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For Providers
Welcome to a special set of Web pages with valuable information just for providers affiliated with Univera Community Health. This page includes specific information available to Providers such as provider guidelines and the provider newsletter.
When a child has a potentially life-threatening illness, the family is often overwhelmed physically and emotionally. Providing the support families need during their child's illness is CompassionNet. A program recently introduced by Univera Community Health, CompassionNet coordinates comprehensive services for Western New York children with serious health conditions and their families. The program is open to Univera Community Health members. Although families insured by Univera Community Health already have access to excellent medical care if a child becomes very ill, CompassionNet takes that care one step further. CompassionNet substantially expands the scope of care for very sick children and provides assistance for their families. Physicians, nurse practitioners and other health professionals may make referrals to the program. Unlike traditional hospice care, CompassionNet accepts patients who may experience full recovery and doesn't restrict life-prolonging treatments. The program's philosophy is that no child should face unnecessary pain, and all families can hold on to the hope of healing. A CompassionNet case manager develops an individual plan of care for each enrolled child and his/her family. The case manager coordinates social and support services beginning at diagnosis and throughout the course of the child's illness - even if those services may not be a benefit under the family's health plan. Before CompassionNet, few seriously ill children were able to receive this kind of "all-inclusive coordination of care" that combines institutional and community-based services. For one family, it may mean arranging for a child undergoing chemotherapy to have a wig, while for another it is securing counseling for the child's siblings. Little Things Make All the Difference Families report that CompassionNet has offered tremendous comfort during their time of need by providing a community support network that helps them cope with their child's serious health condition and treatment. The CompassionNet case management program is accepting referrals from community pediatricians and pediatric specialists. Physicians may make a referral to the program by calling (716) 857-6211 or toll-free at 1 (877) 741-3915. Family Health Plus Benefit Changes On September 1, 2005, New York State has changed eligibility and benefits for Family Health Plus members. Please see the grid for more information - PDF. Child Health Plus and Family Health Plus Quality Care Dosing under the CHP and FHP Formulary Guide Forms for Providers Administration Ancillary Services Benefits Management Billing and Remittance Credentialing
Tools for Your Office: Member Brochure - UCH version Prenatal Risk Assessment Provider Services The Univera Community Health Provider Guidelines are prepared through a committee structure that includes input from the physician community to establish evidence-based clinical guidelines and standards. Preauthorization Guidelines (Effective April 1, 2006) Preauthorization Guideline - PDF Outpatient Procedure List (Effective April 1, 2006) Outpatient Procedure List - PDF Univera Community Health Provider Manual (New) See the Univera Community Health Provider Manual online at univerahealthcare.com. WNY Examiner with Univera Community Health Insert, Winter 2008 - PDF
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The CompassionNet philosophy is no
child should face unnecessary pain, and all families can hold on to the hope of healing.
