Ohio PPO Connect, LLC is a statewide PPO network consisting of three provider owned Members (Ohio Health Choice, Quality Care Partners, The Ohio State University Health Plan). The network offers a wide selection of participating hospitals/physicians/ancillaries, and carrier competitive discounts to employer/payors. Ohio PPO Connect offers Third Party Administrators and broker/consultants a complete PPO network option for self-funded employers who have employees throughout the state of Ohio. Whether an employer has multiple worksite locations or employees working from home remotely, more and more self-funded employers are finding the need for a seamless, cost-effective, reliable statewide solution.
Ohio PPO Connect (OPPOC) will be Ohio’s premier provider owned Preferred Provider and Care Management Organization, delivering the most valuable network available to Ohio’s employers, through partnerships with health care delivery systems.
Includes a pre-certification and pre-determination program for plan-selected services as well as concurrent review for inpatient stays.The program focuses on quality discharge planning process and alternatives to hospitalization, including preoperative calls and welcome home from hospital calls that ensure a smooth and successful transition.
This program focuses on aggressive, appropriate avoidance of ER visits and hospital admissions, coordination of complex outpatient services and negotiation of out-of-network discounts. Our case managers are knowledgeable about local network sources and the availability of these resources.
This program focuses on helping individuals with chronic or high-cost conditions better understand, learn, and routinely engage in self management activities to improve their health and long term quality of life.
Claims and pharmacy data is used to place individuals on the appropriate care track including Case and/or Disease Management;to track member and provider compliance with Evidence-Based Medicine Protocols; and, to identify patterns in provider utilization and performance. No individual data obtained in this way is shared with clients. Data can also be used to establish a unique network and to develop incentive/reward strategies.
Provides a triage system designed to help individuals make decisions that will often avoid unnecessary expensive services such as emergency room visits. Employees are given 24-hour telephone access to personal one-on-one health counseling with a trained nurse consultant.The nurse can offer medical advice, peace of mind in uncertain situations, and an immediate alternative to an ER or physician visit. HealthPhone offers clients improved employee satisfaction, an inexpensive method to enhance a benefit package, and an effective way to reduce unnecessary ER/provider visits.
Voluntary and comprehensive on-site health screening with self reported Health Risk Assessment is available.This program includes complete confidential reporting to members regarding screening results, interactive website support, nurse follow up and health education opportunities.