- Our mission is to enhance our members' health and quality of life.
- We understand and advocate preventive care through regular doctor visits and health management planning for chronic conditions. Addressing potential medical conditions before they become a problem helps improve member health and reduces medical costs.
- We advocate proactive communications with members and providers. Efforts include reminders for health screenings to both members and providers as well as identification and coordination of high-risk conditions and development of critical care management plans.
- We embrace cultural diversity by providing benefit information in English, Ilocano, Tagalog, Mandarin Chinese and Korean as well as translation support through our Customer Service team.
- `Ohana's care model matches members with support coordinators who then work with a cross-functional case management team capable of addressing clinical, pharmaceutical and behavioral health issues.
- We recognize our responsibility as a corporate citizen, so through our affiliated health plans, we support national, regional and local charitable organizations that are dedicated to enhancing the health and quality of life of the members and communities we serve.
- Community partnerships are at the heart of our business plans, which is why we establish relationships and sponsorship programs with schools, churches, recreation centers, housing authorities, food pantries and other community- and faith-based organizations throughout the markets we serve.
- Effective partnerships with providers are a key factor for the success of all of our affiliated health plans. As a testament to our success in establishing new provider networks, we surpassed provider network requirements during the launch of Medicaid programs in Ohio and Georgia in 2006.
- We take a strategic approach to building provider networks and consider important factors such as our members' physical proximity to providers as well as provider qualification and experience.
- We provide local support to our providers by establishing provider relations representation in the markets were we serve, so we can continually cultivate successful partnerships.
- We offer our providers access to electronic applications for core capabilities such as checking member eligibility, processing claims electronically, checking authorization verifications and tracking claims status.
- Quality initiatives for our affiliated health plans are patient-focused and emphasize preventative care and other initiatives such as member satisfaction surveys, site audits and credentialing for providers, member and provider education programs, health plan accreditation and audits of providers' patient medical records.
- Our parent company, WellCare Health Plans, Inc., has made significant investments in our people and technology as demonstrated by our state-of-the-art Command Center that manages more than 10 million calls a year and has increased customer support satisfaction over 11 percent since its implementation.
- Our affiliated health plans have exceeded industry goals in issue resolution with an 80 percent first-call resolution rate and by responding to escalated issues within 24 hours.
- Our parent company, WellCare Health Plans, Inc., received a 2007 J.D. Powers and Associates Certification for excellence in customer service and has been commended by J.D. Powers and Associates for the courtesy and genuine concern our representatives express for members.