ECU's Medical Solutions Program
Compliance with ECU's Medical Solutions Program will result in preferred pricing.
- Plan Language that includes the following:
- Add plan language that will not limit the use of UCR (usual, customary and reasonable) language to Network or Non Network claims.
- Add plan language that will limit the cost of surgical implants, i.e. pacemakers, AED's, screws, cages, prosthesis and other external implantable mechanisms to invoice +25%.
- Add plan language that will limit the coverage of Specialty and Biotech Drugs to ECU's preferred vendor LDI.
- Add plan language that will limit the coverage of Dialysis care to Golden Triangle's Renal Network and Case Management.
- Agree to use ECU's preferred vendors:
- Care Assist (www.assistgroup.com)and Progeny Health (www.progenyhealth.com) for High Risk Pregnancy, Neonatal Case Management and Hospital Bill Audits.
- Optum Health Care Solutions (www.optumhealth.com), Interlink (www.interlinkhealth.com), or LifeTrac (www.lifetracnetwork.com) for Transplants, Case Management and Centers of Excellence
- American Medical Strategies (AMS www.mdstrat.com), Global Excel (www.globalexcel.com), Nurse Audit (www.nurseaudit.com), Medavant (www.medavanthealth.com) or Asert (www.asert.net) for hospital claim audit's and negotiations in or out of network claims
- LDI (www.ldipbm.com) for Specialty Drug Program
- Golden Triangle Specialty Network, LLC (www.gtspecnet.com) for Kidney Dialysis Management
- Premier Healthcare Exchange or Advanced Medical Pricing Solutions, Inc. for data mining for cost containment services
(Please note preferred vendors of the TPA may be substituted for ECU's preferred vendors with approval from ECU. ECU will also provide plan language for the proposed SPD amendments, when requested.)
For additional information or questions please call Maureen Wilkie at 864-542-1590 or Donna Duncan at 864-542-1523.
Downloadable Forms
Forms and information packages available online - click here.
Spartanburg SC 29306
Phone: (864) 542-1565