As you know from the letters you have received in the mail, CareFirst BlueCross BlueShield (CareFirst) and CareFirst BlueChoice, Inc., have selected Alternative Medicine Integration of Maryland (AMI) to provide re-credentialing services for their chiropractic network and to implement their new outcomes-based chiropractic initiative.  They are sponsoring this initiative in recognition of the merits of outcomes-based utilization management; part of a national trend away from the more prescriptive approach that targets the chiropractic community.

The overall goal of this initiative is to establish an initial baseline of a patient’s health status and measure the subsequent outcomes attributed to chiropractic care.  AMI accomplishes this by working with chiropractors to collect data and perform a post treatment quality review assessment.

The first phase of this initiative is your completion of a brief description of your practice’s modalities and demographics and a clinical assessment tool.  These must also be completed by those of you who were notified in CareFirst’s announcement letter and AMI’s letter of introduction that you are also required to complete the recredentialing application at this time according to NCQA guidelines and CareFirst policy.

Upon successful completion of the initiative’s first phase, the second phase includes the use of clinical outcome measurement tools for each of your CareFirst patients from which AMI documents the outcomes of care provided by each of you.  Prior to beginning this second phase of this initiative, AMI will train you and/or your office staff on how to work with AMI’s data collection system and outcome-based utilization management program.

Given the importance of this quality initiative to CareFirst and its members,  participation in this process and successful completion of the clinical assessment tool are mandatory for you to continue as an in-network chiropractor for CareFirst BCBS and CareFirst BlueChoice, Inc.  The deadline for providing the request information and completion of the Quality Initiative Materials (QI Questionnaire Form and Clinical Assessment Tool) and Recredentialing Application (if applicable) is August 1, 2005.

Thank you for your cooperation.  If you have any questions about this initiative, please call the CareFirst/CareFirst BlueChoice Credentialing department at 410-872-3500 or 877--269-9593. To check on credentialing status call AMI’s Provider Relations Staff at 1-800-BestMed.

We look forward to working with you in continuing to provide quality chiropractic services to your CareFirst patients.