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ACO Management services cover the spectrum of health delivery. It includes the following:
  1. Start-up development: ACO Management assists in the development of the ACO governance. Develop structure to receive payments, methodology in distribution of savings, develop patient centric processes.
  2. IT tools to counts for cost and quality
  3. Managing Quality and Care: We provides the following services:


Providers
-Provider Recruitment
-Provider Orientations disease base).
-Provider Profile Reporting
-Provider Network Assessments
-Provider Incentive Programs
-Provider Credentialing Facility:
  Credentialing/Certification


Quality Excellence
-Quality Improvement Plans
-Grievances and Appeals
-Benchmarking


 
Members
-Member Profiling
-Member Incentive Programs
-Member Pharmacy Lock-In Programs
-Member Call Centers


 


Managing Care 
-Health Risk Assessments
-Patients (Risk, cost) Distribution
-Care Plan Development
-Complex Case/Care Management
-Disease Management
-Health Education and Wellness Programs
-Benefits Administration



Provider Services Representatives
-Outreach and Education
-Extensive Analysis and Reporting
-Training

 


Managing Utilization
-Prior Authorization of Services
-Retrospective Review
-Concurrent Review
-Utilization Review
-Level of Care Determinations


Value Adds Programs
- Health Outreach
- Customer Services
- Disease Management
- Member Incentive Programs
- Health Fairs
- Provider Service Representatives
- Finance


Current Others Programs
- Diabetes Control Network
- Asthma Focus
- Smoking Cessation Program
- ROSEBUD® Pregnancy Program
- Preventive Health Reminders
- Claims
- Case Management
- Credentialing
- Utilization Management Services
- Pay for Performance and Monitoring

For More information about our Services, Contact Us