8 Health Care Management Services
8 Health Care Management Services
IntegraNet continuously seeks to improve the quality of care provided to its members. We encourage and expect our providers to participate in health promotion and disease prevention programs. Providers are encouraged to collaborate with IntegraNet in efforts to promote healthy lifestyles, improve quality of life and wellbeing through member education and removing barriers to health care.
Providers must fully comply with:
The health care delivery system is a gatekeeper model that supports the role and relationship of the PCP. The model includes PCPs, hospitals, specialty physicians and other providers as required to deliver Medicare benefits, additional benefits and IntegraNet programs for members with complex medical needs.
All members select a PCP upon joining the plan. IntegraNet works with the member, the physician and the member’s representative, as appropriate, to ensure the PCP is suitable to meet the member’s special needs. Members must have access to their PCP or a covering physician 24 hours a day, 7 days a week.
IntegraNet is delegated by the health plan to administer services except for:
We can assist providers with gaining access to any of these services from the health plan, but the health plan administers/manages these services.