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Provider Manual

Additional Programs

Last Updated on January 24, 2019

Security Health Plan has programs available that are above and beyond the normal Medicare benefit to help improve member health. Security Health Plan use established criteria and assessment tools to identify members who may benefit from these programs. Not all members are eligible for these programs. If a member is selected to participate, they must also be willing to participate in Security Health Plan’s Case Management program. These programs are available at no extra charge to the member.

Referring members: As a provider, you may refer a member you think would benefit from any of the programs listed below to Security Health Plan. Referrals, which are at Plan’s discretion, may result from, but are not limited to, members receiving hospital inpatient, skilled nursing facility or chronic care services or health risk assessment results. Please call our provider services line (PAL) at 1-800-548-1224 and ask to speak to a care manager.

Below is a brief summary of the programs available to Medicare Advantage members.

1. Nurse On-Call program

  • Required criteria: Not homebound; in need of one home visit to assess for home maintenance management, safety, psychosocial/behavioral health needs; and member must give verbal consent to Security Health Plan Care Manager
  • Product line: Medicare Advantage
  • Reimbursable code: 99600

2. Telemonitor program

  • Criteria: Not homebound; Class III or IV CHF; frequent hospital admissions or ER visits; in need of disease self-management stabilization; member consents to Security Health Plan Case Management enrollment and is agreeable to placement of the monitor in their home.
  • Product line: Medicare Advantage
  • Reimbursable code(s): S9110-21 and 99600