Closing Gaps in Care
Evidence-based clinical guidelines are scientifically derived guidelines for the diagnosis and treatment of certain specified medical conditions. Following these guidelines can lead to improved care and lower costs.
Controlling chronic conditions prevents them from accelerating to acute conditions, and acute conditions accelerating to catastrophic conditions.
Our care management program identifies gaps in care, noncompliance with treatment plans, individuals at risk for adverse medical events, and drug interactions for the entire covered population.
As specific risks are identified, our Nurse Care Managers work one-on-one with at-risk patients and their physician or physicians.
Health Utilization Management
To ensure you get the right care, at the right time, and in the right setting, our health utilization management services incorporate two leading edge programs: hospitalist services at CHN hospitals and URAC-accredited review of outpatient services.
Primary Care Services
You can select from any of the primary care physicians in the network to meet your and your family’s needs, whether it’s an Internist, Family or General Practitioner, Pediatrician or OB-GYN. The choice is yours … and you can change physicians at any time. No plan approval required.
Specialist, Hospital and Ancillary Care Services
Specialist, hospital, and ancillary care services are available through CHN network contracts with health care providers throughout the Central Valley and in major referral centers across the State of California.
Finding a Health Care Provider
Finding a health care provider is easy. You can search using Search Providers or Contact Us us at 1.855.537.6769.
Referral and Emergency Care
CHN members have access to over 500,000 other health care providers across the country. In the event of an emergency outside of the CHN service area or for care approved to be provided out of network by your plan, we have you covered!
Spending Your Health Care Dollar Wisely
Our health care provider contracts include highly competitive reimbursement rates for providers. This means your health care dollars go to work for you, locally, and in the best way possible.
Benefit Plan Design and Administration
Benefit plan design and your plan’s third party administrator are determined by your employer. Contact your benefits or human resource department for more information.