2013 Practitioner and Provider Manual - Presbyterian Healthcare ...

Presbyterian Healthcare Services2. Provider Network Management2. Provider Network ManagementPresbyterian has an internal Provider NetworkManagement (PNM) team that is dedicated toworking with our network of practitioners andproviders. The department is committed todelivering an exceptional provider experiencethrough relationship management andengagement, timely and informativecommunications, modern resources and services,and good customer service. We develop and shareprograms, tools, and communications that provideour network with critical information, managedcare-relatedtraining and education, facilitation, andsupport. As part of the Health Plan, we areconstantly evaluating new services and tools thatmay increase efficiency, add value, and lower costsfor our network and all other stakeholders.What We DoPNM team members provide their expertise andservice to the following areas: practitioner andprovider relationship management andtraining/education, credentials verification,practitioner and provider e-business resources,network communications, and business analysis.Each practitioner or provider within thePresbyterian network has a designated PNMrelationship executive who is available as youradvocate within the health plan. Our relationshipexecutives are reaching out to their assignedpractitioners and providers through in-person visits,phone calls, and emails. They are your first anddedicated resource for questions and supportrelating to Presbyterian products, services, andinitiatives.Keep Us Updated: Provider Change NotificationFormThe PNM team is dedicated to maintaining andproviding up-to-date information aboutPresbyterian’s network of practitioners andproviders. Help us maintain accurate practitionerand provider data and keep automated processesrunning smoothly by providing us with up-to-dateinformation about your office.Your contract with Presbyterian requires you tosubmit changes to your relationship executive inwriting. This includes any changes related to yourpractice, such as an address change, taxpayeridentification number change, panel status, andcontract status. This information is used inelectronic and paper provider directories, and forregulatory reporting purposes. An electronicnetwork change form can be submitted athttps://www.phs.org/providers/trainingreference/Pages/update-provider-directory.aspx.Expanding Contracted ServicesAll practitioners and providers interested incontracting for an additional location, services, orspecialty must comply with the applicable2-12014 Practitioner and Provider Manual - Ver. 3