Provider Services

Provider Management Functions

The nation's ever-expanding Home and Community-Based Services (HCBS) system demands that quality providers be utilized to deliver medically necessary care to consumers. Quality is only accomplished and achieved through a comprehensive provider management process.

CareStar is proficient in the development and implementation of successful provider management and monitoring systems. Our company has the ability to monitor and manage thousands of providers and assure services are delivered according to a service plan, thus providing HCBS systems confidence in the safety and cost-effectiveness of their programs. Three primary categories in CareStar’s current processes include: enrollment/orientation, ongoing provider compliance oversight & monitoring and incident management/incident response.

Provider Enrollment / Orientation
Quality begins at provider enrollment. CareStar reviews the applicant's verification of national and/or state regulatory compliance and basic education to ensure State and/or specific program requirements are satisfied before granting permission to provide direct care.

Provider Monitoring
HCBS systems need the assurance that on-going provider compliance is maintained, updates are communicated, performance goals are satisfactorily met and only authorized reimbursement occurs for any delivered service.

CareStar's comprehensive monitoring achieves each of these and more through the following:

• Completion of an annual performance evaluation, taking into consideration provider billing, consumer outcomes & satisfaction and updated criminal background checks.
• Follow-up procedures to assure compliance with submitted plans of correction written in response to identified performance improvement needs.

Incident Management
Consumer safety is paramount for HCBS. CareStar conducts activities that assure consumers are protected from situations that may result in harm, injury or loss through:

• Investigation of incidents for substantiation of risk, identification of violation and violator
• Creation of a prevention plan of correction, if appropriate
• Review of incidents and providers for at-risk patterns and trends
• Reports and recommendations of providers for State sanctions

Provider Portals

This exciting new technology offers a web-based, full-loop communication mechanism which organizes all program information onto one private, individualized page. It includes important records, forms, tools, surveys, news/updates, resources, contact information and more. This portal can be uniquely adapted for any HCBS program. The portal is essentially a personal page which every provider can customize to fit their personal preferences. 

View this Video Presentation of a customized consumer portal CareStar has developed for the Ohio Home Care Program. 

OHIO Home Care Provider Information
For enrollment details with the Ohio Home Care Waiver, all forms, resources and other contact information, go to www.ohiohcp.org.

 

 

To learn more, contact:

Customer Service

866-834-4712
customerservice@carestar.com