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Victoria Medical Foundation (IPA) offers a variety of “value added” services to physicians:

 

Managed Care Contracting Services via Messenger Model

The Victoria Medical Foundation facilitates managed care contracts using the messenger model system.   Some terms the Victoria Medical Foundations contracts include are delegated credentialing, prompt payment, payment of claims, clean claim language, eligibility and authorization clarity and other significant terms that are important to a successful provider’s practice.  The Victoria Medical Foundation uses the messenger model system to disseminate the fee proposals as it is a non-affiliated group of facilities and physicians.

 

Delegated Credentialing through Managed Care Plans

The Victoria Medical Foundation has an in-depth credentialing program and has been successful  in obtaining delegated credentialing through all of its managed care contracted payers.  The Victoria Medical Foundation follows the National Committee for Quality Assurance  and State of Texas guidelines for physician credentialing.  This benefit is very useful to the physician so there is not a need to complete several different standardized applications with numerous managed care plans. There is only one application required for all plans within the IPA.

 
 

 

Vaccine Savings Program

The Victoria Medical Foundation and the Victoria Medical Associates works with Kelson Physician Partners for savings through their Vaccine Savings Program. Kelson is unique in offering wider access to competitive pricing and, more importantly, in being able to show purchasing strategies tailored to the needs of your practice thus produces the lowest possible price and achieves the greatest margin. Kelson is committed to providing physicians a choice of manufacturer’s products that they determine are best for their practices. There is no participation costs for the practice and the savings are immediate! Practices continue to order directly and orders are shipped directly to the physician practice.

 

Claims Resolution

The Victoria Medical Foundation and the Victoria Medical Associates takes responsibility to its physician members when claims are not processed correctly. The Victoria Medical Foundation works with the managed care plan and the physicians office to correct the claims for timely payment.

 

Facility Benefits

The Victoria Medical Foundation and the Victoria Medical Associates facilitates managed care contracting services for its facility providers.

 

Provider Plan Participating Effective Dates

VMF provides the physician member a list of all plans with effective dates of his/her participation.

 

Quarterly Office Manager Luncheon Meetings​

VMF holds Office Managers Meetings quarterly for any key personnel to discuss plan issues, claim processing problems, new plans in the area, educational topics and other pertinent information​

 

 

The Victoria Medical Foundation has partnered with MD Health Group in 2008. MD Health Group is a Health Group Cooperative for the purpose of employers to band together to form a large group for purposes to be underwritten and rates as one large group to obtain health and employee benefits.

 

MD Health Group is able to use it's purchasing power to bring you a rich selection of plans and benefits typically only large employers enjoy.  Providers who belong to the Victoria Medical Foundation may join MD Health Group and obtain coverage for their employees.  Employer's main office must be located in Texas and have two or more employees.  The Texas Department of Insurance requires a two year commitment from employers who join the cooperative to assure stability within the group.

 

The plans available are:

PPO 500; PPO 1000; PPO 2000; PPO 2500; PPO 3000; HSA 2500

 

If you are interested in any of the “value added” services listed above please contact our

office at (361) 582-0505

 

 

CONTRACTED HEALTH PLANS

 

EMPLOYER & INDIVIDUAL HEALTH PLANS

  Beechstreet

(Viant/Concentra/PPO Next)

 
  Choice Care Inc.  
  Cigna Healthcare

(Great West Healthcare)

 
  Community Health Regional Systems

(formerly Southeast Texas Health Systems)

 
  Coventry Health Care

(Purchased by Aetna)

 
  First Health

(Purchased by Aetna)

 
  Galaxy Health Network  
  Healthsmart Preferred Care

(Accountable/Interplan)

 
  Humana Inc.  
  Independent Medical Systems  
  MedCorp Southwest Inc.  
  Multiplan Inc.  
  Private Healthcare Systems  
  Three Rivers Provider Network  
  USA Managed Care Organization  

 

 

MEDICARE & MEDICAID

  Driscoll Children’s Health Plan  
  Humana Medicare – Choice Advantage  
  Molina Healthcare Inc.  
  Superior Health Plan  
  Amerigroup Inc.  
  Christus Health Plan  

 

 

WORKER'S COMPENSATION

  Beechstreet

(purchased by Multiplan) 

 
  Coventry Health Care

(Purchased by Aetna)

 
  First Health

(Purchased by Aetna)

 
  Healthsmart Preferred Care Inc.  
  Multiplan Inc.  
  Rockport Community Network  
  USA Managed Care Organization  

 

 

 
 

Victoria Medical Foundation/Association - Victoria, Texas 361.582.0505

Independent Physician Association 5.01(a) Non-profit - Certified as a non-profit health organization on behalf of the Texas Medical Board

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