Network Administrative Guidelines
Who We Are
Brighton Health Plan Solutions (BHPS) is an innovative health care enablement company on a mission to improve how health care is accessed and delivered in the self-funded health plan market. It offers several industry-leading brands, including MagnaCare and Create®, accessing the Brighton Health Network (BHN).
Contents
- Claim Reconsideration and Dispute Resolution
- Claims Process
- Credentialing
- ID Cards
- Medical Management/Quality Assurance/Utilization Review
- Precertification/Prior Authorization
- Provider Responsibilities
- Reimbursement
- Subrogation and Coordination of Benefits (COB)
- Transition of Care/Continuity of Care
- General Compliance and Fraud, Waste, and Abuse Requirements
- New York State IPA Participating Provider Agreement
- New Jersey ODS Participating Provider Agreement