Medical Network Management Services of Delaware, Inc.
(MedNet)
Enabling Physicians to Lead
Empowering Physicians to Serve
A subsidiary of the Medical Society of Delaware
The Physician Organizations
Powered by MedNet Delaware
Are you one of over 700 physicians in Delaware that belong to the Physician Organization? Membership in one of Delaware’s four Physician Organizations can greatly impact your bottom line. And that’s just one of the many benefits. So what are you waiting for? The Physician Organizations (PO’s), were developed in the late 90’s by physicians, for physicians. Over the years, the PO’s successfully contracted with several insurance companies. They are (each name is linked to their provider site on thier website):
CHP (Community Health Plan) 
Creenaght 
DPCI (Delaware Physicians Care, Inc) 
MultiPlan & PHCS 
Click here for MultiPlan/PHCS Client Listing
NCCPO (National Capital PPO) 
TriCare - Health-Net Federal Servcies 
Unison Health Plan of Delaware 
- Eliminate Staff Paperwork! Your office staff only needs to complete one credentialing packet every three years. The time saved on completing credentialing paperwork is astronomical!
- Access! By virtue of your PO membership, you have access to the administrative services of MedNet; the organization that manages the PO’s, maintains the insurance contracts, and secures credentialing. You or your office staff can save precious time by contacting MedNet for assistance with claims issues, reimbursement concerns, and many other billing and/or practice related matters involved with the insurance companies. Think about how many times your office staff has made numerous calls to insurance companies to seek resolution, only to be left on hold for hours on end. Since MedNet has dedicated contacts at each of these insurance companies, you/your staff can now make one call to MedNet, who in turn will escalate the issue.
- Money! These insurance companies usually pay higher reimbursements to PO physicians. There are dedicated fee schedules that are usually more favorable then if a physician contracted directly with the insurance company.
Join Today! Joining the PO is easier than ever….and only $210.00 per year covers the Contract Administration Fee. Contact the MedNet Manager, Lori Ann Rhoads, to become a member. (302) 224-5196, or lar@medsocdel.org.
HISTORY OF MEDNET AND THE PHYSICIAN ORGANIZATIONS
MedNet’s development began in 1995 when the Long Range Planning Committee of the Medical Society of Delaware (MSD) recognized a need to evaluate managed care and its potential impact in Delaware. A Steering Committee reviewed approaches taken by several other state societies and determined the method employed in Pennsylvania to be most effective. Under the guidance and counsel of the Pennsylvania Medical Society (PMS) and its subsidiary, PennMed Member Services Company (PMSCO), the Steering Committee initiated the “Managed Care Strategy Initiative” (MCSI). The purpose of MCSI was to develop a comprehensive strategy for MSD to assist Delaware physicians to effectively transition into a managed care market, while preserving cost-effective, quality patient care and health care delivery. This ideal, embodied in the term physician-directed managed care, led MSD to become involved in the development of local, community-based medical care delivery organizations. Once formed, the Medical Society would provide technical and operational support via MedNet of Delaware.
The first task was to find the proper vehicle to help physicians adapt to the managed care environment. The 1996 Antitrust Guidelines promulgated by the U.S. Department of Justice laid out the model for a non-exclusive clinically integrated physicians organization (PO). This model required 16-criteria compliance, but allowed physicians to enter into contracts on a single signature without violating antitrust regulations. One requirement for a clinically integrated physicians organization is the performance of medical management. In order to fulfill this obligation, the PO would need access to integrated clinical data. An extensive search for a data warehousing and infrastructure manager that would partner with the POs resulted in a strategic alliance with Maryland-based InforMed. In addition to state-of-the-art data warehousing capabilities, InforMed is equipped to manipulate and analyze risk-adjusted data down to the minutest detail. This capability, key to medical management, is the primary mechanism by which the POs achieve their goal of physician-directed managed care. InforMed also provides easy access to health activity information via the web and integrated medical management that coordinates information with treatment/professional services, third party administration services, innovative risk management techniques, and insurance/re-insurance processing.
While the POs currently serve as provider networks for several PPO contracts, the most important arrangement is the Community Health Plan (CHP). Under this plan, the POs are provided access to clinical data, vital to the ultimate goal of assuring the delivery of cost-effective, quality medical care. The CHP product is targeted to large, self-funded self-insured employers and offers a substantial provider network of specialties and comprehensive administrative services at a significant cost savings over most ASOs. Additionally, MedNet brings the full spectrum of medical management capabilities including disease management, case management, and quality assurance.
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MEDNET OF DELAWARE
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Michael J. Bradley, D.O., Chair
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| Robert G. Altschuler, MD |
Jerome Groll MD |
| David M. Bercaw, MD |
Richard P. Simons, DO |
| David S. Grubbs, MD |
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