Services

At Premier Care Partners, we’re here to help with all of your management needs.  Our goal is to partner with our PCPs and health plans to ensure that a member’s case is being properly coordinated, adequately coding is being captured by PCPs, billing is performed timely, utilization management is in place and growth and retention strategies are in place. 

We provide dependable management services to over 50 primary care physicians throughout Florida. Our provider coverage extends throughout Miami-Dade, Broward, Orange, Seminole and Polk County.

Benefits of Working with Premier Care Partners

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As a team, we will enhance the quality of care that each member receives by providing indispensable medical management services for:

  • Facilitate credentialing paperwork for new and existing providers
  • Membership growth and retention strategies
  • Monthly HEDIS Reconciliation of measures
  • Provide recommendations for referral coordinators
  • Coordinate with health plans on all PCP related initiatives
  • Medicare Risk Adjustment (MRA) and Coding audits

  • Monthly PCP Performance reports:
    • Membership trends by PCP group
    • Medical Cost and Rx Spending
    • Hospital and ER Utilization
    • HEDIS Non-Compliant Measures
    • MRA Education
    • MRA Improvement Reports

Monthly Medical Reports

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As part of our managment services, we provide you with a Monthly Premier Care Partners’ Medical Management Report, which gives you relevant, at a glance overviews of:

  • ER utilization
  • Inpatient and Outpatient census
  • Rx utilization
  • Specialist utilization
  • MRA Scores
  • Provider Lineal

    Medical Management

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    The MSO Medical Management Team will serve as a medical conduit to liaise effective communication between the Plan, the Providers and the Members within several key focus areas:

    1. Improve provider and member quality of care/quality measures
    2. Promote the importance of adherence and persistence to treatment regimens
    3. Assist with coordination and transitioning of care
    4. Achieve cost-effective alternatives while not compromising care objectives

    Marketing Growth & Retention

    Together we will create a marketing communication and sales campaign that is unique to your medical office and your community, providing opportunities for growth while retaining existing membership.

    New Member Strategy

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    • Membership conversions
    • Co-branding Direct Mail communication
    • Events, such as, health education seminars, seasonal, etc.
    • Marketing promotion through social media, print advertising, and radio

    Retention Strategy

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    • Targeted events, such as birthdays, holidays
    • Direct Mail, such as, personalized mail outs (birthday, center anniversary), health awareness, etc.
    • Educate Medicare patients on health plan services and benefits for informed decision making
    • Phone campaigns

    Provider Partnership

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    • Request for provider offices with opportunities
    • Sample success stories and projection for wholly owned centers
    • Assurance of Premier Care Partners business knowledge and experience