HOW DOES CARECENTRIX ASSIST HOME HEALTH CARE PATIENTS & AGENCIES?
CareCentrix is the leader in managing patient care to the home.
We have nearly 20 years of experience working with payors and providers to create programs that improve quality and lower costs by managing patient care to the home. We are passionate about making care at home safe, high quality, accessible, and low cost.
WHAT SETS US APART
CLINICAL CARE & PATIENT FOCUS
Our teams of highly trained nurses, all experienced in specific disease areas and in managing care to the home, coordinate care with physicians, case managers and network providers. We are URAC accredited for Health Utilization Management (UM) and conduct prospective, and retrospective utilization reviews of requested home care services.* We leverage proprietary data and monitor trends to help enhance the UM policies of our customers, enabling them to make more informed decisions on their coverage policies.
HIGH PERFORMANCE NETWORK
Our national network of home care providers has been credentialed using NCQA credentialing standards. Our network boasts more than 8,000 qualified provider locations. In collaboration with our network, we can provide the right provider for the right level of care.
PROVEN ABILITY TO REDUCE COSTS
Leveraging almost 20 years of experience and best practices, CareCentrix has consistently delivered cost reductions for customers as a result of our innovative programs and expertise in home health care utilization review, network management and care coordination. When patients receive the care they need, when they need it, for the right cost, in the comfort of their home, the result is a win-win: savings for our customers and improved outcomes for patients.
The individualized needs of the patient and their loved ones guide all of our decisions as we continue to develop optimal solutions for successful healing in the home. From sleep, to hospital readmission reduction, to home infusion and more, our programs utilize technology, our expert staff, our contact with patients and family to guide, educate and support patients towards healthier outcomes and increased satisfaction.
CareCentrix is fully dedicated to making the home the center of patient care. By managing the services, therapies, and resources that enable patients to heal and age at home, we’re able to support plans in meeting the Triple Aim of health care: lower costs, improved outcomes, and higher patient satisfaction. This is particularly important as care continues to shift out of inpatient settings, and healthcare strategies migrate from fee-for-service to value-based care. By 2018, as much as 50% of Medicare benefits will be delivered under value-based payment models,1 a fact that underscores the importance of patient outcomes, even when not in a hospital or acute-care facility. Our Integrated Care at Home offering combines the critical components for ensuring a well-managed plan that extends beyond the hospital’s four walls. Home Provider Network. We provide our clients with access to one of the most comprehensive home provider networks in the nation. We have credentialed and contracted with over 8,000 provider locations for:
Durable Medical Equipment
Home health services (in-home nursing services by registered nurses, physical therapists, occupational therapists, medical social work services)
Home infusion services
Respiratory therapy services
Orthotics, prosthetics, and medical supplies
Our comprehensive credentialing process meets or exceeds the standards of nationally recognized accrediting bodies, such as URAC and NCQA*
Clinical Support. Our teams of highly trained nurses, all experienced in specific disease areas and in managing care to the home, coordinate care with physicians, case managers and network providers. We are fully accredited by URAC for Health Utilization Management (UM) to conduct prospective and retrospective utilization reviews of requested home care services. We leverage proprietary data and monitor trends to help enhance the UM policies of our customers, enabling them to make more informed decisions on their coverage policies. Because care at home is our focus and area of expertise, we implement best practices to help ensure optimal outcomes in the home. Care Coordination. We know that one of the most important drivers of satisfaction is that care in the home starts when it should. We take extraordinary measures to ensure that the start-of-care date from the physician or discharge planner is met; on average, we meet the start-of-care date 99.3% of the time, in many cases coordinating among different home care providers. To help ensure that providers have been able to fulfill services by the prescribed start-of-care date, CareCentrix performs a service validation program, in which we contact patients 24 hours after the documented start-of-care date to confirm that the service was delivered on time and with adherence to quality standards. Reduced Administrative Burden. Plans often contract with us for eligibility determinations, claims processing and payment, billing (to both providers and members), member services and engagement, as well as to minimize Fraud, Waste, and Abuse.
With an aging U.S. population, a greater incidence of chronic conditions and increased health coverage, the need to manage durable medical equipment (DME) and home health services is growing. By managing patients in the home, effective daily treatment costs can be reduced by 89% as compared to a skilled nursing facility and as much as 98.5% as compared to an acute care hospital setting.2
Demand for DME continues to grow at an annual rate of 4.8% and is estimated to reach $43 billion by 20193
DME waste and abuse is growing as well – estimated at $1.5 billion to $5 billion per year causing unnecessary costs and risks to patients4
CareCentrix’s Integrated Care at Home program relieves plans of the complexity and burden of administering end-to-end care at home through an efficient and scalable approach. The program facilitates appropriate, cost effective, and patient-centered care without compromising quality that can:
Reduce the risks and costs of fraud
Coordinate the services and equipment patients need in a timely fashion
Reduce unnecessary costs and risks attributed to institutional settings
About us: Altruist Home Health Care, we wish for our clients to be well-informed before partnering or partaking in any of our firm’s services. We hope your experience will be better once you know who we are, have more realistic ideals and goals about working with us, as well as understand what we are focused on doing for you and our community. If there are any other questions or concerns you may be having, please contact us at (214)328-8600
WE HAVE TWO GREAT LOCATIONS TO SERVE YOU
6301 Gaston Avenue, Suite 610
Dallas, TX 75214
Phone: (214) 328-8600
5402 Wesley Street, Suite D
Greenville, TX 75402
Phone: (903) 259-6345
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