As a provider or patient who has received a call from Signify Health, you may wonder why they are contacting you. Signify Health is a network of healthcare providers and services that work together to improve patient outcomes and reduce costs. They aim to do this through their advanced technology platform, which enables more accurate diagnoses and personalized treatment plans based on each patient’s unique needs.
There are several reasons why Signify Health may be calling you:
1. You have been referred for participation in a care management program
If you have recently been discharged from the hospital or diagnosed with a chronic condition, your primary care physician (PCP) or insurance company may refer you to a care management program managed by Signify Health. These programs provide additional support for patients who need help managing their health conditions and navigating the healthcare system.
Signify Health’s care managers work closely with patients to develop personalized care plans that meet their specific needs. This can include coordinating appointments with specialists, arranging transportation to medical visits, providing education about medications and treatments, connecting patients with community resources, and monitoring symptoms to prevent exacerbations before they become serious.
2. Your insurance company wants more information about your health status
Insurance companies sometimes use third-party companies like Signify Health to gather additional information about their policyholders’ health status before making coverage decisions or setting premiums. For example, if an insurer suspects that certain members may have undiagnosed conditions that could lead to costly medical claims in the future, they might contract with Signify Health to conduct assessments that identify those risks early on.
In these cases, a representative of Signify Health will likely ask questions about your current health status as well as any relevant medical history such as previous surgeries or prescriptions you’ve taken. They may also request permission to access your medical records so they can better understand your past experiences with different conditions and treatments.
3. You are participating in an alternative payment model (APM)
Signify Health has developed several APMs that aim to improve healthcare quality and reduce costs by incentivizing providers to deliver more efficient, effective care. These models vary depending on the patient population being served, but they often involve having a team of healthcare professionals work together using evidence-based best practices to manage patients’ conditions.
If you are a provider participating in one of Signify Health’s APMs, you may receive calls from their representatives updating you on your patients’ progress or asking for additional information about their health needs as part of ongoing care coordination efforts. Patients themselves may also be contacted to participate in surveys or assessments designed to measure healthcare satisfaction and outcomes.
4. You are considering voluntary hospice services
Finally, if you or a loved one is reaching the end stages of a life-limiting illness, Signify Health offers hospice services designed to provide comfort and support during this difficult time. Hospice care can include symptom management (e.g., pain relief), emotional support for both patients and families, help with daily living activities such as bathing and dressing changes, respite care for caregivers who need a break from providing full-time care, spiritual counseling if desired–and much more.
A representative from Signify Health will likely call you or your family member directly to discuss hospice options available in your area if this service is deemed appropriate given your clinical circumstances.
In conclusion, there are many reasons why Signify Health might contact providers or patients directly–from coordinating complex medical appointments or conducting assessments aimed at improving coverage decisions made by insurance companies through partnerships with payers like Medicare Advantage plans which utilize alternative payment models focused on efficiency-based incentives intended achievable only when high-value medical procedures take place within defined networks where cost-control measures can be implemented effectively while still ensuring quality-of-care benchmarks remain intact over time. Whatever the reason behind these calls may be know that you’re answering them not just because someone wants something from you – but rather because they’re trying to help you achieve better health outcomes over the long run.
Signify Health: Improving Patient Outcomes Through Advanced Technology and Care Coordination
As a provider or patient who has received a call from Signify Health, you may wonder why they are contacting you. Simply put, Signify Health is a network of healthcare providers and services that work together to improve patient outcomes and reduce costs. They aim to do this through their advanced technology platform, which enables more accurate diagnoses and personalized treatment plans based on each patient’s unique needs.
In this article, we will provide an in-depth understanding of the reasons for which Signify Health might contact providers or patients directly.
1. You Have Been Referred For Participation In A Care Management Program
If you have recently been discharged from the hospital or diagnosed with a chronic condition, your primary care physician (PCP) or insurance company may refer you to a care management program managed by Signify Health.
These programs provide additional support for patients who need help managing their health conditions and navigating the healthcare system. Typically provided telephonically but potentially also in person via home visits if required, caseworkers called clinical advocates assigned by Signify work closely with patients to develop personalized care plans that meet their specific needs. This can include coordinating appointments with specialists, arranging transportation to medical visits, providing education about medications and treatments such as ensuring opioid stewardship best practices are being undertaken e.g., avoiding interaction risks between multiple prescriptions among other related modalities; connecting patients with community resources covering both social determinants of health as well mental/behavioral programs where applicable plus checking adherence rates for desired behaviors while monitoring symptoms to prevent exacerbations before they become serious- all under HIPAA regulations privacy controls since violation could jeopardize counseling coverage eligibility status regarding potential life events’ impact impacting income-related benefits.
2.Your Insurance Company Wants More Information About Your Health Status
Insurance companies sometimes use third-party companies like Signify Health to gather additional information about their policyholders’ health status before making coverage decisions or setting premiums.
In these cases, a representative of Signify Health will likely ask questions about your current health status as well as any relevant medical history such as previous surgeries or prescriptions you’ve taken. They may also request permission to access your medical records so they can better understand your past experiences with different conditions and treatments thereby enabling better predictive analytics for cost-analysis over time. Essentially this helps insurers minimize the exposure from patients who have co-morbidities but are not forthcoming in terms of risk-related information that could lead to higher healthcare-utilization costs down the line if left unchecked over multiple claim periods.
3. You Are Participating In An Alternative Payment Model (APM)
Signify Health has developed several APMs that aim to improve healthcare quality and reduce costs by incentivizing providers to deliver more efficient, effective care specifically tied procedure/service types which payers want managed through pre-established bundled payment arrangements using specific practice patterns endorsed by CMS-required guidelines plus QI/QA metrics specified.
These models vary depending on the patient population being served, but they often involve having a team of healthcare professionals work together using evidence-based best practices to manage patients’ conditions optimally within defined episode(s) of care thus minimizing risks associated with lack-of-care coordination since all actors involved in servicing patient is “on-roll” at one-third-party site utilizing technology-enabled workflows aimed at timely documentation while ensuring seamless transitions during handoff between clinic/clinic settings where shared governance agreements must act upon insights derived out claims data – both administrative claims & EMR related points-to-align-variance analysis when possible [such as mapping CPT codes w/ ICD-10 codes etc]).
If you are a provider participating in one of Signify Health’s APMs, especially those who service large volumes across underserved communities faced with Socio-economic barriers galore including HEDIS measures – which marks top performers among US Managed Care Organizations (MCOs) – you may receive calls from their representatives updating you on your patients’ progress or asking for additional information about their health needs as part of ongoing care coordination efforts in line with established clinical guidelines which often vary according to plan benefits / population demographics etc.
Patients themselves may also be contacted to participate in surveys or assessments designed to measure healthcare satisfaction and outcomes. This helps capture insights into whether the desired interventions aimed at meeting efficacy-effectiveness objectives, intent-to-continue care-plan participation & other metrics that are desirable based upon the specific goals set forth by APM-payers.
4. You Are Considering Voluntary Hospice Services
Finally, if you or a loved one is reaching the end stages of a life-limiting illness, Signify Health offers hospice services designed to provide comfort and support during this difficult time. This usually occurs following Medicaid eligibility determinations using CMS-powered algorithms which assess everything from current residence status including homestead-ownership criteria taken into consideration when calculating cost-sharing subsidies based upon income levels recorded within tax records filed both state-wise + federally speaking; insurance policy limitations impacting out-of-pocket expenses therefore potentially providing caps on people’s overall burden while still giving best-case scenarios affirmable through house reviews conducted by post-certified social workers employed by Signify Health .
A representative from Signify Health will likely call you or your family member directly discussing hospice options available as per above rationale in order determine what optimal approach ensure necessary palliative-care treatment steps can performed using limited-time there is little doubt concerning endocrine/symptoms needing expert attention sans pretenses such pain-meds inadvertently worsening situation rather working complimentarily alongside disease-modifying regimens given contraindication issues arising fr interactions between old-new meds not clearly communicated across sections involved patient’s management protocol plus ethical considerations related capacity-building exercises dealing with “Do Not Resuscitate” clauses regarding decision-making processes towards EOL circumstances always held confidentially and with utmost care.
In conclusion, there are many reasons why Signify Health might contact providers or patients directly–from coordinating complex medical appointments or conducting assessments aimed at improving coverage decisions made by insurance companies through partnerships with payers like Medicare Advantage plans which utilize alternative payment models focused on efficiency-based incentives intended achievable only when high-value medical procedures take place within defined networks where cost-control measures can be implemented effectively while still ensuring quality-of-care benchmarks remain intact over time. Whatever the reason behind these calls may be know that you’re answering them not just because someone wants something from you – but rather because they’re trying to help you achieve better health outcomes over the long run.