Skip to main content

HEALTH PLANS & AT RISK PROVIDERS

Our value-based
home care model

Better, more coordinated care
at a lower cost.

Better, more coordinated care at a lower cost.

Health Plans

As the leading home care benefits manager, we’re dedicated to making administrative tasks more efficient for staff, providers, and members.

At-Risk Providers

Providers with alternative or risk-based payment models can get the insights and services they need, when they need them, to better manage care and costs.

OUR BENEFITS

IHCS for Health Plans

IHCS offers a single point of contact so plan partners can easily delegate all
administrative and clinical home care functions to us. Our vertically integrated model
lowers the administrative burden, unnecessary utilization, and the total cost of care while
improving satisfaction for all stakeholders.

A vertically integrated, multi-pronged
approach:

  • Focused pricing initiatives to reduce care costs
  • Efficient utilization management and unit cost management with streamlined hospital discharges and more coordinated care
  • Value-based model that aligns incentives between payers and IHCS

A model that helps save you time and resources:

  • 25 years of TPA experience and best practices 
  • Delegation of UM, network, and claims management 
  • Your staff can focus on higher-value tasks

Fully accountable for program performance. Our performance with all health plan partners guarantees:

  • Top notch service
  • Excellent patient experience
  • High quality home health care, infusion services, and DME
  • Guaranteed financial performance

IHCS provides support to improve HEDIS ratings via:

  • OASIS medication reconciliation and discharge information
  • Data sharing collaboration to identify care gaps and missing data
  • In-home assessments and telehealth

Real-time insights

Our Home Care Insights and Outcomes Platform offers a single place to manage provider networks, real-time plan access, and patient encounters. 

Home Care Benefits Management

Utilization Management

Claims Processing
& Payment

Provider Network
Credentialing & Management

Value based for
greater value

Our clinically coordinated, integrated
model enables us to put the value in
value-based care and be fully accountable
for home care program performance.

OUR BENEFITS

IHCS for At Risk Groups

We stand behind our partnership promises. IHCS is the ideal partner to help you efficiently manage and deliver optimal care and value. We stand behind our promises with performance guarantees and decades of experience managing home care without compromising quality or satisfaction.

IHCS keeps you informed with real-time, transparent data to eliminate delays and reduce risk.

Having leading, real-time authorization and discharge intake data instead of 90-day service- fund and claims lag information, allows for prescriptive vs. reactive analytics and interventions

Our customized, intentional network management model streamlines hospital discharges. With a vertically integrated model, we simplify care coordination across services. This empowers timely discharges and appropriate care transitions. Patients receive timely care and experience fewer unnecessary ER visits and readmissions.

    • Designated member outreach to ensure appropriate and timely starts of care
    • Detailed home assessments and OASIS reports that specify conditions which may lead to readmissions
    • Electronic maintenance of all hospital discharge information and records for any patient taken under care post-discharge
    • Medication reconciliations on all starts of care

We enable providers to streamline care and workflows to save time and reduce costs and utilization.

    • Efficient hospital discharges and care coordination
    • Streamlined credentialing processes and procedures
    • Electronic claims and medical record submission
    • Faster claims processing and denial notifications

Lower risk.
Higher quality.

You can’t manage care and costs without access to timely, accurate insights. IHCS gives you the immediate visibility you need, across all home care services and patient populations, to lower risk and improve care.

Claims Processing and Payment

  • Claims adjudication and processing and payment of penalties in accordance with state and federal laws
  • 99%+ accurate and timely processing of all claims with monthly reporting

Provider Network Credentialing & Management

  • NCQA compliant
  • Rigorous credentialing, auditing, and provider education
  • Monthly credentialed, re-credentialed, and terminated provider reports
  • FDR training and compliance oversight
  • Performance, sanctions, and complaint monitoring
  • Management of provider appeals process

Utilization Management

  • NCQA compliant
  • Referral evaluation and determination of qualifying services
  • Referral assignment based on geography and clinical needs of patient
  • Back-end web services with integrated address validation and real-time eligibility verification
  • Built-in reporting for pending referrals and productivity management
  • Turnaround reports detailing daily orders

A MODEL THAT DELIVERS

Our results speak for themselves

2

Patients served

9

Average cost of care savings

24

Hours of daily customer service availability

Driving transparent value

Our award-winning Home Care Insights and Outcomes Platform drives transparent value with real-time insights into all aspects of the home care ecosystem. Gain more visibility into member health and care utilization, access built-in reporting options and customer management services, and gain critical insights into pending referrals and productivity.

24-hr. access:

  • Request a refill
  • See order status
  • Arrange for a service call
24-hr. access:

  • Real-time patient documentation and interactions
  • Patient encounters tracking
  • Network physician credentialing data
  • Utilization and cost tracking/analytics
  • Coverage determinations and benefit eligibility
  • Submitting and reconciling encounter data
  • Claims adjudication and payment
24-hr. access:

  • Automated referral and regulatory metrics
  • Clinical decision support and utilization management
  • Credentialing and contract management
  • Live communication support

Insights

Real-time information delivery and
utilization optimization tools

Reporting

Comprehensive, real-time referral
tracking and automated reporting

Efficiencies

Optimized authorization and
claims workflows

WE DELIVER MORE

Services We Offer

Home Health Services

Skilled, compassionate nursing, therapy, and personal care services

Durable Medical Equipment

High-quality equipment delivered on time and on budget

Home Infusion
Services

Safe, comprehensive, therapeutic infusion services
“

This past year has been a pleasure dealing with staff, and there is barely ANY wait time in answering my calls.

Referring ProviderThe Palace Nursing and Rehab Center
“

We are completely satisfied with all we services receive. Thank you for helping us with provide swift and efficient care to our patients.

Referring ProviderShiv A. MD
Contact Us