Memberships |
| ABC Pediatrics |
| Cabin Creek Health System |
| CAMC Family Medicine Center |
| CAMC Primary Care |
| Charleston Nephrology |
| Community Health System (Plateau Medical Center, Greenbrier Valley Medical Center) |
| FamilyCare Health Centers |
| Grafton City Hospital |
| Henry Kinder & Associates |
| HIMG |
| Hygeia Facilities Foundation |
| Kanawha Nephrology |
| KidCare West |
| Logan Regional Medical Center |
| Minnie Hamilton Health System |
| Mon Health |
| Montgomery General |
| Mountain Health Network |
| Mountaineer Cardiology |
| Pozega Wellness |
| Princeton Community Hospital |
| Pulmonary Associates |
| Roane General Hospital |
| Robert C Byrd Clinic/WV School of Osteopathic Medicine |
| Rural Health Access Corporation - Coalfield Health Center |
| Thomas Health System |
| West Virginia Health Right |
Resources
| Site | Purpose |
| Aetna Better Health of WV | Resource for ABH prior authorization submission and status inquires. |
| Aetna Better Health WV HEDIS Toolkit | Downloadable reference guide for HEDIS measures |
| CMS website | CMS Website |
| HCC Coding Education | Provides detailed information on understanding Hierarchical Condition Categories, a risk adjustment model that allows for a more accurate picture of patient health in a chronic disease state. |
| Humana Provider Resources | For providers: Valuable starting point for claims, preauthorizations, referrals, clinical support, pharmacy resources, dental resources. Online portal (Population Health Compass) available with additional reporting features, gap closure attestation. Please contact your Practice Transformation Specialist to sign up for access to your facility. |
| PEIA | Provides fee schedules, provider manuals, enrollment forms and other helpful resources. |
| The Health Plan | For Providers: Serves as a launching point for information regarding training, patient care programs, claims support, case management referral, clinical support, prior authorizations and referrals. |
| Unicare | Starting point to access Unicare manuals, policies and guidelines (provider and claims), HEDIS reference, prior authorization and eligibility, payor resources available to patients. |
| United HealthCare | Resource for physicians, administrators, and healthcare professionals with information including policy/protocols, eligibility and benefits, claims, prior authorization, pharmacy information. Online portal (Practice Assist) available with additional reporting features, gap closure attestation. Please contact your Practice Transformation Specialist to sign up for access to you facility. |
| WV Bureau for Medical Services |
Other Resources
| Site | Purpose |
| Aunt Bertha | Online resource to connect with available social services within an area. |
| United Way 211 | Online resource center for available services for assistance with finding food, bill payment, mental health services. |