Peach State Health Plan is very proud of its record of being recognized as a “Best Practices” organization. As a team, we believe in setting the example for others to follow.

Our “Best Practices” recognition includes:

Medical Management

• Utilization Management Process for TAT   
• UM Audit Tools (other Plans using our tool)
• NICU CM Follow-up Calls within 24-48 hours following discharge from the hospital   
• ER Case Management and Outreach  
• Case Management process (the only Plan that counts cases as active, only if there is a care plan developed)
• 17P Program  
• CM Audit Tools  

 Pharmacy Management

• Lock-In Program
• PA Tracking Spreadsheet
• In-Patient Per Diem Program
• Pharmacy Training Manual

Finance

• AOP and Operating Plan Template
• Month End Close Summary Template 

 Operations

• Member Services Call Center
• Communications – Web Portal Design & Build Out
• Provider Data – Encounter Submissions
• Operations – Operations Dashboard

 Contracting

• Network Right Sizing/Efficiency