Physicians Network

How You Benefit

• You can see your patients as often as you do now, or you can choose to rotate with the Nurse Practitioner for individuals in nursing homes. You control standing orders.
• After-hours and weekend nurse phone services are available for members and providers (depending on plan).
• The availability of a Nurse Practitioner reduces calls from skilled nursing facilities.
• Reimbursement is the same as or better than Medicare for many plans. In some cases, we reimburse for services that Medicare doesn't. (For example, family conferences are not reimbursed under regular Medicare.)

How Your Patients Benefit

Most Evercare health plans offer the following:

• Non-emergency transportation, including trips to doctors’ offices
• Access to specialists with referrals
• No, or low, copays
• Treatment in place for nursing home resident
• Routine health check-ups
• Coverage for Medicare Parts A, B and D for Medicare Advantage plans
• Additional benefits beyond what is covered by Original Medicare, such as vision and dental care

How Your Office Staff Benefits

• In most cases, no secondary carrier billing or collection is necessary. You receive full and timely payment from Evercare as your single payer source, reducing the administrative burden on your staff.
• Our electronic interface streamlines billing, enrollment verification and claim status.
• Local Provider Relations Specialists offer product and billing education and serve as your resource for operational questions.
• Our Care Management Services help members coordinate care with their primary care team and help them gain access to home health and other community services.

Being Part of a Care Management Team

Individualized Care Management is the core of our clinical model. The primary team includes the Primary Physician and Nurse Practitioner, Physician’s Assistant or Care Manager, depending on the plan. The Care Management Team:

• Gets to know enrollees, responsible parties and caregivers personally.
• Completes thorough assessments of the health history and the physical and mental condition of each enrollee.
• Encourages preventive care and compliance with treatment plans.
• Works with Medicare and/or Medicaid to maximize coverage and benefits.
• Facilitates communication and coordination among everyone on the care team.
• Develops individualized care plans and assists with appropriate medication management.
• Improves coordination between acute and long-term care needs.
• Assists physicians in managing the complex psycho-social health care needs of patients without adding to the administrative burden of office staffs.