Resources
| Site | Purpose |
| Aetna Better Health of WV | Resource for ABH prior authorization submission and status inquiries. |
| Aetna Better Health WV HEDIS Toolkit | Downloadable reference guide for HEDIS measures |
| CMS website | CMS Website |
| CMS HCC V28 - Condensed | The condensed version of the CMS Hierarchical Condition Categories (CMS-HCC) |
| HCC Coding Education | Provides detailed information on understanding Hierarchical Condition Categories, a risk adjustment model that allows for a more accurate picture of patient health in a chronic disease state. |
| Humana Provider Resources | For providers: Valuable starting point for claims, preauthorization's, referrals, clinical support, pharmacy resources, and dental resources. An online portal (Population Health Compass) is available with additional reporting features and gap closure attestation. Please contact your Practice Transformation Specialist to sign up for access to your facility. |
| PEIA | Provides fee schedules, provider manuals, enrollment forms and other helpful resources. |
| The Health Plan | For Providers: Serves as a launching point for information regarding training, patient care programs, claims support, case management referral, clinical support, prior authorizations and referrals. |
| United HealthCare | Resource for physicians, administrators, and healthcare professionals with information including policy/protocols, eligibility and benefits, claims, prior authorization, pharmacy information. Online portal (Practice Assist) available with additional reporting features, gap closure attestation. Please contact your Practice Transformation Specialist to sign up for access to you facility. |
| VHN Quality Measure Crosswalk Codes 2024 | |
| Wellpoint | Starting point to access Wellpoint manuals, policies and guidelines (provider and claims), HEDIS reference, prior authorization and eligibility, payor resources available to patients. |
| WV Bureau for Medical Services |
Other Resources
| Site | Purpose |
| Find Help | Online resource to connect with available social services within an area. |
| United Way 211 | Online resource center for available services for assistance with finding food, bill payment, mental health services. |
Vaccines in a Value-Based World
<
Population Health & Clinically Integrated Networks
Social Determinants of Health in a Value Based Care Approach
Caring for Patients with Chronic Conditions
Diabetes In a Value Based Care World
Cancer Screenings in a Value Based World
2024 HCC Coding Lunch and Learn
Medicare AWV - Utilizing a Team-Based Approach for Higher Quality Care
CIN-ACO-Premier-Value Based Update and Success
Memberships |
| Appalachian Regional Healthcare |
| Boone Memorial Hospital |
| Broaddus Hospital |
| Cabin Creek Health System |
| CAMC Greenbrier Valley Medical Clinics |
| CAMC Family Medicine Center |
| CAMC Primary Care |
| Davis Health System |
| FamilyCare Health Centers |
| Grafton City Hospital |
| KidCare West Pediatrics LLC |
| Logan Regional Medical Center |
| Minnie Hamilton Health System |
| Mon Health |
| Montgomery General Hospital |
| PARS Healthcare (Now part of Vandalia Health) |
| Pozega Wellness |
| Roane General Hospital |
| Robert C Byrd Clinic/WV School of Osteopathic Medicine |
| Rural Health Access Corporation - Coalfield Health Center |
| Webster Memorial Hospital |
| West Virginia Health Right |