OUT-OF-NETWORK PROVIDERS FEE SCHEDULE UPDATE

Date: 12/13/23

Meridian is committed to working alongside providers to ensure our members can achieve optimal health outcomes. To best serve providers and members, we encourage the development of strong relationships with qualified, high performing providers. And to improve provider partnership performance, we are focusing on our in-network partnerships with the goal of improving member compliance, quality, and performance outcomes.

With those goals in mind, effective January 1, 2024, reimbursement for Meridian Medicaid Plan providers that do not participate in the Meridian Medicaid network will be paid at a discount to Meridian’s existing reasonable and customary payment for the provider type.

As a reminder, providers are prohibited from billing Meridian members the cost difference between the charged amount and the amount paid. In addition, Meridian expects existing in network providers to refer members to participating providers, when possible, per language in their Meridian participating provider agreement.

To ease administrative burden for non-participating providers, Meridian will amend prior authorization requirements for non-contracted providers to mirror our contracted network providers.

For resources, access the Meridian pre-auth tool, clinical and payment policies, and apply to become a contracted provider. Or contact Meridian Provider Services at 866-606-3700, Monday through Friday, from 8 a.m. to 5 p.m. for more information.