2018 Physician Incentive Plan Rates and 2017 Proof Forms
|Network Requirement: Each physician must participate in at least one of the following as a prerequisite for earning well-care incentives:
|W15: Children receiving 6 well-care visits by 15 months of life||$51.85|
|W34: Children ages 3, 4, 5 & 6 years who complete their annual well-care visit||$51.85|
|AWC: Adolescents (ages 12-18 years) who complete their annual well-care visit*||$51.85 (all members ages 12-18 years)|
*Adolescents enrolled in the Aged, Blind and Disabled or Foster Care Programs are eligible to age 21 years.
In addition to making payments for the first quarter of 2018, we’ll also make a final sweep, or “True Up” payment of 2017. With this payment, we will provide a final non-compliant patient list for the 2017 claims. If you see a patient on this list for whom you provided a well check, please fill out the Proof Form (one per patient), attach an appropriate HCFA or EOP, and fax to (614) 355-3185 or email to PFKProviderRel@NationwideChildrens.org. Once submitted information is verified, payments for these claims will be included in the 2018 quarter 2 check later this year.