phtech.comPerformance Health Technology - Business Process Outsourcing To Helps Health Plans Transform Healthc

Toggle navigation Home Who We Are What We Do Join The Team Our Leadership News Connect IN THE COMMUNITY: CCOS EARN 2016 INCENTIVE FUNDS Top performing CCOs earned $44,625,284 in quality incentive funds for calendar year 2016 USING CCOMetricsManager Powered by inteligenz, a strategic partner of PH TECH. Read More IN THE COMMUNITY: UMPQUA HEALTH AND PH TECH Umpqua Health has chosen to partner with PH TECH and leverage its full suite of products in order to help continue their efforts to improve health care quality, lower costs and enhance customer experience in Douglas County. Read More IN THE COMMUNITY: PRIMARYHEALTH AND PH TECH PrimaryHealth has chosen to migrate to PH TECH's key core systems and service platform to support the needs of their organization and the healthcare community they serve. Read More Let's Make Healthcare Local Again We help provider sponsored health plans as they take on and manage risk, which ultimately allows for local healthcare decisions. We are tenacious in our commitment to help them improve healthcare and support the people in their community. Read More Champions for community based health plans We bring a 'yes we can' approach to helping community health plans manage risk. Whether that is modeling a complex benefit, creative provider contract or improving a process to create better care. Our team’s creative approach, control over our platform and years of experience give you what you need to achieve your goals. Read More Control Over How Healthcare is Delivered PH TECH supports provider sponsored health plans with control over benefits, contracts with providers, medical decisions, care management and population health. We help make personal connections to your members and providers, empathetically and expertly helping to navigate health care systems. Read More Who we are It may sound overly ambitious, but we want to make healthcare local again. We see ourselves as champions for community based health plans at PH TECH and our platform and administrative services give you control over how healthcare is delivered. . Champions for community based health plans As a community health plan, we believe you do what you do because you care for people and your community. We believe healthcare is best managed at the local level because – time and time again – we are reminded that, when it comes to health plans, larger member populations and national brand recognition rarely (if ever) encourage the highest quality care. We are a strategic partner, purpose built to simplify and strengthen community based health care delivery. Our technology platform and services are tailor made to scale with the growing and ever-changing needs of the local health plan. Even the smallest health plans feel confident they have the proactive solutions they need to boost patient experience, lower costs and improve health care delivery. As a community based health plan, you face a daunting task. You need support from someone who’s been there - someone who knows the risks you face. You need expertise, sophisticated technology, and the ability to scale your operation when you need to grow. As champions of community based health plans, we will meet these needs for you, and help you make healthcare local again. Supporting Healthy Communities COUNTIES SERVED SERVICE TRANSACTIONS 13,000 ACTIVE USERS 10 MILLION HEALTH CLAIMS PROCESSED PER YEAR What We Do PH TECH gives community based health plans flexibility to contract with, and pay providers how you want. We deliver flexibility to define and administer benefits your members need, and to decide what is medically necessary. We help make personal connections to your members and providers, empathetically and expertly helping to navigate health care systems. We see your members and providers as our members and providers. The following product suite list explains the solutions we provide to give you control over how healthcare is delivered in your community. Claims Processing Compensation is the underlying incentive for your providers to deliver exceptional care to your member population. Our five levels of adjudication intervention allow you to model even the most progressive payment methodologies while still paying providers quickly and accurately. Benefit & Reimbursement Config Determine the providers you wish to contract with and establish the benefits your community and members need. Our platform delivers timely and accurate loading of critical provider information to meet and maintain your business needs. Encounter Data Management Details matter, especially when someone else sets the rates affecting top line revenue. Ensure that data in your systems and the systems of government entities and large health plans accurately reflects membership and costs. Care Management Manage interventions with members with community stakeholders through coordination, communication, empowerment, engagement. Use a centralized system that allows plan, provider and community organizations collaborate to ensure members with enhanced needs receive the right care at the right time. Utilization Management Manage your healthcare costs with our system to evaluate the appropriateness and medical necessity of services, performed by providers and facilities. Proactively drive your care decisions with timely and accurate case-by-case information. Population Management Managing population health requires accurate and efficient data to close gaps in overall patient care. Effective quality metrics provide insights to direct action and allow you to provide the highest quality care to your community. Appeals & Grievances Appeals and grievances can act as the barometer of the satisfaction of members and providers with your plan. Issues can vary in severity and need timely responses. Manage member, provider, authorization denials, payment issues, and other types of appeals and grievances with our solution. Customer Service Members and providers need assistance navigating a complex healthcare system. PH TECH increases member engagement through our CRM platform, customer service centers, mail and outreach services. We emphatically and expertly care for your members as our very own. Use our call centers, staff your own using our platform or find a blend of the two that fits your needs. Community Portal PH TECH's portal allows community stakeholders at the provider office, health plan, plan partners, delegated entities and other community organizations to collaborate to coordinate the care of members. Our portal provides the opportunity for users to participate in more than just verifying eligibility and claim status. It allows designated users to participate in utilization management, care management , population health management and other key plan processes. Join The Team Join PH TECH on the pursuit to make healthcare local again. We are innovative and solution oriented. We work hard but know how to have fun. We are family. We are constantly searching for innovative high performing individuals to help us transform the healthcare world. If you’re looking for a place to bring your very best every day, we’d love to hear from you! Join Us On Our Mission Today! At PH TECH, we provide a dynamic and innovative work environment, where you can thrive and discover the path to a successful career. We believe in leadership and management that inspires top achievers to reach measurable and gratifying achievements. In turn these milestones support our community based health plans, and help to make healthcare local again. If you’d like to be a champion for community based health plans, we want to talk to you! We’re looking for creative solution providers with a positive and ambitious drive for success. If you have an eagerness to join a performance driven environment, this could be the place for you. Together we will can create a supportive and solution-oriented experience for our customers, giving them the tools they need to have control o...