Case Management
Our professional and friendly case managers will effectively coordinate with patients, their families, and providers to maximize available resources for a quality and cost-effective outcome that meets patients’ health needs. This, in turn, helps your organization achieve its utilization management goals.
Credentialing
A fast and efficient transaction allows you to work and complete your application at your leisure. Let our Credentialing team, which is fully National Committee for Quality Assurance (NCQA) compliant, assist you with its proprietary physician database that offers a quick turnaround time of 24 hours.
Claims
Fully delegated to process all professional claims, our Claims team adheres to strict regulatory guidelines to ensure timely and accurate payments. We use the latest electronic processing software to digitize claims and eliminate the hassle that paper claims can cause.
Customer Service
When there are questions, we are prepared to give answers. Our Customer Service team is available to promptly assist our providers with any patient inquiries related to patient care. Furthermore, we can also serve as a liaison between the Primary Care Physician, Specialist, and Member whenever needed.
Contracting
We work closely with our business partners such as health plans, hospitals, laboratories, and ancillary providers to carefully examine key contract elements, such as language, capitation, incentive, and matrix of responsibility, to ensure the maximum benefits for your organization.
Marketing
The quest to market your brand is not only time-consuming but also never-ending. That is why we are here to help you. Our Marketing team will assist in developing strategic plans through various media and collaborating with partners in the health care community in accordance with the plans of IPAs and medical groups.
Utilization Management
In an era where health care costs are skyrocketing, the efficient allocation of resources is paramount. Our Utilization Management team works diligently to ensure that patients not only get the best care over a continuum of time to achieve positive clinical outcomes but also that appropriate utilization for optimal patient care is being followed.
Data Management
It can be hard to keep up in the digital age when data is rapidly being processed and transferred. With Astrana Health handling your electronic data interchange (EDI), data analytics, and web portal operations, you can focus on delivering quality care with peace of mind.
Quality Care and Management
Our Quality Management Program is designed to promote the highest quality medical care and service to members of Astrana Health and its affiliate IPAs. You can trust our coordination that brings together management and physicians to collaborate on improvement initiatives.
Information Technology
Accurate. Efficient. Secure. Astrana Health combines the latest hardware and software to ensure that data gathering and statistical reporting processes meet these three essential guidelines. We also provide training and technical support to all administrative staff and providers who utilize our online applications.
Member Services
At Astrana Health, we strive not only to take care of your business but also your members. Our affiliated partners offer a suite of health services, including urgent care, post-acute care, ambulatory surgical centers, and diagnostic laboratories. We encourage all members to take advantage of these resources.
Health Services
At Astrana Health, we strive not only to take care of your business but also your members. Our affiliated partners offer a suite of health services, including urgent care, post-acute care, ambulatory surgical centers, and diagnostic laboratories. We encourage all members to take advantage of these resources.