Enhanced Personal Health Care Program
The Enhanced Personal Health Care Program empowers PCPs to more fully engage in those comprehensive primary care functions that move us toward a coordinated, evidence-based care model that has the greatest impact on achieving the triple aim of improved quality, patient experience and affordability.
We believe the doctor-patient relationship is the most important in health care.
Every patient should have a relationship with a PCP who knows and understands their individual health care needs, can provide comprehensive “whole patient” health care services, and will serve as their champion, helping them navigate the complex health care system to ensure they get the care they need when and where they need it. This is the key to improving quality and outcomes and, subsequently, lowering costs.
Our program is based on a simple principle — that PCPs and their practice team, provided with the right tools, information and resources, are best equipped to optimize the health of their patients and improve the affordability of health care.
This program will:
Make a significant investment in primary care
That allows PCPs and their practice team to do what they can do best: manage all aspects of their patients’ care.
Provide PCPs with tools, resources and meaningful information that promote
- Shared decision making.
- Proactive health management.
- Coordinated care delivery.
- Adherence to evidence based guidelines.
- Care planning built around the needs of the individual patient, leading to improved quality and affordability for our customers and their patients.
Help redesign the current payment model to move from volume based to value based payment
Aligning financial incentives and providing financial support for activities and resources that focus on care coordination, individual patient care planning, patient outreach and quality improvement.
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Precertification lookup tool
- Precertification requirements
- Claims overview
- Member eligibility & pharmacy overview
- Policies, guidelines & manuals
- Training academy
- Pharmacy information
- Electronic data interchange (EDI)