New Claims System Update

IntegraNet Health’s MISSION is to enable physicians to provide quality care and improve clinical and quality of life outcomes to every patient we serve. We believe physicians should be in control of their practices and the clinical protocols used to affect patient outcomes. We also believe physicians deserve to be properly compensated for their time and expertise, including the receipt of prompt reimbursements from insurance providers.

Our VISION is to be the innovator within the health care delivery system of our community and to be a revolutionary force in shaping new clinically relevant responses to the health care needs of the people we serve. We’ll achieve this vision through risk-sharing relationships and through cultivating risk rewards and creative partnerships with those who share our values. We’ll attract, involve, retain and empower talented staff with state-of-the-art knowledge that’s shared with our clients and partners.

Improved Healthcare Approach

IntegraNet Health serves as an independent physician association that is a consortium of medical resources and best practices. We provide cost-effective and comprehensive medical home-based care coordination and complex case management in order to significantly reduce medical risks and improve the clinical outcomes and quality of life. By meeting our Pay-for-Quality and Pay-for-Performance guidelines, physician office-based quality measure compliance greatly improves and Four to Five Star status is attained by our partner health plans. This increases revenues per member (patient) per month, resulting in significant increases in physicians’ bonuses each quarter. Our proven Pay-for-Performance (P4P) system has also been recognized by health plans for better chart documentation, ICD9 and HCC coding and generally healthier patients. Additionally, our managed care patients appreciate the coordinated quality healthcare that’s provided through IntegraNet’s network of multiple, independent specialists who stay in continuous communication with the primary care medical home. Our entire medical supply chain benefits.

Our Primary Differentiator: Care Coordination A critical element to IntegraNet Health’s system is comprehensive care coordination, which is categorized by two key focuses:
  • Medical Home
  • Hospitalist Program

Both aspects of care coordination keep the patient as the focus and allow a best-practice group of medical specialists to thoroughly treat patients while sharing medical information with the PCP Medical Home to improve the overall health of patients, streamline processes and reduce costs.

IntegraNet Health Benefits to Physicians: Physicians can join the IntegraNet Health system at no charge and reap the following benefits:
  • One-stop credentialing for all our health plans
  • Tracking and communication about changes to health plans
  • Plan negotiation and administration
  • Coding education and assistance
  • On-site educational/training opportunities
  • Practice management expertise to support well-run operations
  • Electronic medical records (EMR) to monitor and track patient data over time
  • Aid with HEDIS and other reports through a dedicated provider relations representative
  • World-class claims resolution service
  • Care coordinators assigned to patients to alleviate primary care physicians
  • Strong pay-for-performance bonuses that help physicians achieve improved patient care, healthier patient populations, higher reimbursements and improved compliance with Centers for Medicare & Medicaid Services (CMS) and other care guidelines
  • Online tracking of physicians’ pay-for-performance progress so they can see if they’re on track for reaching bonuses for quality care and guideline compliance
Learn more about IntegraNet Health’s value-added services by clicking on the icons below.

We invite you to visit our frequently asked questions (FAQs) page or contact us to inquire about joining the IntegraNet Health System.