Unison Health Plan Quality – Focused Health Care Delivery System
Unison Health Plan employs a contracted network of independent providers for the delivery of health care services. Unison Health Plan operates a mixed care model with hospital-based, multi-specialty, and individual providers, and federally qualified health centers (FQHCs).
This seamless healthcare delivery system provides responsive support for each member enrolled in a Unison Health Plan. An innovative delivery system support, like the Special Needs Unit, demonstrate that Unison Health Plan is an industry leader in providing successful government sponsored healthcare programs and making accessible healthcare a reality for more individuals and their families. Here are just a few of Unison Health Plan's value added benefits.
Value Added Benefits
Individual Case Management – This provides ongoing support for our members with complex or catastrophic illnesses or injuries.
Special Needs Unit (SNU) – This unit provides additional support, including coordination with social service agencies for children meeting criteria for special needs. We proactively reach out to social service agencies and establish partnerships that enhance coordination of care for our members with multiple physical, behavioral, and social needs.
Miracles Pregnancy Care Management Program – Through our Miracles program, we actively promote early and regular prenatal care and the reduction of risk factors, such as smoking. A one-on-one relationship is established between the mother and a member of the Case Management staff, which lasts throughout the pregnancy. The Miracle “buddy” coordinates care with the OB/GYN, makes sure that the mother attends all prenatal appointments, and coordinates all aspects of care with our Pregnancy Case Manager, who is a registered nurse.
Member Newsletters – Our newsletter is distributed quarterly to all of our members as a means of providing valuable information on clinical and non-clinical issues related to health and wellness. Dates for community service events are included to encourage members to join us in some health improvement activities.
Unison Health Plan Website – Our website contains up to date information for both the member and provider. It is user friendly and contains valuable and helpful information and additional resources that are very useful. Our provider directory is updated weekly to ensure the members have accurate and complete information. The Providers have resources to clinical guidelines available to them specifically from the Medical Directors as well as access to our formulary. Providers can:
- Check claim status and member eligibility 24 hours a day, 7 days a week, with a secure login.
- Get the most up-to-date claim and eligibility information available. Providers can also call Unison's 24- hour Member Eligibility Verification Line at 888.586.4766 to check member eligibility.
Fact Sheets – The Quality Improvement Department continually provides educational resources to the members. These sheets enable a member to become more knowledgeable about their disease which promotes compliancy with medical regimens.