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NACHC Members, click belowIHP

Care Management

Innovative Health Plan (IHP) has a unique approach to medical management. We begin by building a partnership with our clientele, thoroughly analyzing and understanding the unique challenges they face through a health assessment and biometric screening process. We then apply cutting-edge cost containment methods, reducing costs while maintaining a quality employee benefits program.

We provide comprehensive medical management services through a professional staff of physicians and nurses who are highly qualified in cost management issues including quality assurance standards.

Utilization Review

IHP’ Utilization Review program combines the expertise of registered nurse reviewers to ensure you are optimizing your benefits plan. IHP works with board certified Medical Directors and practicing physicians to help direct patients and providers toward the most cost-effective, quality-driven treatment available.

Our Utilization Review services use established national medical guidelines to evaluate the medical necessity for hospitalizations, outpatient services and appropriateness of overall treatment plans.

Comprehensive Reporting

IHP’ reports identify trends in health care spending (a macro view) as well as opportunities for specific member level care improvement/cost avoidance (a micro view). We provide guidance for evaluating health plan performance, benefit planning, areas of cost avoidance, and clinical intervention opportunities.

Our reports include a summary of your health plan, its membership, and the complex array of clinical and medical resources that serve that membership. These reports provide meaningful insights into how benefit plan design can be positively impacted.

Health Promotion Services provide our clients with proactive wellness tools for their employee population such as:

 

Utilization Management supports patient:

Innovative Health Plan’s Case Management supports the management of Catastrophic Complex and Chronic Medical Management needs.

Innovative Health Plan also provides a variety of administrative services including: Clinical expertise, Appeals, External Review Organization Facilitation, Pharmacy Coordination, Post-claim Medical Review and  review for Stop Loss.