Country: This is the state or country in which the services are performed.
  • Written Contract: As previously mentioned, this can be a written or verbal contract for services. If written, please advise here.

Slide 9: Thank You

Thank you for your assistance in completing this section of the CRICO Renewal. If you have additional questions regarding the submission or collection of this data please contact CRICO Underwriting at [email protected] or 617.450.8219.

Please note a copy of this video’s transcript along with a list of FAQs are also available through this site.


April 12, 2019
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