At Alignment Healthcare, we believe the relationship between doctors and the communities they serve is second to none. That’s why we’ve carefully chosen dedicated local doctors and empowered them with some of the most innovative tools in the world to provide their patients with a new, higher level of care.
Alignment’s Patient360 is a provider-facing dashboard that presents a snapshot of a member’s health and treatment history to help providers facilitate care coordination. The longitudinal patient record allows care providers to access the health plan’s view of information associated with a member including gaps in care, claims, eligibility, utilization, pharmacy, labs, care management, communications and documents.
With more than 5000+ clinical alerts from AVA®, our proprietary command center, we are able to better monitor and track our members’ health care utilization and changes in health status, enabling us to identify potential challenges earlier, giving health care professionals more time to try preventive actions.
Focused on the delivery of in-home care, Care Anywhere is Alignment’s program for our highest risk members. Our clinical team, in coordination with a member’s primary care physician, provides a differentiated care experience to not only reduce unnecessary ER visits and inpatient care, but also to improve health outcomes and quality of life.
We believe service has never been more needed—or more valuable. Alignment strives to meet all Medicare STAR rating criteria and provide a five-star experience for every member. The health plan’s STAR rating directly impacts quality bonus payments, which are used to improve benefits and services for members.
Alignment’s operational policy and procedures that support many of our programs and services are outlined in our provider operations manuals. We have one manual for independent physician associations (IPAs), medical groups, and participating providers who Alignment has delegated to perform certain managed care functions as outlined in their agreement with Alignment. We also have another manual for those participating providers who are not delegated for such functions.
California providers and their staff can verify member eligibility, submit reports and find information to assist with day-to-day operations through a dedicated portal.
A provider authorization system, Access Express is currently available for contracted IPA providers and directly contracted providers. This tool is used by providers to initiate and request authorizations, view status of authorized services and view claim status.
Transforming health care delivery starts with Alignment. We are purposeful and passionate believers in what we can do for seniors. To put the senior first, Alignment supports their doctors. If you are a physician group or hospital system experiencing downward pressure on your bottom line, Alignment can help lighten your load, create long-term sustainability and increase revenue.