Training and Education
Our provider training and education program ensures our participating providers are informed of our standards and guidelines, educated and trained regarding various topics and are in compliance with federal and state regulations. These resources are available for participating physicians, health care professionals and office staff in a variety of formats to meet your needs.
Sessions are designed to help reduce administrative time, improve member health outcomes, maximize revenue and help you to work with us effectively and efficiently.
Contracted providers must demonstrate that they are knowledgeable and trained on important topics annually. Participation in our quarterly provider orientation and training course satisfies this annual requirement.
The course offers a detailed overview and provides important information to meet the needs of our members on topics including:
- Claims information
- Member identification cards
- Product information/benefit overviews
- Online tools/resources
- Prior authorizations
Trainings are offered via quarterly webinars, or are available at any time through our online learning course.
To register for an upcoming webinar, please view the Webinars page.
To access online learning courses, go to the Provider Online Courses page.
The Model of Care (MOC) training is conducted annually to ensure all contracted and non-contracted medical providers and staff receive training on the DSNPs MOC as required by the Centers for Medicare & Medicaid Services (CMS). Completion of the annual MOC training is mandatory for all providers who serve our DSNP members.
The course offers a detailed overview and provides important information to meet the needs of our members on topics including:
Comprehensive Training and Education for Dual Eligible Special Needs Plans (D-SNPs) are Medicare Advantage (MA) health plans which provide specialized care and wrap-around services for dual eligible beneficiaries (eligible for both Medicare and Medicaid). Trainings are offered annually or available at any time through our online learning course.
To register for an upcoming webinar, please view the Webinars page.
To access online learning courses, go to the Provider Online Courses page.
Complete an online course and receive a printable certificate of completion.
We are required to effectively manage and oversee FDRs that assist in providing services for our Medicare members.
We prohibit all illegal and/or unethical conduct by members, employees and providers and address questionable activity by investigating referrals of illegal and unethical conduct.
We offer complimentary provider webinars on various topics in various formats to fit your needs.