At IntegraNet Health
At IntegraNet Health, we believe it is essential that our providers and staff have a solid understanding of our contracted health plans as well as our established quality and performance measures. Within 30 days of successful completion of provider credentialing and approval to participate in our network, our provider relations department conducts an on-site orientation for providers and their staff. This training covers all provider manuals for each health plan, policies and procedures, software integration and pay for performance criteria.
A provider relations representative is assigned to each participating provider based on geographic location. As a follow-up to the initial orientation session, the assigned provider relations representative regularly contacts each provider and staff to act as a liaison between the provider and IntegraNet Health’s contracted health plans.
IntegraNet Health’s provider relations representatives are available to assist you with:
- Providing membership rosters, HEDIS reports and Five Star Criteria, pay for performance status, care coordination assistance for patient care
- Delivering resource information such as provider directories and quick reference guides
- Assist with NCQA certification for Patient Centered Medical Home
- Utilization of IntegraNet Health resources and value added services
- Assisting with claims issues and complaint resolution
- Specialty recruitment when needed
- HEDIS
- ACO/GPRO reporting
- Coordinating Coding Education assistance
If you are already an IntegraNet Health member but are not sure who your Representative is, please reference the list below: