Provider Connection Newsletter - Fall/WInter 2016

  • General Gundersen Health Plan Updates
    • CMS Star Rating
    • NCQA Ratings
  • Pharmacy Department Updates
    • Updates for Commercial Members
    • Updates for Senior Preferred Members
    • Pharmacy and Therapeutics Committee and formulary updates
    • Senior Preferred Part D Formulary Updates
  • Quality Management Department Updates
    • Disease Management
    • Case Management
    • Clinical practice guideline updates
    • Preventive care guidelines and routine prenatal care guidelines
    • Quality improvement project updates
    • Provider survey results
  • Provider Network Management Department Updates
    • Complaint Resolution by Providers (Policy 11.218)
    • Access to Specialty Care and Outreach Referrals – HMO Products (Policy 11.200)
    • Member Rights and Responsibilities
    • Communication Among Network Providers (Policy 11.225)
    • Discrimination against members is prohibited
  • Employee Trust Funds Preferred Insulin Benefit
  • GundersenOne Open Enrollment Began November 1
    • 2017 Open Enrollment
    • GundersenOne Enrollment Center

Provider Connection Newsletter - Spring/Summer 2016

  • Quality Management Department Updates
    • Clinical practice guideline updates
    • 2015 CAHPS Results
    • 2015 HEDIS Results
  • Pharmacy Department Updates
    • Pharmacy and Therapeutics Committee - Formulary Updates
    • Proton Pump Inhibitors
    • Treating Insomnia
    • Medication Tidbits: Most Cost-Effective Versions
    • Digoxin Use in the Elderly Population
  • Medical Management Department Updates
    • Prior Authorization
    • Timeliness of Utilization Management Decisions and Notification
    • Denial Notices
    • Incentives
    • Accessibility of the Medical Management Department
    • Policy Update - CardioMEMS Heart Failure Remote Monitoring Device
  • Provider Network Management Department Updates
    • Gundersen Health Plan Provider Access Standards
  • Choosing Wisely
    • Fifteen Things Physicians and Patients Should Question