Not sure how to submit an authorization for specialty or ancillary services?
A Prior Authorization team member can walk you through the process.
The Prior Authorization Department streamlines the process of referring your patients to specialists by:
Have a patient
who needs extra help?
Care coordination services are available for ALL patients covered under your PHPprime contracts.
The Care Coordination Department works together with physicians, patients and family members to:
Questions regarding contractual arrangements with your practice or other network providers as part of PHPprime?
Contact the PHP Contracting team for answers and assistance accessing the data and resources you need.
The Contracting Department manages details regarding service or participation agreements related to contracts your practice participates in as part of PHPprime, including:
Need information or support from PHP?
The Provider Relations team is here to help coordinate resources and facilitate resolutions.
Provider Relations is the go-to source for our provider practices, connecting you with the PHP resources you need and disseminating and explaining pertinent information with regard to:
Trouble with an internal process? Not meeting quality measure goals?
Contact your PHP quality improvement coach for guidance.
The Quality Improvement Department helps practices build sustainable processes to deliver comprehensive, patient-centered care through data and continuous quality improvement initiatives. Quality improvement coaches provide guidance with:
Are you documenting care for all risk adjusting conditions? Every patient, every year?
Connect with a PHP coding educator for help with Medicare Advantage documentation and coding.
The Coding Education team helps each practice maximize accuracy of patient care documentation and Risk Adjustment Factor (RAF) scores by: