MEMBERSHIP CRITERIA
Physicians must be board certified or board eligible (certified within five years of completion of training) in order to apply to United Physicians. Once credentialed each physician is expected to adhere to the policies and standards developed by United Physicians from time to time. Currently, the requirements are as follows:
Electronic Data Interchange (EDI) & Internet Connectivity
It is highly recommended that physicians meet the following HIT standards:
- Have electronic connectivity with our Health IT team in order to facilitate data exchange.
- Utilize electronic prescribing, either through an EMR or a stand-alone product that allows data exchange with United Physicians.
- Utilize a disease registry capable of sharing data with UP and other physicians.
- Have high-speed internet access in office.
- Submit all claims through EDI.
Health Plan Contract Participation
- United Physicians operates under a messenger model, enabling each physician to opt-in to the contracted arrangement(s) of his/her choice.
- It is highly recommended that physicians participate in Health Plan contracts through UP. Most plans require physicians to participate through a physician organization, however, physicians are not required to participate with all health plans.
- Physicians who elect to participate with Blue Cross, Blue Shield of Michigan (BCBSM) reward programs such as Physician Group Incentive Program (PGIP), Patient-Centered Medical Home (PCMH), and Organized Systems of Care (OSC) with UP are expected to direct patient care (when clinically appropriate) to other UP members/facilities and follow policies and procedures relating thereto. These programs require physicians to participate through physician organizations.