Partners
PROVIDERS
Partners
PROVIDERS
To Serve Others,
This is Our Calling
At Alignment Health, we believe the relationship between doctors and the communities they serve is second to none. That’s why we’ve carefully chosen dedicated local doctors and empowered them with some of the most innovative tools in the world to provide their patients with a new, higher level of care.
THE ALIGNMENT HEALTH METHOD
01.
Alignment Health’s Patient 360 is a provider-facing dashboard that presents a snapshot of a member’s health and treatment history to help providers facilitate care coordination. The longitudinal patient record allows care providers to access the health plan’s view of information associated with a member including gaps in care, claims, eligibility, utilization, pharmacy, labs, care management, communications and documents.
02.
More than 250 advanced Machine Learning models driving proactive, personalized care and exceptional experiences for our members.
03.
Focused on the delivery of in-home care, Care Anywhere is Alignment Health’s program for our highest risk members. Our clinical team, in coordination with a member’s primary care physician, provides a differentiated care experience to not only reduce unnecessary ER visits and inpatient care, but also to improve health outcomes and quality of life.
04.
We believe service has never been more needed—or more valuable. Alignment Health strives to meet all Medicare STAR rating criteria and provide a five-star experience for every member. The health plan’s STAR rating directly impacts quality bonus payments, which are used to improve benefits and services for members.
Provider Resources
Provider Operations Manual
Alignment Health’s operational policy and procedures that support many of our programs and services are outlined in our provider operations manual.
Prior Authorization Guidelines for Nondelegated Providers ❯
Stars Best Practice Guide ❯
Online Resources for Providers
ALIGNMENTHEALTHPLAN.COM
The patient-provider relationship is an integral part of any treatment plan. We are committed to working with you to provide our members with the best quality of care possible. The Provider Resources section on our alignmenthealthplan.com website is designed for Alignment Health Plan providers and their staff to support day-to-day operations, such as verifying member eligibility, checking claims status, reviewing authorization status, and more.
AVA PROVIDER PORTAL
If you are a contracted provider with Alignment Health Plan, you can log on our AVA Provider Portal for secured access to verify member eligibility, check claims status, submit prior authorization, and access other tools and resources. If you are a new user, you can sign-up and access the AVA Provider Portal by clicking here.
WORK WITH US
Transforming health care delivery starts with Alignment Health. We are purposeful and passionate believers in what we can do for seniors. To put the senior first, Alignment Health supports their doctors.
If you are interested in contracting with Alignment Health, please click the “Reach Out” button to email us and make sure to include:
Provider/entity name
Service(s) provided
State(s) where services are provided
County/counties where services are provided
Contact individual and information
Letter of intent and W9 (attachment)
National Provider Identifier (NPI) and Council for
Affordable Quality Healthcare (CAQH) numbers
