COMCARE PRO
COMCARE members now have the opportunity to purchase the Department of Public Welfare's (DPW) required stop loss reinsurance from a new entity called COMCARE PRO. DPW requires that the reinsurance cover, at a minimum, eighty percent of inpatient costs incurred by one member during one year in excess of $75,000. COMCARE PRO will cover eighty percent of inpatient costs exceeding your chosen attachment point, which can be as low as $60,000 or as high as $100,000. This coverage is provided at costs very similar to, and in many cases, lower than what counties are currently paying. All applications are subject to an actuarial review and underwriting process. For an application and additional information, please contact Christie Ward at 1-800-895-9039 or cward@pacounties.org.
Information Clearinghouse
This service will provide COMCARE members with a place to call for help, share responses to RFPs, provide data to help counties negotiate contracts, and review documents used by other
counties. This includes the development of a website and mail service to be accessible by COMCARE members.
Technical Consulting Service
COMCARE members would have access to information concerning potential providers of actuarial, legal, MIS and other services. If a survey of counties/joinders shows enough interest, group
RFPs would be developed on behalf of participating counties.
COMCARE Loan Fund
Designed to assist counties with cash flow problems, consultant fees, delays in state reimbursements, program expansion, innovative programs, data conversion, etc. All of COMCARE loans
are offered at no interest. The Loan Fund is available to counties in the planning phase as well as during implementation of managed care.
Fee For Service Data Project: It is the intent of COMCARE to hire a consultant to compile three years of FFS data to assist members with establishing a baseline
of FFS costs. This baseline can be used in the development of budget for HealthChoices implementation. Project timeline is February 2003.
Training Service Offering
COMCARE members have the opportunity to win registration fees, travel, meals, and overnight accommodations to local and national conferences on managed care. COMCARE posts
sponsored opportunities on the website and members can register online.
Would your county benefit from a training or mentoring session with a fellow county employee that has already implemented HealthChoices? COMCARE members can request
such as a session by contacting Christie Ward at 1-800-895-9039. Training and mentoring in the following topics:
-
Act 68
-
Claims Processing
-
Complaints and Grievances
-
Contract Monitoring and Management
-
Coordination with other systems of care
-
Financing Implementation
-
MIS
-
Model Development
-
Quality Improvement, Quality Oversight, Utilization Management
-
Reporting Requirements
-
Risk Protection Strategies and Instruments
-
Staffing for HealthChoices
-
Working with providers, consumers, clients and family members through implementation
- COMCARE -
County Managed Care Resource
2789 Old Post Rd.
Harrisburg, PA 17110
717.526.1010 or 1-800-895-9039 voice
717.526.1020 fax
Much of the information on this page was provided to COMCARE from an outside source. COMCARE does not guarantee the accuracy or completeness of this information. By listing the vendor or provider of any product or service, COMCARE does not recommend the vendor or provider, and does not warrant the quality or efficacy of the product or service. COMCARE cautions the reader to contact the source of the information and other primary sources for complete and current information, and to exercise their own judgment in selecting products and services.
