Third Party Payer

Medical Association of Georgia (MAG) members and their practice staff who would like advice on the best ways to resolve claims and other third-party payer problems can contact Mark Kishel, M.D., at mkishel@mag.org.

This is a free and exclusive benefit for MAG members and their practice staff.

Dr. Kishel served in key roles at Anthem/Blue Cross Blue Shield of Georgia, and he worked in a variety of group practice, hospital and insurance settings.

MAG's Business Associate Agreement

Before a member sends any private health information to MAG, MAG requires two original, signed copies of the Business Associate Agreement to be mailed to Bethany Sherrer at 1849 The Exchange, Suite 200, Atlanta, GA 30339 or faxed to 678.303.3732.

FAQ

Is there a time limit on retroactive requests for payment recoveries by insurance companies?

Yes, an insurer's post-payment claim audit or retroactive claim denial must be completed within 18 months of that date of service or discharge if a provider submits a claim for payment within 90 days of the last date of service or discharge included on the claim.

If the claim was submitted for payment more than 90 days after the date of service or discharge, an insurer's post-payment claim audit or retroactive claim denial must be completed within 18 months of the claim submission date or 24 months after the date of service, whichever is sooner. § 33-20A-62

Georgia Model Managed Care Contract

The Medical Association of Georgia (MAG) and the Georgia Medical Group Management Association (GMGMA) offer A Georgia Model Managed Care Contract on a joint basis as a resource for Georgia physicians. It's designed to help physicians contend with often-overlooked and complicated contract language. The resource is annotated with Georgia statutes and case law, and it includes language from managed care lawsuit settlements in which MAG was an original plaintiff.

A Georgia Model Managed Care Contract is available online on a password-protected basis at no cost to members. The cost for non-members is $350. It can be obtained by contacting Christiana Craddock with MAG at 678.303.9271 or ccraddock@mag.org.

Click here to access 'A Georgia Model Managed Care Contract'

Click here to access 'MAG Model Medical Staff Bylaws'

MAG cannot provide legal advice or representation to individual members. The information that is provided in this section of the website is intended to serve as useful information. It is in no way intended to serve as legal advice or a legal relationship. You should always discuss specific legal issues with your private health care attorney and your medical malpractice liability carrier for specific advice and recommendations.