Concerned about care disruption, rising healthcare costs, and administration issues? We are too. That’s why we’ve created IH solutions that address some of the biggest issues payers face: member satisfaction, cost containment, and easy benefit administration.
With 30 years of experiencing in managing and administering integrative healthcare benefits, CHP is well-positioned to ensure members experience minimal disruption when payers implement our IH solutions.
Provider recruiting: We have been building local, high-quality integrative healthcare networks for 30 years. We have extensive experience in creating and effectively managing right-sized networks to ensure member access and satisfaction.
Patient satisfaction: We perform an annual Patient Satisfaction Survey to ensure that members are getting care that benefits them. Over the last 10 years, our overall patient satisfaction rate has averaged 97%.
Provider satisfaction and retention: Keeping members happy with their IH benefit requires a stable, mature network of providers. Our network management approach is simple: accept only the best providers and trust them to deliver the right care at the right time. Our outstanding provider satisfaction rate shows that providers are satisfied with this approach and our 98% provider retention rate is proof that our methodology works.
Generally, integrative healthcare is a less expensive care option than conventional medical services. By controlling the number of referrals for specialty care, limiting expensive imaging studies, and reducing the need for opioid prescriptions, cost savings can be quickly realized in many areas.
Well-managed provider network: Our local provider network is closely managed to ensure it is of the appropriate size and composition to serve the member population. Our Clinical Services Department oversees reporting on provider care trends, as well as claims and chart note reviews to prevent over-utilization of services and cost excesses.
Medically ecessary care: At CHP, we ensure our provider network only delivers medically-necessary, evidence-based care. Providers are thoroughly screened during credentialing to ensure that they practice in agreement with our philosophy of care. This ensures member access while controlling costs through utilization management.
Custom benefit options: We have invested in a state-of-the-art enterprise system that allows us to create benefit designs that meet your specific utilization and cost containment needs. From co-pays to co-insurance, annual limits or visit caps, we work with you to deliver the best IH solution for your members or employees.
Our IH solutions cover the entire service spectrum from benefit design to network management to claims administration.
Network management: Our network management approach results in superior provider satisfaction scores and improved outcomes for patients. To ensure a high-quality provider network, our management services include credentialing, utilization management (UM), quality management (QM), continuing education, and industry-leading best practices.
Claims administration: CHP’s enterprise system has been configured specifically for integrative healthcare claims processing. We use the latest technological enhancements for process efficiencies including electronic claims submissions, ACH payments, and online delivery of reimbursement advice (RA) documents. EOB generation and delivery services are available.
Customer service: Our Customer Service and Provider Services Departments have friendly, helpful staff to answer incoming inquiries and have exceptionally low abandoned call rates. Our Account Management team ensures that client inquiries are handled promptly.
Reporting: Our enterprise system allows us to provide detailed reporting on a variety of data points including cross-accumulation and eligibility management. Client service reports are available quarterly, bi-annually, or annually.