Centene Corporation Special Needs Plans (SNPs). Overview of the Centene D-SNPs Evolution of Care Transitions Oversight. Overview. Dual-eligible SNPs only. Advantage by Bridgeway Health Solutions (AZ) Advantage by Buckeye Community Health Plan (OH) Advantage by Managed Health Services (WI)
Special Needs Plans (SNPs)
Evolution of Care Transitions OversightOverview
Advantage by Bridgeway Health Solutions (AZ)
Advantage by Buckeye Community Health Plan (OH)
Advantage by Managed Health Services (WI)
Advantage by Peach State Health Plan (GA)
Advantage by Superior HealthPlan (TX)
Advantage by Sunshine State Health Plan (FL)
Contract arrangements vary by state:
AZ, WI, & TX enrollees may have Medicare and Medicaid with the Centene health plan, or Medicaid coverage through another health plan.
OH, GA, & FL enrollees have FFS Medicaid.
To identify the activities/tasks that needed to be captured on the audit tool, we mapped out the process.
Five work flows were developed:
Improved audit tool captures additional part of the process:
Enhanced audit tool provides the following capabilities: