NY Manual
SHP Manual

SHP Provider Manual
4.8 Provider Participation in Senior Health Partners’ Operations | 5.1 Billing Reimbursement Procedures

4.9 Network Evaluation

The adequacy of the current provider network is reviewed and analyzed on an annual and ongoing basis. Our mission of service provision is to provide the appropriate service, in the appropriate manner, at the appropriate time, with the appropriate provider.

Senior Health Partners monitors service outcomes by documentation of best practices or when service delivery does not match standards or are not delivered within the timeframes specified.
Tracking and trending of utilization and services provides an opportunity for Care Management Team members to report positive efforts by providers and their staff. Data are logged, and analyzed and used to identify best practices as well as provider and access issues, potential inadequacy of the network, and a need to expand the providers of service.