Primaris
Encyclopedia
This article refers to the health care company Primaris. See also Primaris Airlines
.
Primaris is a nonprofit health care consulting company in Columbia, Missouri
. Its mission statement is "to improve healthcare delivery and outcomes by promoting excellence, advancing knowledge and developing innovative solutions for physicians, other providers, businesses, government, patients and consumers." It has held the Medicare
Quality improvement organizations
contract for Missouri since the program was created. This contract was renewed in 2008 by the Centers for Medicare and Medicaid Services
(CMS) for a three year period.
In addition, Primaris oversees the CLAIM program, Missouri's State Health Insurance Counseling and Assistance Program, which provides answers to Medicare-related questions for anyone in Missouri.
At the time of Primaris' founding, its primary function was to provide third-party, non-biased review of complaints about medical care provided to Medicare beneficiaries. This is primarily accomplished through reviews of medical records. This role was federally mandated by Congress through what was then known as the Medicare Utilization and Quality Control Peer Review Program. Since that time, the program evolved several times, eventually becoming the Quality Improvement Organization (QIO) program. Under the current program, Primaris continues to provide medical record reviews; however, it plays a larger role working with hospitals, home health agencies, nursing homes and physicians on a variety of projects to improve CMS-specified quality measures.
CLAIM is Missouri's State Health Insurance Assistance Program (SHIP). Every U.S. state or territory has a SHIP program, though most are run directly by state agencies. Primaris acquired the CLAIM program due to a hiring freeze affecting Missouri state agencies when the program was created. The freeze prevented state agencies from hiring staff to run the program, and so Primaris was contracted for the work.
CLAIM provides assistance navigating the Medicare system to Missourians. CLAIM was originally an acronym for "Community Leaders Assisting the Insured of Missouri," however, this has largely been dropped in favor of the shorter, easier-to-remember, name CLAIM.
Primaris provides this service through a network of over 100 partner organizations and more than 200 volunteers trained by the company. Missourians with Medicare questions can call the CLAIM helpline or send an electronic request on the CLAIM website. This gets referred to a local volunteer, if available, or a staff member, who answers questions or provides in-depth assistance.
Primaris Airlines
Primaris Airlines was an American charter airline located in Enterprise, Nevada, USA It operated in domestic and international services. Its main base was McCarran International Airport, Las Vegas.-History:...
.
Primaris is a nonprofit health care consulting company in Columbia, Missouri
Columbia, Missouri
Columbia is the fifth-largest city in Missouri, and the largest city in Mid-Missouri. With a population of 108,500 as of the 2010 Census, it is the principal municipality of the Columbia Metropolitan Area, a region of 164,283 residents. The city serves as the county seat of Boone County and as the...
. Its mission statement is "to improve healthcare delivery and outcomes by promoting excellence, advancing knowledge and developing innovative solutions for physicians, other providers, businesses, government, patients and consumers." It has held the Medicare
Medicare (United States)
Medicare is a social insurance program administered by the United States government, providing health insurance coverage to people who are aged 65 and over; to those who are under 65 and are permanently physically disabled or who have a congenital physical disability; or to those who meet other...
Quality improvement organizations
Quality improvement organizations
Quality Improvement Organizations monitor the appropriateness, effectiveness, and quality of care provided to Medicare beneficiaries. They are private contractor extensions of the federal government that work under the auspices of the U.S...
contract for Missouri since the program was created. This contract was renewed in 2008 by the Centers for Medicare and Medicaid Services
Centers for Medicare and Medicaid Services
The Centers for Medicare & Medicaid Services , previously known as the Health Care Financing Administration , is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer...
(CMS) for a three year period.
In addition, Primaris oversees the CLAIM program, Missouri's State Health Insurance Counseling and Assistance Program, which provides answers to Medicare-related questions for anyone in Missouri.
History
Primaris was founded in 1983 by the Missouri State Medical Association, Missouri Hospital Association and Missouri Association of Osteopathic Physicians and Surgeons. The company was originally named the Missouri Patient Care Review Foundation. The company later changed its name to the Missouri Patient Review Organization or MissouriPRO to reflect name changes in its federal contract with CMS. After the CMS contract changed names again, the nonprofit switched its name to Primaris. This generic name was selected intentionally to avoid a need for future changes should the federal contract be renamed.At the time of Primaris' founding, its primary function was to provide third-party, non-biased review of complaints about medical care provided to Medicare beneficiaries. This is primarily accomplished through reviews of medical records. This role was federally mandated by Congress through what was then known as the Medicare Utilization and Quality Control Peer Review Program. Since that time, the program evolved several times, eventually becoming the Quality Improvement Organization (QIO) program. Under the current program, Primaris continues to provide medical record reviews; however, it plays a larger role working with hospitals, home health agencies, nursing homes and physicians on a variety of projects to improve CMS-specified quality measures.
CLAIM Program
Since 1993, Primaris has run the CLAIM program through a contract with the Missouri Department of Insurance, Financial Institutions and Professional Registration. The Centers for Medicare & Medicaid Services provide funding for the program.CLAIM is Missouri's State Health Insurance Assistance Program (SHIP). Every U.S. state or territory has a SHIP program, though most are run directly by state agencies. Primaris acquired the CLAIM program due to a hiring freeze affecting Missouri state agencies when the program was created. The freeze prevented state agencies from hiring staff to run the program, and so Primaris was contracted for the work.
CLAIM provides assistance navigating the Medicare system to Missourians. CLAIM was originally an acronym for "Community Leaders Assisting the Insured of Missouri," however, this has largely been dropped in favor of the shorter, easier-to-remember, name CLAIM.
Primaris provides this service through a network of over 100 partner organizations and more than 200 volunteers trained by the company. Missourians with Medicare questions can call the CLAIM helpline or send an electronic request on the CLAIM website. This gets referred to a local volunteer, if available, or a staff member, who answers questions or provides in-depth assistance.