Gold Star Program
Unison Health Plan's Gold Star program identifies Primary Care Physicians who have achieved Unison’s highest designation of quality standards.
The Unison Gold Star Physicians Program:
- Recognizes participating physicians who provide quality healthcare services to our members;
- Relieves physicians from paper work (reduces prior authorizations requirements); and
- Rewards excellence by thanking our physicians for doing what they do best.
Gold Star providers will only need approval for:
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admission to hospitals, skilled nursing and rehab facilities
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services from providers who are not in our network
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non-formulary drugs and medications that require prior authorization (not applicable in OH – the State manages the pharmacy benefits)
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non-covered benefits
We have implemented three methods for you to easily verify Gold Star status when treating your patients.
Gold Star Portal
- When you log in to the Unison web site to verify member eligibility, the PCP information for your patients will include their Gold Star status by reading: This is a Gold Star Provider
In the Find a Provider section of the web site, this star will appear next to the names of Gold Star providers.
Gold Star on the Interactive Voice Response (IVR)
- When you call the Unison Health Plan Verification Line to verify member eligibility information, the IVR will provide this message during the playback of an eligible member’s PCP information: This is a Gold Star provider.
Gold Star Extension
- The Gold Star Extension is a new component of our Facets system that allows our customer service teams to provide detailed records of a member’s Gold Star status including a member’s Gold Star provider and dates a member is actively with a Gold Star provider.
Any primary care provider or practice with 200 or more Unison members and open to the addition of new members can participate in the Gold Star program. There are also certain quality and efficiency benchmarks that a provider must meet to be included. Please contact your Provider Relations representative at 1-800-600-9007.