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Provider Manual

Additional Programs

Last Updated on May 22, 2021

Security Health Plan has programs available that are above and beyond the normal  benefit to help improve member health. Security Health Plan identifies members, using established criteria and assessment tools, 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 are encouraged to refer members who 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 assessment results. Please call our provider  assistance 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 members (with the exception of members enrolled in Family Health Center, MSA or Medicare Supplement plan).

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. 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. Reimbursable code(s): S9110-21 and 99600