November 20, 2017

 

 

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Our Services

Sales

  • Initial presentation of Center Care and other managed care products to interested groups
  • Work with agents and third party administrators to promote Center Care products
  • Assist with open enrollment and renewals
  • Coordination of health fairs
  • Reinsurance relationship maintenance

Member Services

  • Employee education
  • Claims assistance
  • Network information
  • Member complaints' resolution and tracking

Provider Relations

  • Network development
  • Provider contracting (hospitals, physicians and ancillary providers)
  • Provider education
  • Maintenance of provider relationships within the network
  • Provider complaint and problem resolution

Provider Credentialing

  • Systematic selection, evaluation and monitoring of providers (physicians, hospitals and ancillary providers)
  • Rigorous program based on NCQA guidelines
  • Peer evaluation by committee of local physician leaders

Claims Repricing

  • Ensure timely turn around for claims being repriced
  • Maintain up-to-date information on clients, participants, networks, and providers
  • Reprice claims using a fee schedule, percent to charge or per diem rate
  • Identify claims with possible problems prior to submission to TPA

 

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Copyright 2017    Center Care Health Benefit Programs     All rights reserved.  Legal Disclaimers
Stadium Park Plaza     360 East 8th Avenue, Suite 411     P.O. Box 148
Bowling Green, KY      42101        (270) 745-1517        (800) 972-7038
A division of Commonwealth Health Corporation