Benefits

NORTHCOAST provides one major communication link with ease of access for integrated home health services including home infusion and hospice. Additional benefits of working with NORTHCOAST include:

  • Network management providing credentialing and contracting of providers
  • Verification of insurance benefits prior to starting care and monthly reverification done by seasoned NorthCoast staff
  • Nurse case managers working cooperatively to provide the appropriate level of service within the patient’s benefits while focusing on meeting the patient’s needs
  • Patient management guidelines administered fairly and consistently
  • Intake coordinators available 24/7 facilitating after-hours and weekend discharges
  • Focus on payor and patient needs
  • Claims processed and submitted electronically in HIPAA compliant format utilizing standardized coding
  • Uniform data collection and analysis for outcome measurements including unplanned readmissions
  • Utilization oversight of healthcare benefit
  • Disease management programs such as Heart Failure reducing both hospital readmissions and ER utilization.
  • Problem resolution with patients and providers.
  • Extensive history of coordination, management, and provision of service for Anthem Blue Cross and Blue Shield, Prudential, Medical Mutual of Ohio, United Healthcare, and other payer organizations.
  • Operational efficiencies reducing administrative costs and generating cost savings for third party payors.
  • Management team with many years of experience in home health, infusion, and hospice
  • Case managers experienced in home care and home infusion
  • Operational standards supporting NCQA and HEDIS guidelines.
  • Proven provider satisfaction

Services

NorthCoast links providers with patients to provide quality care to meet their home care, infusion, and hospice needs. Services include:

  • Network development, contracting, and credentialing
  • Medical benefit management
  • Ease of referral/single point of contact
  • Verification of benefits
  • Immediate start of care/available 24/7
  • Care coordination/clinical expertise
  • Proactive performance improvement program
  • Claims management and processing
  • Data Management
  • Disease Management programs as requested
  • Consultative services as requested
  • …and more!

Resources

Ohio Council for Home Care www.homecareohio.org
National Association of Home Care www.nahc.com
National Home Infusion Association www.nhianet.org
American Society of Health-System Pharmacists www.ashp.org
Infusion Nurses Society www.ins1.org
The National Hospice and Palliative Care Organization (NHPCP) www.nhpco.org
Institute for Safe Medication Practices www.ismp.org
Center for Disease Control www.cdc.gov
Center for Medicare and Medicaid Services www.cms.gov
WellPoint/Anthem www.anthem.com
Medical Mutual of Ohio www.mmoh.com
Manchester Consulting Company www.manchester-consulting.com
Quadax www.quadax.com
eMAX Health Systems www.eMAXhealth.net