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Ohio PPO Connect

Ohio PPO Connect is a statewide PPO network sponsored by three leading provider owned networks (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 their contracted employer groups. Ohio PPO Connect offers Third Party Administrators and broker/consultants a complete independent 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 Advantages

  • Offers broker/consultants and Third Party Administrators an easy to access and easy to understand network solution for their clients with employees throughout Ohio
  • Carrier competitive discounts
  • Provider owned and Ohio based network with a local and regional approach to healthcare delivery (100% of provider discounts passed on to the customer. Competitive and fixed PEPM access fees)
  • Excellent rating with leading stop loss carriers
  • Seamless integration and implementation for the customer
  • Informed customer service teams educated on the Ohio PPO Connect product
  • Care Management
  • An informative website including a directory of providers and approved Third Party Administrators available at www.OhioPPOConnect.com

Cost Saving Programs

  • Utilization review
  • Case management
  • Disease management
  • Data management
  • HealthPhone, a 24-hour nurseline
  • Wellness and Nurse Coach follow-up

Utilization Management

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.

Case Management

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.

Disease Management

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.

Data Management

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.

Healthphone

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.

Wellness and On-Site Health Screening

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.

Ohio PPO Connect Contacts

The Ohio State University Health Plan

Theresa Shipley, PAHM, COC, CPC, CPCO, CPC-P, Network Contracting & Provider Relations
614-292-1921
(Sales & Repricing Issues ONLY)
theresa.shipley@osumc.edu
700 Ackerman Rd. Suite 440
Columbus, Ohio 43202
https://osuhealthplan.com/providers
Ohio Health Choice

Lisa Viront, Sr. Account Executive
330-996-8236
800-554-0027
virontl@ohiohealthchoice.com
168 East Market Street
Akron, Ohio 44308
www.OhioHealthChoice.com
Quality Care Partners

Jennifer Martin, Public Relations Marketing Specialist
740-455-5199 ext 1153
888-258-7621
jmartin@qualitycarepartners.com
33 South Fifth St
Zanesville, Ohio 43701
www.QualityCarePartners.com


Vision Statement

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.



Interested in how this PPO Network Option works? More information can be found on the How It Works page