(800) 231-6935 1

PPO NetworkOne Union Square600 University Street, Suite 1400Seattle, WA 98101(800) 231-6935www.fchn.com

GET STARTEDWITH THE NEW STATEWIDECREDENTIALING SERVICE!First Choice Health is very excited about the upcoming implementation of the statewide credentialing data repository service and the opportunity for providers to eliminate unnecessary work currently undertaken to submit the same credentialing information to multiple insurance companies.

What’s in your Fall Newsletter

Get Started with the New Statewide Credentialing Service .................................. 1

Reviewing Washington Childhood Vaccine Program ........................................ 2

Email Address on Provider Web Page ......... 2

Introducing First Choice Health’s New VP of PPO Operations ......................... 3

Pre-existing Condition Insurance Plan - Washington State (PCIP-WA) ......... 3

Provider Update ......................................... 4

2010 Planned Maintenance ........................ 4

2010 Holiday Schedule .............................. 4

“State of the Network” Reporting ................ 4

Fall 2010 - Provider Newsletter

Soon, you can use your OneHealthPort login to use ProviderSource – a free service that can reduce credentialing hassles for good. We anticipate the service going live this fall so you can get your organization ready to hit the ground running by setting up your credentialing staff and practitioners with OneHealthPort accounts.

ProviderSource is an easy-to-use online portal to the OneHealthPort Provider Data Service, a statewide system hosted by OneHealthPort for centralized collection, verification and distribution of all provider data to be used for credentialing and privileging. It will be ready for use in the coming weeks.

To use ProviderSource , each credentialed provider or practitioner in your organization must be set up with his or her own unique OneHealthPort login.

Doing this in advance can save time and make credentialing and privileging with the new service easier.

We encourage you to check the OneHealthPort website frequently for updates and you can find all the information you need at OneHealthPort (www.onehealthport.com), or see below for specific links to ProviderSource information and documents.

Links: • OneHealthPortwebsite:InformationonProviderSourcewww.onehealthport.com/services/providersource_soon.php

• BasicInstructionsforGettingStarted(pdf)www.onehealthport.com/pdf/ProviderSource_Getting_Started.pdf

• ProviderSourceSetUp:AStep-by-StepGuide(pdf)www.onehealthport.com/pdf/ProviderSource_Set_Up.pdf

PPO Network Provider Newsletter - Fall 2010

(800) 231-69352

Since 1990, Washington State has maintained a universal state-supplied vaccine program for children, known as CVP (Childhood Vaccine Program).

The CVP allowed Washington State to purchase vaccines at bulk discount rates from the Centers of Disease Control and provide them to physicians and other providers at no cost for all children residing in Washington. As such, private insurance plans were not billed for the vaccine serums. Budget deficits have led the legislature to eliminate state funding for the program. However, through a combined effort by health plans and the state, this statewide children’s vaccine program will continue through the newly formed Washington Vaccine Association (WVA). The WVA was established through a collaborative process, involving payors, plans and the state, to ensure our children’s continued access to lifesaving vaccines. Among other functions, the WVA will administer the payment for vaccine serum between the health plans and the state.

Effective May 1, 2010, the Washington State Legislature passed enabling legislation (HB 2551) that includes requirements for health plans and third party administrators. Pursuant to the new law, First Choice Health PPO Network (FCH) will reprice the vaccine serum codes for payment allowed under the program.

First Choice Health Actions:• Perstateguidelines,WashingtonVaccineAssociationTIN:27-2251833hasbeenloadedintotheFirstChoiceHealthpricingsystemforservicedatesonorafterMay1,2010.

For claims billed with $0.01, First Choice Health will calculate the allowable according to the WVA reimbursement rate. For claims billed with $0.00, First Choice Health is not able to calculate the allowable rate. Payors are responsible for payment according to the WVA reimbursement rate.

Reviewing Washington Childhood Vaccine Program

ICD-10 Statement of ReadinessFirst Choice Health Preparing for ICD-10

The Department of Health and Human Services (DHHS) has mandated that all health organizations be compliant with the International Classification of Diseases, version 10 (ICD-10) by October 1, 2013. This is because the current version, ICD-9, is no longer a sufficient set of codes to meet the needs of expanded and more detailed disease classification and health care delivery.

These changes affect all aspects of payer and provider businesses. The changes are complex and many payers and providers may not understand the implications of the mandated deadlines. First Choice Health has begun planning for these important migrations with two projects within our 2010 strategic plan.

ICD-10

We are assessing the impact of our transition to ICD-10 across all organizational activities at a sufficient level of detail to be the basis of developing a comprehensive implementation plan. We intend to complete the impact analysis and work plan by the end of 2010.

HIPAA 5010

Our IT Department has begun development to process 5010 along with 4010 transactions. We expect to be testing with trading partners by Q4 2010. Implementation status along with Companion documents will be available on our website in July, 2010.

STAY TUNED FOR STATUS ON THESE PROJECTS!

PPO Network Provider Newsletter - Fall 2010

(800) 231-6935 3

Jacqueline“Jacque”Brainard

VPPPOOperations,FirstChoiceHealth

Pre-existing Condition Insurance Plan – Washington State (PCIP-WA) and Alaska (ACHIA-FED)

Introducing First Choice Health’s New VP of PPO Operations After 12 successful years with First Choice Health, Elizabeth Pelley, VP of PPO operations decided to transition into retirement. Elizabeth’s numerous contributions to the success of First Choice Health have been appreciated by all of us.

Replacing Elizabeth was not easy, but we found someone with considerable talent, solid operations experience and more than 25 years of related industry experience in Jacque Brainard.

Prior to joining First Choice Health, Jacque served as VP of Re-Engineering for Conseco Insurance group, as well as SR VP, Chief Administrative Officer for BCS Financial Corporation.

Jacque brings to First Choice Health her knowledge and leadership experience in the reinsurance, managed care (HMO, PPO, & TPA) and insurance industries. As SR VP, Chief Administrative Officer at BCS Financial Corporation Jacque was responsible for re-engineering at CNO Financial Group, formerly Conseco, LLC, in Carmel, IN. Her prior positions as Vice President – Audit and Compliance and HIPAA Privacy and Security Officer for BCS will prove to be an added asset.

F.Name L.NameM890##### Health Single

BMI890Group Number

EffectiveDate: 07/01/2010

Policy Number

Jacque’s recent appointment to serve on the Board of Directors for Childhaven of Seattle is a reflection of her dedication to the community in addition to her many professional accomplishments.

PLEASE JOIN US IS WELCOMING THE NEWEST MEMBER OF OUR TEAM.

A component of recent federal heal thcare reform legis la t ion, specifically The Affordable Care Act, included the creation of a temporary federal high risk pool called the Pre-existing Condition Insurance Plan (PCIP). Each State could choose to administer the program or defer to the federal program and administration. In Washington, the PCIP program will be administered for Health & Human Services by a subsidiary limited liability company of the Washington State Health Insurance Pool (WSHIP). PCIP-WA will use WSHIP’s current claims administrator Benefit Management, Inc (BMI), pharmacy benefit manager (Medco), care manager (Qualis Health), and First Choice Health PPO Network (FCH). Individual applications were available starting in August and the first

members were effective in September. PCIP-WA enrollees are issued typical identification cards (see sample). To be eligible, individuals must have a pre-existing medical condition and been without health insurance for at least six months. If your patients have questions about the PCIP-WA program, they can call (877) 505-0514 or visit www.wship.org/PCIP-WA.

PCIP CARD EXAMPLE

Alaska’s counterpart program has a similar arrangement with partners BMI, Medco, and FCH. Their existing state program is the Alaska Comprehensive Health Insurance Association (ACHIA) and the new Alaska federal high risk pool is called ACHIA-FED. Their ID sample is also attached.

ACHIA CARD EXAMPLE

2010 Holiday ScheduleFIRST CHOICE HEALTH IS CLOSED FOR THE FOLLOWING HOLIDAYS:

• ThanksgivingDayThursdayNovember25,2010

• DayafterThanksgivingFridayNovember26,2010

• ChristmasEveDayThursdayDecember23,2010

• ChristmasDayFridayDecember24,2010

• NewYearsEveDayFridayDecember31,2010

Access to our Customer Service and Provider Relations voicemail systems will be available the days we are closed. We will respond to all messages within 24 hours of re-opening.

If you have any questions regarding the holiday schedule, please contact Provider Relations at (800) 231-6935 ext 2103.

(800) 231-69354

PPO Network Provider Newsletter - Fall 2010

“State of the Network” Reporting

In an ongoing effort to maximize value to our network, First Choice Health is always working to recruit new providers, target expansion areas and fill any gaps that may exist within out network service area. We are pleased to announce that as of September 2010, our network includes 54,194 practitioners, 253 hospitals, and 1,823 ancillary facilities.

AK

ORID

MT

WA

Payor UpdateNew Payors:

• Benefit&RiskManagementServices(BRMS)isneweffective5/1/10.TheirfirstgroupisClackamasCountyFireDistrict.

• CombinedBenefitAdministratorsisneweffective7/1/10.TheirfirstgroupisValleyFreshFoods.

• ACNGroup,dbaOptumHealthisneweffective7/1/10,andtherearemultiplegroups.ThisclientispartofUnitedHealthCare.TheyareaccessingFCHNinWashingtononly,andforacupuncturists,massagetherapists,andnaturopathsonly.

• OregonProcessorsEmployeesTrustisneweffective5/1/10.

• PierceCountyProjectAccessisneweffective6/1/10.TheirserviceareaisPierceCounty,Washington.

• TotalBrokerBenefitsisneweffective9/1/10.TheirfirstgroupisLifeways,Inc.

Terminating Payors:

• TheCovenantterminated12/31/09.

• USAccess’lastgroupsterminated3/31/10.

• VentureNetHealthcarehasnoactivegroups.

Other Updates:

• Kipp&CompanyhasmergedintoEmployeeBenefitManagementServices(EBMS).Asof7/1/10,allformerKippgroupshavetransitionedtoEBMS.

• Sheffield,Olson&McQueenhasreactivatedtheirrelationshipwithFCHNeffective4/1/10.TheirnewgroupisHBSpecialtyFoods

Email Address on Provider Web Page First Choice Health is now offering our Providers the opportunity to receive notification via email when we have posted new publications to the Provider web page such as the List of Payors (Yellow Pages), Newsletters and Provider Bulletins.

Please register your email address with First Choice Health by accessing our web site (www.fchn.com) and under•CoreServices,•SelectPPONetwork,ForProviders,Publications;andthen,

•Subscribeviaemail.

First Choice Health has been making improvements to our Provider Web page and has discontinued the mailing of our List

of Payors and Newsletters. It is our hope providers will utilize our web site for this information as it contains the most up-to-date information available.

As always, please feel free to contact the Provider Relations Department with any questions at (800) 231-6935 ext. 2103 or via email at ProviderRelations@fchn.com.