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Provider Manual

Providers' Expectation of Family Health Center

Last Updated on January 24, 2019

Providers of care can expect Family Health Center to:

  • assist the provider in meeting the expectations of Family Health Center
  • pay claims fairly and efficiently
  • provide due process to the provider when complaints or grievances are lodged against him or her, or when a provider wishes to appeal Security Health Plan decisions
  • strive to interfere as little as possible with the process of care, unless there are significant issues related to quality, cost or coverage
  • support the provider in practice by identifying opportunities to improve care when information is available on a practice basis or an individual member basis
  • maintain an appeals process that can respond quickly and appropriately to members and providers. 
  • educate and encourage members to be seen for appropriate preventive services 
  • inform providers of initiatives that may affect them or Family Health Center members before such interventions occur, and before members are aware of them (such as educational programs which may result in questions being asked of the provider) 
  • maintain internal processes to improve service to members and providers 
  • review clinical information when making decisions about coverage; staff do not receive financial compensation for denying benefits for health care services nor is Family Health Center’s performance measured on such denials 
  • inform providers of changes in benefit administration policies that may affect them or Family Health Center members’ awareness 
  • provide a written copy of Family Health Center’s Quality Improvement program evaluation upon request