Manuals
HCS publishes this manual for network providers, hospitals and their administrative staff to help with daily interactions with HCS and its clients. Information in this manual is current and replaces all other manuals previously published by HCS.
Network physicians, other healthcare professionals, hospitals, and ancillary providers are required to follow the policies and procedures contained in this manual. Failure to comply with any policies and procedures may constitute a breach of the Agreement.
Statement of Nondiscrimination
Practitioners and facilities must not differentiate or discriminate in the treatment of patients on the basis of race, color, gender, national origin, age, disability, pregnancy, gender identity, sex, sexual orientation or health status in the administration of the plan, including enrollment and benefit determinations. Practitioners must have policies to prevent discrimination in health care delivery and implement procedures to monitor and ensure it does not occur.
Appeals
Arbitration
Billing & Reimbursement
Claimant ID Cards
Fraud Detection and Control
Information Privacy & Confidentiality
Participating Physicians and Other Health Care Professionals
Utilization Management
This manual does not modify the terms of any Agreement with HCS. In the event of any conflict between the Agreement and the information contained in this manual, the terms of the Agreement shall prevail.