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OCMA Blog

CMA Develops Simple Tool to Identify Physician Participation Status in Exchange Plans

January 23, 2014

On January 1, 2014, Covered California began providing health coverage to more than 500,000 patients statewide. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff have a clear understanding of their exchange plan participation status so that they can communicate this information to patients before scheduling. It’s equally as important that practices understand the reimbursement rates and other terms associated with the plans with which they are contracted.

Even if you did not intentionally contract with any exchange plans, the California Medical Association (CMA) urges physicians to check their participation status. It is very possible that physicians may have been unknowingly opted into an exchange plan network due to the way that major insurance plans have structured their provider agreements.

If you've attempted to look up your exchange plan participation status on the Covered California website, you know that it's not a straightforward process. Because it is critical that physicians know what plans they are contracted with, CMA has created a quick and easy tool to look up your exchange plan participation status in just a few clicks.

The tool, available to members only, requires simply your first and last name and middle initial and it will tell you which plans list you as a contracting physician (as of September 2013, the most recent data released by Covered California). To access the tool, visit http://www.cmanet.org/exchange-lookup.

Please note: You will be required to login with a member account. If you have not already activated your web account, visit http://www.cmanet.org/activate. If you need assistance activating your account, contact CMA's member service center at (800) 786-4262 or memberservice@cmanet.org.

For more information on Covered California, visit CMA’s exchange resource center at www.cmanet.org/exchange. Physician members and their staff also have free access to CMA’s practice management experts at (888) 401-5911 or economicservices@cmanet.org.


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