Provider Manual

MARTIN’S POINT HEALTH CARE

Martin’s Point Health Care (MPHC) is a progressive, not-for-profit, health care organization with experience and demonstrated excellence in both clinical patient care and health plan administration. Understanding both aspects of our health care system (clinical care and payment) gives us unique insights that allow us to make meaningful improvements to the health care system. We bring together primary care providers, specialists, health plans, systems and processes to deliver the best possible health care experience to each individual. This coordinated approach is designed to create more quality time with health care providers, greater consistency in care and ultimately, lower overall costs to the system. The Martin’s Point difference lies in our mission to exemplify and inspire health care and service excellence through leadership, education and innovation.


Please Note: This manual is an extension of the participation agreement between MPHC and all network provider types including, but not limited to, physicians, hospitals and ancillary healthcare providers (“provider(s)”) and furnishes providers and their office staff with information concerning policies and procedures, claims, and guidelines used to administer MPHC health plans. This manual replaces and supersedes all previous versions. A paper copy may be obtained upon written request. In accordance with our participation agreement, all providers must abide by all provisions contained in this manual, as applicable. Revisions to this manual constitute revisions to MPHC’s policies and procedures. As policies and procedures change, updates will be issued and incorporated into subsequent versions of this manual.