Training and Education
Our provider training and education program ensures our participating providers are informed of our standards and guidelines, educated and trained regarding various topics and are in compliance with federal and state regulations. These resources are available for participating physicians, health care professionals and office staff in a variety of formats to meet your needs.
Sessions are designed to help reduce administrative time, improve member health outcomes, maximize revenue and help you to work with us effectively and efficiently.
Contracted providers must demonstrate that they are knowledgeable and trained on important topics annually. Participation in our quarterly provider orientation and training course satisfies this annual requirement.
The course offers a detailed overview and provides important information to meet the needs of our members on topics including:
- Claims information
- Member identification cards
- Lab and other benefit carriers
- Online tools
- Prior authorizations
Mandatory training for providers serving our D-SNP members to maintain compliance with DHS, CMS and NCQA.
We are required to effectively manage and oversee FDRs that assist in providing services for our Medicare members.
We offer complimentary provider webinars on various topics in various formats to fit your needs.
We prohibit all illegal and/or unethical conduct by members, employees and providers and address questionable activity by investigating referrals of illegal and unethical conduct.
Pennsylvania’s mandatory, managed Medicaid program for residents with Medicaid and Medicare, individuals with physical disabilities and members with long-term care needs.
Complete an online course and receive a printable certificate of completion. Complete three and we will acknowledge your practice in our quarterly newsletter!