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Provider Manual

Providers' Expectations of Security Health Plan

Last Updated on March 02, 2020

Providers of care can expect Security Health Plan to:

  • assist the provider in meeting the expectations of Security Health Plan
  • 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 Security Health Plan 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 Security Health Plan’s performance measured on such denials 
  • inform providers of changes in benefit administration policies that may affect them or Security Health Plan members’ awareness 
  • provide a written copy of Security Health Plan’s Quality Improvement program evaluation upon request