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The
foundation of our business is the providers who
participate in our network. Health Network One (HN1)
shares your commitment to providing patients with the
highest level of medical care.
That’s why we focus on developing partnerships that
enable us to offer our clients and their members
convenient access to the best providers.
HN1
maintains contracts with over 5,000 providers in
various, covering most major specialties. Accessed by
over 1,200,000 members in Florida through network
agreements with several area health plans and care
management organizations. It maintains a high
concentration of providers in South and Central
Florida with certain specialties available statewide.
HN1
specialty panels consist of direct-contract providers
and are available to Payers through a variety of
network management models. The networks are accessible
for Medicaid, Medicare, Healthy Kids and Commercial
lines.
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Primary Care |
Ophthalmology |
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Dermatology |
Podiatry |
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Gastroenterology |
Urology |
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Therapy |
Chiropractic |
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All Specialties (Network Access
Agreements) |
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Delegated
Services
Under a network services arrangement, Payers
customarily delegate
some or all of the following administrative functions
to HN1:
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Network Development |
Referrals / Authorizations |
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Provider Relations |
Claims Payment |
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Utilization Management |
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UM/QM Programs
Objective is to
ensure that utilization is appropriate, without
evidence of over or under utilization, and that
our activities measurably impact favorable
health outcomes for the populations that we
serve.
Network Medical Director for each specialty
Specialty Advisory Committee
Satisfaction Surveys (PCP, Specialist, Member)
Clinical Outcome Studies
Chart Reviews Toll-free numbers for members and
physicians
Concurrent review of medical records, surgical
outcome studies,
and encounter reporting
Ongoing analyses of access & availability
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