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Accreditation reflects excellence

Security Health Plan continually strives to improve our members' experience in line with guidelines established by the National Committee for Quality Assurance (NCQA). An independent, non-profit organization, NCQA promotes improvements in the quality of managed care services. 
Security Health Plan has been accredited by NCQA for its individual and group plans every year since 2002 and for its Medicare Advantage plans since 2005.* We are also the first plan in Wisconsin to receive NCQA accreditation for our BadgerCare Plus program.

How we assure quality of our services

Quality management and improvement

We make sure the health services you receive are effective and timely. We work with our providers to identify opportunities to improve care and service.

Credentialing and provider relations

Using NCQA specifications, we thoroughly screen health care providers when they apply to be part of our network. Then we periodically check to make sure they maintain their professional credentials and quality. Our representatives visit clinics to assure that providers are consistently providing the highest possible quality of care.

Utilization management

We want to do what’s best for our members. We help you control costs by requiring prior authorization in certain situations and checking to make sure members receive care in the most efficient location for their condition. We help coordinate home health care services with your doctor to get you out of the hospital, and back into your home, sooner. We also measure how well services such as preventive care are used.

Preventive health services

We encourage all of our members to get the services they need to stay healthy. Our plans include coverage for immunizations, mammograms, cervical cancer screenings, colonoscopies and many other preventive health services.

We stay on top of medical advances

We evaluate new technology in medical care and treatment on a regular basis to determine when new services should be covered. Security Health Plan medical experts review information from government health agencies and scientific publications. We also get input from providers who offer the service.

Member rights and responsibilities

Plan members receive clear information on how to access care, choose or change providers and address problems or concerns.

Medical record standards

We follow strict standards that ensure: â—¦Our members’ medical records are maintained properly

  • Physicians follow up quickly on test results
  • Specialists and primary care providers communicate effectively

Independent studies show that Security Health Plan members generally:

  • Have fewer unnecessary hospitalizations
  • Pay fewer unnecessary health care costs
  • Find it easier to get tests and treatments they need
  • Have fewer hassles with claims
  • Are more satisfied with their health plan**

Producing results every day

Security Health Plan uses resources such as the Health Plan Employer Data and Information Set (HEDIS) to improve health care outcomes for our members.

Effectiveness of care

We evaluate childhood and adolescent immunization rates, flu shots for older adults, post-natal check-ups, treatment of childhood ear infections and the overall health of our senior members.

Care Access

Security Health Plan ensures the availability of primary care, mental health/chemical dependency, obstetrical and prenatal providers. We work closely with pregnant members to encourage early prenatal care.

Informed health care choices

Our members need the right information to make wise health care choices. At Security Health Plan we provide new member education and a 24-hour Nurse Line. To meet the needs of our diverse population, we also provide language translation services.

*NCQA’s Private Health Insurance Plan Rankings, 2015-2016
**Based on Healthcare Effectiveness Data and Information Set (HEDIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) results and scores.