The Vermont Managed Care Provider Manual is referenced throughout your Provider Contract with VMC as the source for policies, procedures, plans, and organizational information.  We are very pleased to present this material here on our website for easy viewing, printing, downloading and use even when you're not in the office.

To make downloading and viewing easier and less time consuming, we have separated the manual into its 8 individual sections.  Below is an outline of the Table of Contents, with a brief description of what you'll find in each section.

Finally, we have included a "Recent Updates" area on each of the 8 Section pages of the manual.  This will list all updates to that particular section, since the last official annual revision and update notification.  So, the VMC Website is your ultimate destination for up-to-the-minute accurate information.

TABLE OF CONTENTS

Section 1 - About VMC
Letter from the Medical Director
Confidentiality Statement
Information about VMC, The Network, and our contracted health plans
Board of Directors
VMC Organizational Chart, Departments, Phone Numbers
Care Management Model, and Staff Information

Section 2 - Plans
Utilization Management Plan
Credentialing Plan

Section 3 - Policies
Care Management Policies
Credentialing Policies
Network Policies

Section 4 - Practice Management Operational Tools
Payer Matrices outlining TVHP/BlueCare contracts
Payer Matrices outlining MVP Health Care plans
Payer Matrices outlining Fletcher Allen Preferred Medical Plans
Sample Matrix Descriptions
Glossary of Key Terms and Abbreviations

Section 5 - Fletcher Allen Preferred Medical Plans Information
Details on Fletcher Allen Preferred Medical Plans
APEX Adjudication Codes

Section 6 - MVP Health Care Information
MVP Practitioner Resource Manual
Primary Care Capitation Reports
Preventive Care Guidelines

Section 7- TVHP / BlueCare information
Information from BCBSVT Provider Manual
Membership and Capitation Detail Reports
Preventive Care Guidelines

Section 8 - State and Federal Legislation

State of Vermont- BISHCA....Regulations for Rule 10 Quality Assurance Standards
http://www.bishca.state.vt.us/HcaDiv/RegsBulls/hcaregs/INDEX_REGS_HCA.htm